A model for the prospective identification of the prenephrotoxic state during gentamicin therapy

A computer method has been investigated to differentiate the prenephrotoxic patient from the nontoxic patient by routine monitoring of serum gentamicin concentrations during therapy, without the need to discontinue medication. The method deliberately assumes an incorreect pharmacokinetic model and uses a nonlinear regression program to analyze data collected during continuous dosing. In principle, it appears that the prenephrotoxic patients may be identified on the basis of a decreasing "apparent" elimination rate constant of gentamicin during continuous therapy.