中国药物警戒 ›› 2022, Vol. 19 ›› Issue (12): 1368-1371.
DOI: 10.19803/j.1672-8629.20210812

• 安全与合理用药 • 上一篇    下一篇

基于指南推荐的万古霉素给药方案与血药谷浓度相关性研究

段晓红, 张杰, 王颖彦, 罗懿妮, 赖潇潇, 汪小惠, 陈设, 沈玉巧   

  1. 广州中医药大学第二附属医院,广东 广州 510120
  • 收稿日期:2021-08-26 出版日期:2022-12-15 发布日期:2022-12-21
  • 作者简介:段晓红,女,硕士,副主任药师,临床药学。
  • 基金资助:
    广东省医学科研基金项目（A2017459）

Correlations between vancomycin administration regimen recommended by the guidelines and blood trough concentrations

DUAN Xiaohong, ZHANG Jie, WANG Yingyan, LUO Yini, LAI Xiaoxiao, WANG Xiaohui, CHEN She, SHEN Yuqiao   

  1. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong 510120, China
  • Received:2021-08-26 Online:2022-12-15 Published:2022-12-21

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摘要： 目的 探讨基于指南推荐的万古霉素给药方案与血药谷浓度的关系。方法 收集某院2017年1月1日至2020年2月28日使用过万古霉素并进行药物治疗监测（TDM）的患者199例,根据监测浓度分为低谷浓度组（<10 μg·mL-1）、谷浓度组（10~20 μg·mL-1）及高谷浓度组（>20 μg·mL-1）,按照药品说明书/指南对患者的治疗方案进行评价。结果 199例患者中,低谷浓度组45例（22.6%）,谷浓度组95例（47.7%）,高谷浓度组59例（29.7%）;按照推荐方案给药者共122例,浓度位于谷浓度组52例（42.6%）。女性的血药谷浓度显著高于男性（P<0.001）,年龄<18岁组的血药浓度达标率显著低于其他年龄组（P<0.05）。结论 按照药品说明书/指南推荐的万古霉素给药方案患者血药谷浓度达标率不高,需要根据患者年龄、性别、体重、肾功能情况、合并用药、合并症制定更详细的初始给药方案,加强万古霉素的谷浓度监测并调整用药有助于患者的用药安全。

关键词: 万古霉素, 给药方案, 谷浓度

Abstract: Objective To investigate the relationships between blood trough concentrations of vancomycin and medication regimens. Methods A total of 199 patients who received vancomycin and TDM services in our hospital between January 1, 2017 and February 28, 2020 were selected. According to the monitoring concentrations, they were divided into the low-trough concentration group (< 10 μg·mL-1), through concentration group (10~20 μg·mL-1) and high-through concentration group (>20 μg·mL-1). The treatment regimens of the patients were evaluated according to the drug instructions/guidelines. Results Among the 199 patients, 45 (22.6%) were in the low-trough concentration group, 95 (47.7%) were in the trough concentration group, and 59 (29.7%) were in the high trough concentration group. Fifty-two (42.6%) of the 122 patients with correct dosage were in the trough concentration group. The trough concentrations of females were significantly higher than those of males ( P<0.001), and the trough concentration of the group under 18 years old was significantly lower than that of other groups (P<0.05). Conclusion More detailed guidelines and recommendations need to be formulated for initial administration according to patients’ age, gender, weight, renal function, drug combinations and complications. More vigorous monitoring of trough concentrations of vancomycin and adjustment of medications can enhance drug safety of patients.

Key words: vancomycin, dosing regimen, through concentration

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