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Comparative Study
. 2004 Nov;58(5):521-7.
doi: 10.1111/j.1365-2125.2004.02201.x.

Comparison of gentamicin dose estimates derived from manual calculations, the Australian 'Therapeutic Guidelines: Antibiotic' nomogram and the SeBA-GEN and DoseCalc software programs

Mitali Mohan  1 , Kevin T Batty, Jennifer A Cooper, Richard E Wojnar-Horton, Kenneth F Ilett
Affiliations
Comparative Study

Comparison of gentamicin dose estimates derived from manual calculations, the Australian 'Therapeutic Guidelines: Antibiotic' nomogram and the SeBA-GEN and DoseCalc software programs

Mitali Mohan et al. Br J Clin Pharmacol. 2004 Nov.

Abstract

Aim: To compare gentamicin dose estimates from four predictive methods.

Methods: A retrospective study was conducted, comprising patients at Fremantle Hospital who received gentamicin therapy and had at least one gentamicin serum concentration reported. A manual calculation method, the Australian 'Therapeutic Guidelines: Antibiotic' (TGA) nomogram and the SeBA-GEN and DoseCalc software packages were compared. SeBA-GEN dose estimates were regarded as the reference standard.

Results: There were 64 males and 30 females with mean age of 58 +/- 16 years. In patients with moderate renal impairment (CL(Cr) = 30-60 ml min(-1); n = 21), mean dose estimates using DoseCalc and the manual calculation method were comparable to SeBA-GEN but the mean TGA nomogram dose (230 mg; 95% confidence interval 179, 281) was significantly lower than SeBA-GEN (286 mg; 261, 311; P = 0.002; one-way RM anova). In patients with mild renal impairment (CL(Cr) = 60-90 ml min(-1); n = 48), DoseCalc (392 mg; 367, 427) was comparable to SeBA-GEN (377 mg; 362, 392). Although the manual method (341 mg; 306, 376; P = 0.007) and the TGA nomogram (335 mg; 302, 368; P < 0.001) estimates were significantly lower than SeBA-GEN, the practical difference was modest.

Conclusions: SeBA-GEN and DoseCalc are generally comparable for estimation of gentamicin doses in patients with renal impairment. The 'Therapeutic Guidelines: Antibiotic' nomogram is a valid approach to dosage estimation, but only when used in patients with normal renal function. Simple manual calculations are a suitable alternative in patients with renal impairment.

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