Computer based methods for the prescribing of aminoglycoside antibiotics

Abstract

The purpose of this study was to produce a computer program which would use clinical information about individual patients to prescribe drug regimes for then. These regimes should ensure that the serum concentration of the drug would remain within a defined therapeutic range during the whole course of the treatment.
The program should be able to fit with minimum disruption into the hospital environment. The input data should be available without recourse to non standard laboratory teats. The doses prescribed should be convenient for nurses to measure and administer. The times of administration should be suitable for the existing routine of medical or surgical wards.
It was considered important that the program should have extensive checking facilities for the data input and that it should provide sufficient information for the physician to assess the agreement between predicted serum concentrations and actual measurements. These measurements in their turn should be usuable as reference points for further calculations.
The program should be able where appropriate to prescribe a loading dose followed by a mnintenance regime or to take account of previous doses and prescribe a continuing maintenance regime. This last facility would enable the program to be used at any point in a course of treatment and make it possible to allow for previous under - or over - prescribing.
When fully validated the computer program should make it possible to construct simple nomograms which could be used at the bedside to prescribe loading and maintenance doses for patients in a clinical steady state.