Dosage adjustment and clinical outcomes of long-term use of high-dose tobramycin in adult cystic fibrosis patients
| Autor: | Robin E. Hooper, Denis Spelman, Glenn Bowes, Shu C. Li, Allan J. McLean, Nicholas Tong, W. John Spicer, L L Ioannides-Demos |
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| Rok vydání: | 1991 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Cystic Fibrosis Population Cystic fibrosis Group B Ototoxicity Pharmacokinetics Internal medicine medicine Tobramycin Humans Pharmacology (medical) Trough Concentration Pseudomonas Infections education Infusions Intravenous Pharmacology education.field_of_study business.industry Aminoglycoside Bayes Theorem Bacterial Infections medicine.disease Surgery Infectious Diseases Female Kidney Diseases business Software medicine.drug |
| Zdroj: | The Journal of antimicrobial chemotherapy. 28(4) |
| ISSN: | 0305-7453 |
| Popis: | A two-phase study was undertaken designed to investigate the impact of computer-aided drug monitoring on tobramycin concentrations and clinical outcomes in adult patients with cystic fibrosis. In phase one, a baseline (historical control) study of drug use patterns was performed. During the second phase, patients admitted for intravenous treatment with tobramycin for acute exacerbations of pseudomonal pulmonary infections were randomly allocated to one of two schedules. Group A patients had tobramycin dosage regimens decided by clinicians based on pre-existing protocols using serum tobramycin assay data determined three times weekly. Group B patients had dosage regimens determined by a computerized pharmacokinetic predictive program using both population-based pharmacokinetic parameter estimation and fitting of serum concentration-time data using Bayesian regression. The agreed therapeutic target was a peak serum tobramycin concentration of 8-10 mg/L and a trough concentration of 1-2 mg/L. There was a major difference between the two groups comparing the number of paired trough and peak concentrations within the target concentration ranges (group A-14%; group B-34.7%, chi 2 test, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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