期刊文献+

重症患者管饲万古霉素后其血清谷浓度监测及影响因素 被引量:1

Surveillance and analysis of vancomycin trough concentration via feeding tube in critically Ⅲ patients
原文传递
导出
摘要 目的研究耐甲氧西林金黄色葡萄球菌(MRSA)肠炎或伪膜性肠炎重症患者管饲万古霉素后期血清谷浓度范围及变化,分析患者病情严重程度和肾功能等因素对管饲万古霉素的血清谷浓度水平的影响。方法收集2017年1月31日至2018年1月31日于重症监护室(ICU)住院治疗的12例MRSA或伪膜性肠炎并管饲万古霉素患者的临床资料,进行回顾性分析。结果最终纳入10例患者,20次血清谷浓度监测结果,其中85%的血清谷浓度<5mg·L^-1。性别、年龄、疾病严重程度、连续肾脏替代疗法(CRRT)、初始剂量和肾功能对患者万古霉素血清谷浓度的影响均无统计学意义(P>0.05)。结论管饲万古霉素治疗MRSA肠炎或伪膜性肠炎,生物利用度低,需要警惕因肠道黏膜损坏导致的万古霉素的全身吸收。患者基础状况对管饲万古霉素血清谷浓度无较大影响。随着病情好转,万古霉素血清谷浓度逐渐下降。 AIM To study the range and variation of trough level of vancomycin administered via feeding tube in critical ill patients with methicillin-resistant Staphylococcus ( MRSA ) or Pseudomembranous enteritis, and to assess the effects of disease severity and renal function on the serum concentration of vancomycin. METHODS Retrospective analysis was carried out in intensive care unit (ICU) including 12 patients with MRSA or Pseudomem-branous enteritis, from January 31, 2017 to January 31, 2018. RESULTS The 20 vancomycin trough levels from 10 patients were included, with 85% of the readings less than 5 mg·L^-1. No statistically significant difference was found in vancomycin trough level among patients of different gender, age, severity of disease, continuous renal replacement therapy ( CRRT), initial dose and renal function. CONCLUSION Despite the low bioavailability of vankncomycin via feeding tube, cautions should still be taken in case of systemic absorption due to intestinal mucus damage. Patients' baseline disease status was not associated significantly with vancomycin trough level. However, as disease status improved, vancomycin concentration shows the trend to decrease gradually.
作者 陈晨 徐颖 孙秋艳 罗小丽 梁培 CHEN Chen;XU Ying;SUN Qiuyan;LUO Xiaoli;LIANG Pei(Department of Pharmacy,Chongqing Three Gorges Central Hosptial,Chongqing 404100,China;Intensive Care Unit,Nanjing Drum Tower Hospital,Nanjing 210008 ,China;Department of Pharmacy,Nanjing Drum Tower Hospital,Nanjing 210008 ,China)
出处 《中国临床药学杂志》 CAS 2019年第3期209-212,共4页 Chinese Journal of Clinical Pharmacy
关键词 重症患者 万古霉素 管饲 血清谷浓度 critical ill patient vancomycin tube fedding serum trough concentration
  • 相关文献

参考文献1

二级参考文献15

  • 1Christie CD, Lynch-Ballard E, Andiman WA.Staphylococcal en- terocolitis revisited : cytotoxic properties of staphylococcus aure- us from a neonate with enterocolitis [J].Pediatr Infect Dis, 1988, 7 : 791-795.
  • 2Takesue Y, Yokoyama T, Kodama T, et al. A study on post-oper- ative enteritis caused by methicillin resistant Staphylococcus au-reus [J].Surg Today, 1993,23(1): 4-8.
  • 3Boyce JM, Havill NL. Nosocomial antibiotic-associated diarrhea associated with enterotoxin-producing strains of methicillin-re- sistant Staphylococcus aureus [ J ].Am J Gastroenterol, 2005,100 (8): 1828-1834.
  • 4Lo TS, Borchardt SM. Antibiotic-associated diarrhea due to methicillin-resistant Staphylococcus aureus [J].Diagn Microbiol Infect Dis, 2009,63(4): 388-389.
  • 5Takeuchi K, Tsuzuki Y, Ando T, et al. Clinical studies of enteri- tis caused by methicillin-resistant Staphylococcus aureus [J]. Eur J Surg, 2001,167(4): 293-296.
  • 6Konishi T, Idezuki Y, Knbayashi H, et al. Oral vancomycin hy- drochloride therapy for postoperative Methicillin-cephem-resis- rant Staphylococcus aureus enteritis [J].Surg Today, 1997, 27: 826-832.
  • 7Ruddell WS, Losowsky MS. Severe diarrhea due to small intesti- nal colonization during cimetidine treatment [J].BMJ, 1980, 281 (6235) : 273.
  • 8Garner JS.Guideline for isolation precautions in hospitals.The Hospital Infection Control Practices Advisory Committee [J].In- fect Control Hosp Epidemiol, 1996,17:53-80.
  • 9Kodama T, Santou T, Yokoyama T, et al. Postoperative enteritis caused by methicillin-resistant staphylococcus aureus [J].Surg Today, 1997,27 : 816-825.
  • 10van Nood E, Vrieze A, Nieuwdorp M, et al.Duodenal infusion of donor feces for recurrent Clostridium difficile[J].N Engl J Med, 2013,368(5) :407-415.

共引文献3

同被引文献15

引证文献1

二级引证文献1

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部