ABSTRACT 723
Bibliographic record
Abstract
Background and aims: Once daily dosing (ODD) of aminoglycosides has been shown to be less toxic and as efficacious as multiple daily dosing regimens. There is a lack of pharmacokinetic (PK), safety, and efficacy data for aminoglycoside ODD in critically ill paediatric patients. Aims: To evaluate the proposed exclusion criteria for use of ODD gentamicin by examining gentamicin PK disposition in patients excluded from ODD therapy, and to adapt the criteria as appropriate. Methods: A retrospective chart review (approved by Research and Ethics Board) of 176 critically ill paediatric patients excluded from ODD therapy was done. PK parameters were calculated based on available therapeutic drug monitoring (TDM) levels. Extrapolated serum gentamicin levels achieved using a dose of 9 mg/kg were calculated and used to determine whether an excluded patient would have adequately cleared ODD gentamicin. Exploratory analyses were done to assess other characteristics that may predict if a patient will adequately clear ODD gentamicin despite prior exclusion. Results: The majority of patients (56%) were excluded from ODD therapy based on having a weight of ≤5 kg. Thirty-nine percent of patients excluded due to weight may have been able to adequately clear ODD gentamicin based on extrapolated PK parameters. Of these patients, 53% were estimated to achieve target Cmax, and 97% were estimated to achieve target drug-free interval. Conclusions: Patients with a weight of ≤5 kg can potentially be considered a conditional exclusion criterion, whereupon critically ill pediatric patients started on gentamicin for non-cardiac indications can be subsequently switched to gentamicin ODD if TDM levels show adequate clearance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.212 | 0.080 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".