新生儿万古霉素血药浓度监测与用药分析

Monitoring of Blood Concentration of Vancomycin in Neonates and Drug Use Analysis in Neonates

目的:调查我院万古霉素在新生儿患者中血药浓度监测情况,为新生儿应用万古霉素提供参考。方法:收集我院2016年7月1日—2017年6月30日采用万古霉素血药浓度监测的新生患儿病例,对患儿基本情况、万古霉素血药浓度、病原学检查、疗效、不良反应评价等进行分析。结果:纳入符合标准的114例患儿中,新生儿败血症诊断比例最高,为48例;万古霉素血药谷浓度在10～15 mg/L的占27.27%,在15～20 mg/L的占10.74%;病原学送检率为100%,其中阳性率52.63%;治疗过程中未见明显不良反应出现;治疗有效率为97.37%。结论:使用万古霉素治疗新生儿革兰阳性菌引起的重症感染疗效确切,为保障用药安全,应监测血药浓度,使其维持在安全有效范围内。

Objective:To investigate the monitoring of blood concentration of vancomycin in neonates in our hospital,and to provide a reference for the application of vancomycin in neonates.Methods:Neonatal cases whose blood concentration of vancomycin was monitored in our hospital from July 1,2016 to June 30,2017 were collected.The basic conditions,the blood concentration of vancomycin,etiological examination,curative effect and adverse reaction evaluation were analyzed.Results:In 114 children who met the criteria,the highest proportion of neonatal sepsis was diagnosed,48 cases.The blood concentration of vancomycin was at 10~15 mg/L,accounting for 27.27%,at 15~20 mg/L,accounting for 10.74%.The etiological examination rate was 100%,of which the positive rate was 52.63%.No obvious adverse reactions occurred during the treatment.The effective rate was 97.37%.Conclusion:The use of vancomycin for the treatment of severe infection caused by Gram-positive bacteria in newborns is effective.To ensure the safety of drug use,blood concentrations should be monitored to maintain them within a safe and effective range.