去甲万古霉素在新生儿败血症患者体内药代动力学及其疗效

Pharmacokinetics and application of demethylvancomycin in treatment of neonatal septicemia

目的：对新生儿败血症患者静脉滴注去甲万古霉素进行药代动力学研究，探讨血药浓度与疗效、不良反应关系。方法：５例新生儿患者静滴去甲万古霉素１５ｍｇ·ｋｇ－１，进行药代动力学参数测定；观察临床疗效并进行不良反应监测。结果：峰浓度达（３４．８９±６．２３）ｍｇ·Ｌ－１，８～１２ｈ降至５ｍｇ·Ｌ－１以下，药物消除半衰期为（６．０８±１．２２）ｈ，表观分布容积为（０．４４±０．０８）Ｌ·ｋｇ－１，清除率为（０．０８９±０．０１４）Ｌ·ｋｇ－１·ｈ－１。治疗７～１４ｄ后，有明显疗效，未出现严重耳、肾毒性。结论：去甲万古霉素１５ｍｇ·ｋｇ－１静脉滴注后，能够维持有效药物浓度，用药间隔应为８～１２ｈ。该药物用于新生儿耐药葡萄球菌感染安全、有效。

OBJECTIVE:To study the pharmacokinetics of demethylvancomycin after single intravenous infusion in neonates with staphylococal septicaemia,and the relations between serum concentration and clinical efficacy.METHOD:The pharmacokinetic parameters were determined after single intravenous infusion 15mg·kg -1 in 5 neonates.clinical efficacy and adverse reactions were observed.RESULTS:The peak concentrtion was 34.89±6.23mg·L -1 ,and the concentration after 8～12 hours was below 5mg·L -1 .The t 1/2 β was 6.08±1.22 h.The V(c) was 0.44±0.08L·kg -1 ,and Cl(s) was 0.089±0.014L·kg -1 ·h -1 .The satisfied effect was observed,no severe ototoxity and nephrotoxity were found.CONCLUSION:Demethylvancomycin could maintain the effective concentration in neonates at the dosage of 15mg·kg -1 and the dosage interval should be 8～12h.