Validation of the use of Bayesian analysis in the optimization of gentamicin therapy from the commencement of dosing

A computer program based on the statistical technique of Bayesian analysis has been adapted to run on several microcomputers. The clinical application of this method for gentamicin has been validated in 13 patients with varying degrees of renal function by a comparison of the accuracy of this method to a predictive algorithm method and one using standard pharmacokinetic principles. Blood samples for serum gentamicin analysis were taken after the administration of an intravenous loading dose of gentamicin. The results produced by each method were used to predict the peak and trough values measured on day 3 of therapy. Of the three methods studied, Bayesian analysis, using a serum gentamicin concentration drawn four hours after the initial dose, was the least biased and the most precise method for predicting the observed levels. The mean prediction error of the Bayesian analysis method, using the four-hour sample, was -0.03 mg/L for the peak serum concentration and -0.07 mg/L for the trough level on day 3. Using this method the corresponding root mean squared prediction error was 0.60 mg/L and 0.36 mg/L for the peak and trough levels, respectively.