Majerus T C, Caplan E S
Clin Ther. 1980;3(4):316-28.
A one-compartment, open-linear, pharmacokinetic model for gentamicin dosing has been developed at the Maryland Institute for Emergency Medical Service Systems (MIEMSS). The model was used to predict both the gentamicin dose required to achieve desired peak and trough serum concentrations and the peak and trough serum concentrations that would result from administering empirically chosen doses. This model was tested in 31 patients, aged 15 to 82 years (mean 39.3 +/- 17.7 years), whose creatinine clearance (CCI) ranged from 12 ml/min to 197 ml/min (mean 106.9 +/- 53.1 ml/min). The predictions of the dosage model were compared with the measured peak and trough serum concentrations in these patients. The predicted peak serum levels correlated highly with the measured peak serum levels (r 0.97). The mean difference (+/- SD) between the predicted and measured peak levels was 0.28 +/- 0.22 mu g/ml. The predicted trough serum levels correlated well with the measured trough serum levels (r 0.91). The mean difference between the predicted and measured trough levels was -0.03 +/- 0.18 mu g/ml. This approach makes it possible for bactericidal levels of gentamicin to be maintained in patients with wide variations in stable renal function. Frequent serum gentamicin determinations are unnecessary. Requiring only an inexpensive calculator, the method has proved to be economical as well as clinically useful.
马里兰紧急医疗服务系统研究所（MIEMSS）开发了一种用于庆大霉素给药的单室开放线性药代动力学模型。该模型用于预测达到所需血清峰浓度和谷浓度所需的庆大霉素剂量，以及给予经验性选择剂量后产生的血清峰浓度和谷浓度。该模型在31名年龄在15至82岁（平均39.3 +/- 17.7岁）的患者中进行了测试，其肌酐清除率（CCI）范围为12 ml/min至197 ml/min（平均106.9 +/- 53.1 ml/min）。将剂量模型的预测结果与这些患者测量的血清峰浓度和谷浓度进行了比较。预测的血清峰水平与测量的血清峰水平高度相关（r 0.97）。预测峰水平与测量峰水平之间的平均差异（+/- SD）为0.28 +/- 0.22μg/ml。预测的血清谷水平与测量的血清谷水平相关性良好（r 0.91）。预测谷水平与测量谷水平之间的平均差异为-0.03 +/- 0.18μg/ml。这种方法使得在稳定肾功能差异很大的患者中维持庆大霉素的杀菌水平成为可能。无需频繁测定血清庆大霉素。该方法只需要一个便宜的计算器，已证明既经济又具有临床实用性。
