KIM MJ, BERTINO JS, ERB TA, JENKINS PJ, NAFZIGER AN; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 5.
Bassett Healthcare, Cooperstown, NY
BACKGROUND: The application of BT converts prior probabilities (PRIOR) by multiplication in proportion to likelihoods to determine posterior probabilities (POST). POST = p l[j]/S p l[j] where p = PRIOR, l[j] = probability of outcome j. In this study, BT was applied to examine the incidence of AAN with EIA, IPM and MDD.METHODS: Multiple literature searching techniques identified 120 studies using EIA, IPM or MDD that reported AAN in patients >/= 16 years. Studies enrolling only neutropenic patients were excluded. Each study was assigned a quality score based on the rigor of definition of AAN, duration of therapy and length of follow-up of renal function after completion of therapy. After studies were analyzed and scored, BT was applied to 57 studies with duration of therapy and follow-up of >/= 2 days, and increase in serum creatinine of >/= 15% or of >/= 0.25mg%. PRIOR1 derived from a review of the most rigorous studies for each method of dosing are shown below [table: see text]. BT was also applied to studies using PRIOR2 derived by reducing or eliminating the PRIOR1 extremes % of AAN [table: see text].RESULTS: Twelve EIA, 12 IPM and 33 MDD studies were analyzed. Total number of patients in EIA, IPM and MDD were 916, 2,365, and 5,589, respectively. Starting with PRIOR1, and applying likelihoods obtained from 57 studies, the maximum densities for the final posterior distributions of AAN for EIA, IPM and MDD were located at 15%, 10%, and 15%, respectively. Applying these likelihoods to PRIOR2 produced similar results.CONCLUSIONS: The application of BT demonstrates that AG dosing by IPM results in less AAN than EIA or MDD.KEYWORDS: Aminoglycoside; Bayes analysis; Nephrotoxicity
Publication Types:
Keywords:
- Aminoglycosides
- Anti-Bacterial Agents
- Bayes Theorem
- Creatinine
- Humans
- Immunoenzyme Techniques
- Monitoring, Physiologic
- pharmacokinetics
- surgery
Other ID:
UI: 102246932
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