31例住院患者万古霉素的用药分析

Analysis of Vancomycin Medication in 31 Cases of Hospitalized Patients

目的：结合监管部门与国内外共识的要求和意见，分析住院患者万古霉素的用药情况。方法：统计2012 年度经静脉使用万古霉素的非死亡病例，并对其用药指征、用法与用量、用药疗程、血药浓度的监控和联合用药情况作一分析。结果：31 名患者均采用常规给药方法，其中缺乏用药指征 4 例（12.90%），监测血药浓度 20 例（64.52%）；在血药浓度监测的患者中，其中 35.48% 患者测检时机选择不合理，75.00% 患者测得的血药浓度不在10-20 mg/L 范围内，用药疗程均在 1-24 d 之间，经验性用药时间尚不统一，联用抗菌药物的指征较合理，但同类药换药仍需规范。结论：临床医师与药师应加强沟通，共同制订万古霉素个体化的用药方案。

Objective： To analyze 31 patients using vancomycin according to the requirements and recommendations of corresponding agencies and consensuses. Methods： Summarizing and commenting on indication, dose regimen, duration, therapeutic drug monitoring, and concurrent drugs of eligible patients since 2012. Results： 31 patients received dosing regimen and 4 of them with inappropriate indication. 64.5% patients received the therapeutic drug monitoring and 35% had the incorrect monitoring time. Vancomycin duration ranged from 1 to 24 days, which is inconsistent for empirical treatment. Almost every patient had concurrent antibacterial agents with proper indication. The drug alternation with the same target should be further specified. Conclusion： more communication is needed between clinicians and pharmacists in order to provide better personalized vancomycin therapy.