Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 21, 2020
Date Accepted: Oct 28, 2020
ColistinDose: an eSolution for determining intravenous dosage regimens of colistimethate in critically ill adult patients
ABSTRACT
Background:
Determining a suitable dose of colistimethate for intravenous administration is challenging due to complicated pharmacokinetics, confusing terminology, and the potential for renal toxicity. Only recently have reliable pharmacokinetic/pharmacodynamic data and dosing recommendations for intravenous colistimethate become available.
Objective:
The aim of the study was to develop a clinician-friendly, easy-to-use mobile application (app) incorporating up-to-date dosing recommendations for intravenous colistimethate in critically ill adult patients.
Methods:
Swift programming language and libraries were used for the development of the app on the iOS. The compatibility among different iOS versions and mobile devices was validated. Dosing calculations were based on equations developed in our recent population pharmacokinetic study. Recommended doses generated by the app were validated by comparison against doses calculated manually using the appropriate equations.
Results:
We developed ColistinDose, which provides three major functionalities, namely calculation of a (1) loading dose, (2) daily dose based upon the patient’s renal function (including differing types of renal replacement therapies), and (3) retrieval of historical calculation results. It is freely available for iOS (version 9) and above at the Apple App Store. Calculated doses accurately reflected doses recommended in patients with varying degrees of renal function based on the published equations. ColistinDose performs calculations on a local mobile device (iPhone or iPad) without the need for an internet connection.
Conclusions:
With its friendly user interface, ColistinDose provides an accurate and easy to use tool for clinicians to calculate dosage regimens of intravenous colistimethate in critically ill patients with various degrees of renal function. It has significant potential to avoid prescribing errors and patient safety issues that currently confound the clinical use of colistimethate, thereby optimizing patient treatment.
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