--- title: New Continuous Learning PK Model Outperforms Published PopPK Models for Gentamicin description: Evaluation of pharmacokinetic models to help improve vanc dosing in pediatric oncology, finding the general Colin 2019 model more effective than specialized models. image: https://blog.insight-rx.com/hubfs/Blog%20Generic%20Product%20Innovation.png --- [![InsightRX](https://blog.insight-rx.com/hubfs/insightrx_logo_white-teal.svg)](https://blog.insight-rx.com/) - For Providers - Solutions - [MIPD for Providers Explore our full solution for Bayesian model-informed dosing](https://www.insight-rx.com/mipd) - [Future of Pharmacy Learn what's next for AI in health tech, and why architecture matters](https://www.insight-rx.com/future) - Products - [InsightRX Nova Bayesian dosing (MIPD) app for bedside clinical decision support](https://www.insight-rx.com/provider/nova) - [InsightRX Apollo Real-time clinical analytics to measure outcomes](https://www.insight-rx.com/provider/apollo) - [Drug Modules Available medications for precision dosing apps](https://www.insight-rx.com/provider/drug-modules) - [For Life Sciences](https://www.insight-rx.com/life-sciences) - Overview - [InsightRX for Life Sciences Explore our solution for biopharma and clinical trial use](https://www.insight-rx.com/life-sciences) - Products - [Nova for Life Sciences Precision dosing app for clinical trial use](https://www.insight-rx.com/life-sciences/nova) - [Astra for Life Sciences AI-native environment for PK/PD modeling and simulation](https://www.insight-rx.com/life-sciences/astra) - Platform - [Continuous Learning Patented process for model retraining and improvement](https://www.insight-rx.com/platform/continuous-learning) - [Integrations Platform interoperability setup with EHRs, EDCs, and more](https://www.insight-rx.com/platform/integrations) - [Security & Regulatory Standards for product development and release](https://www.insight-rx.com/platform/security-regulatory) - [Success & Support Pharmacist-led training, onboarding, and education](https://www.insight-rx.com/platform/support) - Resources - Science - [Data Science Explore the science and learn more about our R&D](https://www.insight-rx.com/data-science) - [Scientific Publications Impactful research manuscripts with at least one InsightRX author](https://www.insight-rx.com/data-science/scientific-publications) - [How to Cite Using one of our apps? Follow this easy guide for citation in research](https://www.insight-rx.com/how-to-cite-insightrx-nova) - Explore - [Success Stories Case studies from real InsightRX customers about their journey](https://www.insight-rx.com/success-stories) - [White Papers In-depth analysis and best practices for review and download](https://blog.insight-rx.com/resources/tag/white-papers) - [Pubs. Using InsightRX Review research that has used InsightRX applications](https://www.insight-rx.com/publications-using-insightrx-software) - [Blog](https://blog.insight-rx.com/resources) - [All Blog Posts Read the latest posts by our team of experts](https://blog.insight-rx.com/resources) - [Product Innovation The latest updates on our products, services, and science](https://blog.insight-rx.com/resources?section=product_innovation) - [Thought Leadership Posts from our team of experts on PK, MIPD, science, and more](https://blog.insight-rx.com/resources?section=thought_leadership) - Company - About - [About Us Our story, what drives us and why we're passionate about our work](https://www.insight-rx.com/about) - [Leadership Founders and team leaders who strive toward excellence in MIPD](https://www.insight-rx.com/leadership) - [Advisory Board Scientists and experts to ensure our collective success](https://www.insight-rx.com/advisory-board) - [Careers Interested in joining? View available openings here](https://www.insight-rx.com/careers) - [Customers Hear what others have to say about their experience](https://www.insight-rx.com/customers) - Press - [All Stories InsightRX news, company updates, and more](https://blog.insight-rx.com/press-releases) - [Press Releases Announcements for events, partnerships, and company updates](https://blog.insight-rx.com/press-releases?section=press_releases) - [Media InsightRX in the news — digital, print, podcasts, and other outlets](https://blog.insight-rx.com/press-releases?section=media) [![Contact Us](https://no-cache.hubspot.com/cta/default/40041574/interactive-193831493462.png)](https://cta-service-cms2.hubspot.com/web-interactives/public/v1/track/redirect?encryptedPayload=AVxigLIVhNAV4frdGw7WK4%2FsUL9BSW7sTFfaUWeB6c0miW6Ak22RBUNE5R8BeaQrWqzDSork53FkrNEqiSn%2FTM4f%2BVzPNcA0Ikxp7y6GqZRUQJ2HulFNF849cXXSebQBDVQXFR3hVvn8tZ3jkxYoygqRgjFUwIOapgI0FM8UFCm2xhxz2SgLhEGqk1U%3D&webInteractiveContentId=193831493462&portalId=40041574) [![Contact Us](https://no-cache.hubspot.com/cta/default/40041574/interactive-193831493462.png)](https://cta-service-cms2.hubspot.com/web-interactives/public/v1/track/redirect?encryptedPayload=AVxigLIVhNAV4frdGw7WK4%2FsUL9BSW7sTFfaUWeB6c0miW6Ak22RBUNE5R8BeaQrWqzDSork53FkrNEqiSn%2FTM4f%2BVzPNcA0Ikxp7y6GqZRUQJ2HulFNF849cXXSebQBDVQXFR3hVvn8tZ3jkxYoygqRgjFUwIOapgI0FM8UFCm2xhxz2SgLhEGqk1U%3D&webInteractiveContentId=193831493462&portalId=40041574) Product Innovation # New Continuous Learning PK Model Outperforms Published PopPK Models for Gentamicin - Published September 5, 2025 By [Dominic Tong](https://blog.insight-rx.com/resources/author/dominic-tong) ![](https://blog.insight-rx.com/hubfs/Blog%20Generic%20Product%20Innovation.png) ## Background Gentamicin is an aminoglycoside antibiotic used to treat gram-negative infections. Its clinical use is limited by a narrow therapeutic window and the risk of ototoxicity and nephrotoxicity. Model-informed precision dosing (MIPD) can improve safety and efficacy, but requires a [sufficiently predictive](https://blog.insight-rx.com/resources/model-informed-precision-dosing-bedside-challenges-opportunities)population pharmacokinetic (popPK) model. [InsightRX Nova](https://www.insight-rx.com/provider/nova) currently supports two published models for adult gentamicin patients ([Xuan 2004](https://pubmed.ncbi.nlm.nih.gov/15164971/) and [Smit 2019](https://pubmed.ncbi.nlm.nih.gov/31016671/)). We [evaluated their performance](https://blog.insight-rx.com/resources/insightrx-nova-verification-pk-models-precision-dosing) on real-world clinical data and developed a new model to improve prediction performance.  ![genta_adults_onepager_figure](https://blog.insight-rx.com/hs-fs/hubfs/genta_adults_onepager_figure.png?width=600&height=375&name=genta_adults_onepager_figure.png) **Figure 1**. Predictive performance of published and new continuous learning model for adult patients dosed with gentamicin, evaluated by (left) accuracy, (centre) mean percent error (MPE), and (right) normalized root mean square error (nRMSE). Closed circles (vertical bars) represent the median (5th to 95th percentile) of 1000 bootstraps. Statistical significance was determined by presence of overlapping confidence intervals: ▲ represents the model with best performance; ▽ represents models not statistically different from the best model. The green horizontal line indicates ideal model performance. ## Results ### Data Collection After removal of anomalous and outlier data, the dataset contained 3,409 gentamicin concentrations across 1,653 treatment courses from 16 hospital systems. ### Model Fit The new continuous learning model, designated the Tong model, incorporates fat-free mass, sex, and estimated glomerular filtration rate (eGFR) calculated using the 2021 CKD-EPI equation. ### Predictive Performance Comparison The Tong model demonstrated the best overall predictive performance across accuracy, mean percentage error (MPE), and normalized root mean square error (nRMSE). For a posteriori MPE, it performed comparably to the model by Xuan et al. (Figure 1). Improvements were most pronounced for peak concentration predictions, though enhanced predictive performance was observed across all sample timings. ## Recommendation for Practice InsightRX recommends the newly-fit Tong model for gentamicin dosing in adult patients. ## Want to Explore More? Read on for the full analysis below, and learn how InsightRX can support precision dosing at your organization. [![Read the Analysis](https://no-cache.hubspot.com/cta/default/40041574/interactive-195575942721.png)](https://blog.insight-rx.com/hs/cta/wi/redirect?encryptedPayload=AVxigLIh3AvHb5Edy8K9B6wmQbZ3HBjrAp4eIppXJNOqvqTFu6N%2Fj7%2FoVI2K6pSI7mEtShpTmQZlcdDQ2xIoC9d7T%2BFGS7TJPr7vba63e1yyZf%2F17a5BEneDPEppPYeryn2sWyduzR9Hd0wwiZKoULxHf94zZvEASK%2BV%2B2jJ%2BJnKr49VSxJZ8%2FXIEn00BkkeR1Au45sZtpBw5%2Fsa99OFSt2R%2BY8IstfTn%2F9VxDYgorzquozwISPkhCSvzSvDdAmEEGnejnhEiYo1ynhu0%2FWl%2BxvN1idGrrljkg%3D%3D&webInteractiveContentId=195575942721&portalId=40041574) [infectious diseases](https://blog.insight-rx.com/resources/tag/infectious-diseases) [aminoglycosides](https://blog.insight-rx.com/resources/tag/aminoglycosides) [gentamicin](https://blog.insight-rx.com/resources/tag/gentamicin) #### On this page… About the author [Dominic Tong, PhD](https://blog.insight-rx.com/resources/author/dominic-tong) Principal Data Scientist **Connect with us to get the latest blog updates, instantly sent to your inbox** ## Dig deeper. Explore related articles and additional posts on the InsightRX blog. [Product Innovation Aug 8, 2025 Improving Vancomycin Dosing in Pediatric Subpopulations (Part II): Guiding Model Selection in Oncology Patients](https://blog.insight-rx.com/resources/vancomycin-dosing-pediatrics-oncology-model-selection) [Product Innovation Jul 16, 2025 Elevating Precision Dosing for Hemodialysis Patients: A New Vancomycin CRRT Model](https://blog.insight-rx.com/resources/new-model-for-vancomycin-patients-on-hemodialysis-improves-predictive-performance) [Product Innovation Jul 30, 2025 Improving Vancomycin Dosing in Pediatric Subpopulations (Part I): Guiding Model Selection in CVICU Patients](https://blog.insight-rx.com/resources/vancomycin-dosing-pediatrics-cvicu-model-selection) #### What We Do ##### For Providers - [Nova (Bayesian Dosing)](https://www.insight-rx.com/provider/nova) - [Apollo (Clinical Analytics)](https://www.insight-rx.com/provider/apollo) - [Drug Modules](https://www.insight-rx.com/provider/drug-modules) ##### For Life Sciences - [Nova (MIPD for Clinical Trials)](https://www.insight-rx.com/life-sciences/nova) - [Astra (AI-Powered Clin Pharm)](https://www.insight-rx.com/life-sciences/astra) - [Companion Applications](https://www.insight-rx.com/life-sciences/nova#companion-applications) #### How We Do It ##### Platform - [Continuous Learning](https://www.insight-rx.com/platform/continuous-learning) - [Integrations](https://www.insight-rx.com/platform/integrations) - [Security & Regulatory](https://www.insight-rx.com/platform/security-regulatory) - [Success & Support](https://www.insight-rx.com/platform/success-support) ##### Science - [Data Science](https://www.insight-rx.com/data-science) - [Scientific Publications](https://www.insight-rx.com/data-science/scientific-publications) #### Information ##### Resources - [Success Stories](https://www.insight-rx.com/success-stories) - [White Papers](https://www.insight-rx.com/white-papers) - [Publications Using InsightRX](https://www.insight-rx.com/publications-using-insightrx-software) - [How to Cite InsightRX](https://www.insight-rx.com/how-to-cite-insightrx-nova) ##### Blog - [All Posts](https://blog.insight-rx.com/resources) - [Product Innovation](https://blog.insight-rx.com/resources?section=product_innovation) - [Thought Leadership](https://blog.insight-rx.com/resources?section=thought_leadership) #### About - [Our Story](https://www.insight-rx.com/about) - [Leadership](https://www.insight-rx.com/leadership) - [Advisory Board](https://www.insight-rx.com/advisory-board) - [Our Customers](https://www.insight-rx.com/customers) - [Press Releases](https://blog.insight-rx.com/press-releases?section=press_releases) - [Media](https://blog.insight-rx.com/press-releases?section=media) - [Careers](https://www.insight-rx.com/careers) - [Contact](https://www.insight-rx.com/contact-us) --- ![CE marking](https://blog.insight-rx.com/hubfs/ce-mark-white.svg) InsightRX Nova is HITRUST CSF r2 certified, CE marked, and 21 CFR Part 11 compliant. Our quality management, risk management, software lifecycle, and usability engineering processes conform to ISO 13485, IEC 62304, ISO 14971, IEC 62366-1, and IEC 82304-1. InsightRX Nova is not considered to be a medical device in the U.S. and has not been submitted to the U.S. Food and Drug Administration for review or clearance. 740-05000-REC-01 · 08/2025 --- [![InsightRX](https://blog.insight-rx.com/hubfs/insightrx_logo_white-teal.svg)](https://www.insight-rx.com/) 548 Market Street #88083 San Francisco, CA 94104 --- © 2026 InsightRX, Inc. All rights reserved. [Privacy Policy](https://www.insight-rx.com/privacy-policy) Cookie Preferences ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Dominic Tong, PhD - Principal Data Scientist", "url" : "https://blog.insight-rx.com/resources/author/dominic-tong" }, "dateModified" : "2025-12-13T02:32:43.625Z", "datePublished" : "2025-09-05T00:17:18.000Z", "headline" : "New Continuous Learning PK Model Outperforms Published PopPK Models for Gentamicin", "image" : [ "https://blog.insight-rx.com/hubfs/Blog%20Generic%20Product%20Innovation.png" ], "mainEntityOfPage" : { "@id" : "https://blog.insight-rx.com/resources/continuous-learning-approach-gentamicin-precision-dosing", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://blog.insight-rx.com/hubfs/insightrx_logo_color%20500%20x%20250-1.png" }, "name" : "InsightRX" } } ```