Gentamicin dosing in elderly patients based on bioelectrical impedance analysis

Sidhu, Jagdev S., Triggs, Edward J., Charles, Bruce G. and Hickey, Barry P. (1994) Gentamicin dosing in elderly patients based on bioelectrical impedance analysis. Therapeutic Drug Monitoring, 16 4: 352-360. doi:10.1097/00007691-199408000-00004


Author Sidhu, Jagdev S.
Triggs, Edward J.
Charles, Bruce G.
Hickey, Barry P.
Title Gentamicin dosing in elderly patients based on bioelectrical impedance analysis
Journal name Therapeutic Drug Monitoring   Check publisher's open access policy
ISSN 0163-4356
0163-4356
Publication date 1994-08-01
Sub-type Article (original research)
DOI 10.1097/00007691-199408000-00004
Volume 16
Issue 4
Start page 352
End page 360
Total pages 9
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
The relationship between gentamicin pharmacokinetics and measures of bioelectrical impedance (BI) in elderly patients was investigated with the aim of developing a potential noninvasive means of individualising gentamicin dosage. Linear regression analyses identified height/resistance2 as a statistically significant predictor of gentamicin distribution volume, V, [adjusted (adj)r2 = 0.53, coefficient of variation (CV) = 15.2%], and resistance/reactance and creatinine clearance (CL(cr)) as predictors of total systemic clearance, CL, adj r2 = 0.52, CV = 20.1%. Individualisation of gentamicin dosage regimens based on these relationships to achieve steady- state (SS), peak gentamicin concentrations, C(ss,max), and SS trough concentrations, C(ss,min), of 7.0 and 1.0 μg/ml, respectively, in an independent group of elderly patients resulted in serum gentamicin levels of 5.9 ± 0.7 and 0.8 ± 0.4 μg/ml. Mean absolute prediction errors averaged 0.7 ± 0.5 μg/ml for C(ss,max) and 0.5 ± 0.3 μg/ml for C(ss,min). Measures of BI provided the best predictions of C(ss,max), whereas models based on CL(cr) alone were the best predictors of C(ss, min). This technique provides a means of complementing routine pharmacokinetic monitoring of gentamicin pharmacotherapy in the elderly hospitalised patient with reductions in patient discomfort and potential savings in time and cost.
Keyword Bioelectrical impedance
Gentamicin dosage
Geriatrics
Noninvasive
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Pharmacy Publications
 
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Created: Mon, 20 Dec 2010, 23:56:24 EST