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Analysis of Various Creatinine Clearance Formulas in Predicting Gentamicin Elimination in Patients With Low Serum Creatinine
Author(s) -
Reichley Richard M.,
Ritchie David J.,
Bailey Thomas C.
Publication year - 1995
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1995.tb02873.x
Subject(s) - creatinine , gentamicin , renal function , mathematics , urology , serum concentration , mean squared prediction error , statistics , medicine , chemistry , endocrinology , antibiotics , biochemistry
Predicted gentamicin elimination rate constants (k el s) using creatinine clearance (C1 cr ) estimates from seven equations were compared with k el s calculated from steady‐state serum gentamicin concentrations in 186 hospitalized patients. In predicting k el , the equations varied significantly in precision (mean absolute percentage error), and were particularly imprecise among patients with serum creatinine values of 71 μmol/L or less. Significant differences in bias (mean prediction error) were also observed. All equations using serum creatinine as an element showed improved precision, and most showed reduced bias when a minimum value of 71 μmol/L was used. The Cockcroft‐Gault normalized to 72 kg and the Hull equations are among the simplest to calculate and, when using a minimum serum creatinine of 71 μmol/L, had significantly greater precision and less bias than several of the equations. We recommend one of these two methods for predicting gentamicin k el in patients with low serum creatinine values.