Bayesian forecasting of serum gentamicin concentrations in intensive care patients

Clin Pharmacokinet. 1990 May;18(5):409-18. doi: 10.2165/00003088-199018050-00005.

Abstract

This study retrospectively evaluated the predictive performance of a 1-compartment Bayesian forecasting program in adult intensive care unit (ICU) patients with stable renal function. A comparison was made of the reliability of 3 sets of population-based parameter estimates and 2 serum concentration monitoring strategies. A larger mean error for prediction of peak gentamicin concentrations was seen with literature-derived parameters than when ICU population-based parameter estimates were used. Bias and precision improved when non-steady-state peak and trough concentrations were used to predict those at steady-state; the addition of steady-state values did not provide additional information for predictions once non-steady-state feedback concentrations were incorporated. The addition of 4 serial gentamicin concentrations obtained at both non-steady-state and steady-state did not noticeably improve the predictive performance. The results demonstrate that initial ICU pharmacokinetic parameter estimates for a 1-compartment Bayesian model provide accurate prediction of steady-state gentamicin concentrations. Prediction bias and precision showed the greatest improvement when non-steady-state gentamicin concentrations were used to determine individualised pharmacokinetic parameters.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bayes Theorem
  • Creatinine / blood
  • Female
  • Gentamicins / administration & dosage
  • Gentamicins / blood*
  • Gentamicins / pharmacokinetics
  • Humans
  • Illinois
  • Intensive Care Units
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Gentamicins
  • Creatinine