儿童万古霉素血药浓度分析及给药方案探讨

The Analysis of Plasma Concentration of Vancomycin in Children and Related Dosing Regimen

目的分析某三甲医院儿童万古霉素血药浓度分布情况,并分析按照说明书的给药方案是否能达到目标血药浓度。方法采用回顾性调查方法,对2014年送检的70例次儿童万古霉素血药浓度标本的临床资料进行统计,分析其谷浓度分布情况,与临床疗效的关系,并与有关因素进行相关性分析。结果 75.72%的患儿万古霉素血药谷浓度未处于10~20mg·L^-1的目标浓度区间。患儿的肝肾功能以及是否按说明书给药是影响其血药谷浓度是否达标的重要因素。结论目前临床的儿童万古霉素给药方案或许存在治疗不足的风险,儿童在应用万古霉素治疗过程中应常规检测血药浓度。

OBJECTIVE To investigate the plasma concentration of vancomycin in paediatric patients,and analyse whether the target plasma concentrations to be achieve in accordance with the instructions of dosing regimen. METHODS A retrospective study was used to count the clinical data of 70 cases of children for plasma concentration of vancomycin in 2014. The concentration distribution,the relationship with clinical efficacy and the relevant factors were analysed. RESULTS 75. 72% of plasma concentration of vancomycin in children weren＇ t in the target concentration range（ 10 ~ 20mg·L^-1）. The liver and kidney function in children as well as whether the drug administration according to the instructions were important factors to affect plasma concentration. CONCLUSION The results suggest that the current clinical children vancomycin treatment regimen may be inadequate and plasma concentration should be routinely detected during treatment with vancomycin.