Hull J H, Sarubbi F A
Ann Intern Med. 1976 Aug;85(2):183-9. doi: 10.7326/0003-4819-85-2-183.
Recent studies that emphasize the unpredictability of gentamicin serum concentrations have cast doubt on the accuracy of commonly used dosing nomograms. We therefore developed a digital computer program to evaluate gentamicin pharmacokinetics and have tested its ability to predict correctly gentamicin serum levels under clinical conditions. A significant relation (P less than .001) was found between 130 measured (bioassayed) and computer predicted levels from 40 patients. Serum levels were reliably estimated in patients with unstable renal function and were statistically, but not clinically, affected by changes in hematocrit. The calculation of volume of distribution on the basis of the patient's lean body weight rather than total body weight was an important factor that contributed to the accuracy of the predicted level. A new dosing chart is presented that incorporates the important variables affecting gentamicin pharmacokinetics into an easily used, convenient form.
近期一些强调庆大霉素血清浓度不可预测性的研究，对常用给药剂量图表的准确性提出了质疑。因此，我们开发了一个数字计算机程序来评估庆大霉素的药代动力学，并测试了其在临床条件下正确预测庆大霉素血清水平的能力。在40例患者中，130次测量（生物测定）的血清水平与计算机预测水平之间发现了显著相关性（P小于0.001）。肾功能不稳定患者的血清水平能够可靠地估计，血细胞比容的变化在统计学上有影响，但在临床上无影响。根据患者的瘦体重而非总体重计算分布容积，是提高预测水平准确性的一个重要因素。本文给出了一个新的给药图表，它将影响庆大霉素药代动力学的重要变量整合到一个易于使用、方便的形式中。
