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An approach to forecast aminoglycoside-related nephrotoxicity from routinely collected clinical data.

Authors
  • Kubota, K
  • Suganuma, T
  • Sasaki, T
  • Ishizaki, T
Type
Published Article
Journal
Therapeutic Drug Monitoring
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Jan 01, 1988
Volume
10
Issue
4
Pages
410–420
Identifiers
PMID: 3201525
Source
Medline
License
Unknown

Abstract

Routinely collected clinical data on 104 critically ill patients who had received an aminoglycoside (gentamicin or tobramycin) were evaluated using a proposed approach to forecast aminoglycoside-related nephrotoxicity. Observed steady-state peak and trough concentrations were greater than the respective predicted values when one-compartment model was assumed. This difference was particularly eminent for trough concentrations. The bias (difference between predicted and observed values) for trough concentrations was analyzed assuming tissue accumulation by an extended least-squares method to estimate population pharmacokinetics. The mean values for terminal half-life of gentamicin and tobramycin in patients who did not develop nephrotoxicity were estimated to be approximately 50 and 116 h, respectively. By using these values, the bias of trough concentration was found to be greater in patients who developed nephrotoxicity during or within 60 days after the therapy than in those who did not. Our results suggest that assessing the bias of steady-state trough concentrations of aminoglycosides can provide a useful index to forecast an aminoglycoside-induced nephrotoxicity.

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