PMID: 9558131Apr 29, 1998Paper

Safety and efficacy of a two-compartment Bayesian feedback program for therapeutic tobramycin monitoring in the daily clinical use and comparison with a non-Bayesian one-compartment model

Therapeutic Drug Monitoring
G R KaufmannW E Haefeli

Abstract

The predictive value of a two-compartment Bayesian feedback program for tobramycin dose optimization was retrospectively evaluated in 199 hospitalized patients and compared with that of a simple non-Bayesian one-compartment model. Before dose adjustment, 64% of the patients were underdosed indicating that tobramycin monitoring is still necessary to avoid ineffective antibiotic therapy. When physicians adhered to the dose instructions calculated with the Bayesian method, 90% of the patients had optimal concentration-time profiles as opposed to only 53% of the 43 patients in whom dose recommendations were not followed. In young patients with normal renal function, precision and accuracy of the Bayesian feedback and the one-compartment method were well correlated, whereas in elderly patients (> 60 years) and patients with impaired renal function (estimated creatinine clearance < 60 ml/minute), the Bayesian method was significantly more precise. Multiple regression analysis revealed that renal function was the only independent variable predicting the performance of the Bayesian program. The results of this study indicate that the Bayesian feedback method is a reliable method for the therapeutic tobramycin monitoring under clinical ...Continue Reading

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Citations

Jun 20, 2003·British Journal of Clinical Pharmacology·Nerea JauregizarRosario Calvo
Mar 8, 2017·The Journal of Pharmacy and Pharmacology·Basma Al-Metwali, Hussain Mulla
Sep 20, 2005·International Journal of Antimicrobial Agents·Gabriel InclanJohn C Lukas
Jan 25, 2005·Therapeutic Drug Monitoring·Shinichi TsuchiwataHiroyasu Ogata
Jun 5, 2020·British Journal of Clinical Pharmacology·Luqman ValiHussain Mulla

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