摘要
目的 对万古霉素在非重症感染患儿中的初始稳态谷浓度(C_(ss,min))的分布情况及其影响因素进行分析,为临床安全合理使用万古霉素提供参考。方法 回顾性选取2020年1月至2021年6月我院接受万古霉素治疗的非重症感染患儿的病历资料,分析万古霉素初始C_(ss,min)分布情况,并采用多因素线性回归方法分析影响万古霉素C_(ss,min)的因素。结果 共纳入83例非重症感染患儿及对应的102个万古霉素C_(ss,min),平均万古霉素C_(ss,min)为(5.7±3.1) mg/L。<5 mg/L、5~10 mg/L、10~15 mg/L组各有36例(43.4%)、40例(48.2%)、7例(8.4%)。多因素线性回归分析显示,初始万古霉素日剂量、血清肌酐值对万古霉素C_(ss,min)有显著影响。结论 按照目前40 mg/(kg·d)、q6h的给药方案,非重症感染患儿万古霉素C_(ss,min)达到目标范围(5~15 mg/L)的比例较低,临床应根据肾功能、临床疗效等综合因素进行剂量调整。
Objective To investigate the distribution of initial vancomycin trough serum concentrations at steady state(C_(ss,min)) in general hospitalized children and determine the influencing factors,and to provide reference for safe and rational use of vancomycin clinically.Methods A retrospective study was conducted in a comprehensive 3 A pediatric hospital from January 2020 to June 2021.The distribution of vancomycin C_(ss,min) were analyzed.The influencing factors of vancomycin C_(ss,min) was analyzed by multivariable linear regression analysis.Results In total,83 patients with 102 vancomycin steady trough concentrations were evaluated in this study.The average initial trough concentration was(5.7±3.1)mg/L.There were 36(43.4%),40(48.2%) and 7(8.4%) pediatric patients in the group <5 mg/L,5~10 mg/L and 10~15 mg/L,respectively.Multivariable linear regression analysis showed that initial vancomycin daily dose and serum creatinine were associated with C_(ss,min).Conclusion The proportion of C_(ss,min) of 5~15 mg/L is low in general hospitalized pediatric patients receiving 40 mg/(kg·d) every six hours,and dose adjustment should be made by comprehensively considering renal function and clinical efficacy and other factors.
作者
吕萌
张胜男
周宇雪
马姝丽
Lü Meng;Zhang Shengnan;Zhou Yuxue;Ma Shuli(Department of Pharmacy,Children′s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《实用药物与临床》
CAS
2022年第10期897-900,共4页
Practical Pharmacy and Clinical Remedies
基金
河南省科技攻关计划项目资助(202102310396)
河南省医学科技攻关计划联合共建项目资助(LHGJ20190975)。
关键词
万古霉素
非重症感染儿童患者
谷浓度
影响因素
Vancomycin
General hospitalized pediatric patients
Trough concentrations
Influencing factors
