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[Clinical significance of correcting the serum level of phenytoin according to the albuminaemia in hospitalized patients and outpatients].

INTRODUCTION
It has recently been reported that in developing countries, which have a high prevalence rate of hypoalbuminaemia, the total concentration of phenytoin in serum would often provide incorrect clinical information.


PATIENTS AND METHODS
The serum levels of phenytoin and albumin were determined in 400 adult patients of both sexes (231 hospitalized and 169 outpatients) attended in our hospital, and the concentrations of the drug were corrected using the Sheiner Tozer equation (STE).


RESULTS
A clinically significant difference between the corrected and experimental concentrations of phenytoin (< 1.2 mg/L) was found in 74.4% of the hospitalized patients and in 21.3% of the outpatients.


CONCLUSIONS
According to these findings and given the fact that determining the concentration of free phenytoin (i.e. not linked to albumin) is not routinely carried out, we recommend the systematic correction of phenytoin levels in our community in order to better adjust dosages. The possible limitations of the use of STE for standardizing phenytoin concentrations are also discussed.