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The following message was posted to: PharmPK
Does anyone have experience of, or know of a literature source that
describes, the limitations of estimating creatinine clearance in the
first
few days postpartum when treating gram negative sepsis with
aminoglycoside
therapy? What would or do you do as an initial population based
estimate of
dosing requirement?
Neil Caldwell
Deputy Chief Pharmacist, Wirral Hospitals, UK
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The following message was posted to: PharmPK
I think that the variability is going to be so great from patient to
patient...Clinically, I would administer a single dose (perhaps
8-10mg...but
I am pulling that out because we know their Vd is larger...just don't
know
how much larger) and collect serial serum concentrations and
individualize
her dose based on her kinetics rather than relying on a highly variable
population. Nice thing about AG's is we can measure serum
concentrations,
and these patients likley need much more than we would have predicted.
Imagine how many patients within this special population we potentially
underdose with drugs that we routinely do not monitor serum
concentrations.
John Mohr, Pharm.D.
Instructor of Medicine
Department of Internal Medicine/Division of Infectious Diseases
6431 Fannin Street, Suite JFB 1.728
Houston, TX 77030
Phone: 713-500-6742
Fax: 713-500-5495
E-mail: john.mohr.-a-.uth.tmc.edu
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