血药浓度监测指导下的51例替考拉宁用药分析

Analysis of 51 Cases of Teicoplanin Administration under the Guidance of Blood Drug Concentration Monitoring

目的:探讨替考拉宁合理的给药方式及进行血药浓度监测(TDM)的必要性。方法:对使用替考拉宁治疗的51例患者的临床资料进行回顾性分析,按负荷给药方式和剂量不同,分为两组,A组:负荷量头三剂400 mg,ivgtt,每12 h给药一次。B组:负荷量头三剂200 mg,ivgtt,每12 h给药一次。所有患者在第4 d用药前30 min采集血样,应用HPLC法进行血药谷浓度(C_(min))监测。结果:C_(min)和负荷给药剂量及疗效相关。使用A组负荷剂量的患者C_(min)要明显高于使用B组负荷剂量的患者(P<0.05),对C_(min)监测患者进行剂量调整后,治疗效果好,且不良反应发生率低。结论:使用替考拉宁时,要规范负荷剂量,且有必要进行TDM监测,根据结果调整给药剂量,避免替考拉宁疗效不佳或发生不良反应。

Objective： To study the necessity of therapeutic drug monitoring（TDM） and the reasonable dose of teicoplanin. Methods： The clinical data of 51 patients who suffered from severe G＋ infection and were treated with teicoplanin were retrospectively analyzed. According to the different loading modes and doses, patients were divided into two groups; group A（400 mg for the first three times, ivgtt, q12 h）, group B（200 mg for the first three times, ivgtt, q12 h）. The bloods samples were collected at 30 min the 4th day before administration, The C_（min） of teicoplanin was measured by means of HPLC. Results： The C_（min） of teicoplanin was closely related to the loading dose and therapeutic effect of patients. The C_（min） of patients in group A was higher than the patients in group B（P0.05）. Clinical effect of patients was good after adjustments of maintenance dose according to the results of C_（min）. The incidence of adverse reactions was low. Conclusion： A regular initial loading dose of teicoplanin made it possible to rapidly attain an optimal administration dose. It is necessary for patients treated with teicoplanin to adjust dose based on the result of TDM so as to avoid low efficacy or occurrence of side effect.