Individualization of drug therapy in general follows three steps:
1- Determination of the initial dosing regimen based on the population parameters.
The patient information is used to estimate the patient pharmacokinetic parameters based on the reported parameters for different patient populations. These parameters are used to determine the initial dosing regimen for the patient.
2- Estimation of the patient specific pharmacokinetic parameters.
After the patient receives the initial drug treatment the patient specific parameters should be determined by designing an appropriate sampling schedule that allows parameter determination.
3- Determination of the dosing regimen based on the patient specific parameters.
The patient specific parameters, are used to determine the appropriate dosing regimen for the patient to achieve the desired plasma concentrations at .
Aminoglycosides are eliminated entirely by the kidney. So, the rate of aminoglycoside elimination is strongly correlated with the .
The patient's can be used to estimate his/her initial pharmacokinetic parameters.
1- Determination of the initial regimen
The patient's kidney function can be determined from the . The creatinine clearance can be or can be .
The fraction remaining of kidney function can be determined as follows:
The estimated patient's aminogycoside can be determined as follows:
This estimate of aminoglycoside and an average value for aminoglycoside (0.25 L/kg) can be used to determine the initial dosing regimen for the patient.
