万古霉素的药代动力学研究进展

Progress in pharmacokinetics of vancomycin

万古霉素(多肽类抗生素)能有效治疗革兰阳性菌尤其是耐甲氧西林金葡菌和表皮葡萄球菌、肠球菌引起的感染,其特点是具有时间依赖性,峰浓度为25～40 mg·L^(-1),谷浓度5～15 mg·L^(-1);主要不良反应肾毒性的发生与过高的谷浓度有关。由于血液透析能清除部分药物,因此行高通量血液透析的患者,预防或治疗使用万古霉素时,要注意调整剂量。血药浓度测定、药代动力学参数的估算等方法,有助于临床医生制订个体化给药方案,减少或避免药物毒性。

Vancomycin is an effective glycopeptide antibiotics against a wide variety of gram positive bacteria and has been widely used in clinical practice especially in patients with methicillin - resistant Staphylococcus aureus （MRSA） infections. Its PK/PD profiles is time - dependent, ideal peak concentration is 25 -40 mg · L^- 1 and trough concentration is 5 - 15 mg · L^-1. Nephrotoxity is one of the major side effects and related to high trough levels. Vancomycin for the treatment or prophylaxis of patients undergoing high flux hemodialysis need for dose adjustments due to dialutie removal. Measurement of serum drug concentration, assessment pharmacokinetie parameters and other ways can help doctors in planning individualized regimens, which will minimize or avoid the occurrence of drug toxicity.