The practice of once-daily aminoglycoside dosing in Canada: A national survey
Bibliographic record
Abstract
Abstract The impetus to adopt the use of once-daily aminoglycoside (ODA) therapy has been growing. Controversy however, regarding the exact role of ODA therapy continues to persist. A survey of Canadian hospitals was undertaken to identify perceptions and practice regarding ODA therapy. Information regarding hospital demographics and the institutional practice of dosing and monitoring traditional intermittent aminoglycoside and ODA therapy was obtained. Of 134 hospitals evaluated, 103 (77%) reported using ODA therapy. Primary applications of ODA therapy included urinary tract infection (84%), intra-abdominal infections (79%), pneumonia (78%), sepsis (75%) and bacteremia (69%). Contraindications for ODA therapy included pregnancy (82.7%), renal impairment (71%), dialysis (56%) and ascites (54%). Wide differences in the daily dosage and monitoring of ODA therapy were noted. Clinical judgement (48.9%) was often used to determine whether aminoglycoside serum concentrations were required for ODA therapy. Extension of the dosing interval was the most common (65%) method of adjusting ODA therapy. The use of ODA therapy in Canada appears widespread. Differences in the daily dosing, monitoring and indications for ODA therapy were noted suggesting that the optimal use of ODA therapy may require further refinement. Resume L'engouement pour le traitement aux aminoglycosides a dos uniquotidienne (ADU) est de plus en plus grand. Cependant, la controverse entourant le role exact du traitement ADU persiste toujours. Un sondage a ete mene aupres des hopitaux canadiens pour connaitre les habitudes de prescription et d'administration du traitement ADU. Ainsi, les renseignements sur les donnees demographiques de la population de patients des hopitaux et sur les habitudes de chaque etablissement en matiere de posologie et de suivi du traitement intermittent classique au aminoglycosides et du traitement ADU on ete recueillis. Des 134 hopitaux sondes, 103 (77 %) ont dit recourir au traitement ADU. Le traitement ADU etait principalement utilise dans les cas d'infections des voies urinaires (84 %), d'infections intra-abdominales (79 %), de pneumonie (78 %), de septicemie (75 %) et de bacteriemie (69 %). Les contreindications au traitement ADU comprenaient la grossesse (83 %), l'insuffisance renale (71 % ), la dialyse (56 %) et l'ascite (54 %). D'importantes differences dans la posologie quotidienne et le suivi du traitement ADU ont ete observees. L'opinion clinique etait souvent utilisee (49 %) pour determiner si oui or non les concentrations seriques d'aminoglycosides etaient necessaires au cours du traitement ADU. Le prolongement de l'intervalle posologique etait la methode d'ajustement du traitement ADU la plus souvent utilisee (65 %). Le recours au traitement ADU au Canada semble donc largement repandu. Les differences en termes de posologie quotidienne, de suivi et d'indication du traitement ADU ont eye relevees et portent a croire que !'utilisation optimale du traitement ADU pourrait necessiter d'autres mises au point.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".