万古霉素血药浓度低于目标治疗浓度因素分析及给药方案优化

Factor Analysis of Substandard Vancomycin Blood Concentration and Optimization of Dosage Regimen

万古霉素是临床用于治疗严重革兰阳性菌感染的一线用药,其药物动力学特性受多因素的影响,药动学参数个体差异较大,在临床应用中常出现血药浓度偏低。为优化万古霉素的临床应用,本文检索文献,总结部分特殊群体中导致万古霉素血药浓度偏低的因素并给出相关剂量调整建议。总的来说,可通过给予个体化的负荷剂量、采取缩短给药间隔或持续输注的后续给药方式、结合贝叶斯法监测AUC等方式来优化万古霉素给药。

Vancomycin is the first-line treatment for severe Gram-positive bacteria infections. Its pharmacokinetic characteristics are affected by many factors, and the pharmacokinetic parameters vary greatly among individuals. To optimize the clinical use of vancomycin, the factors that contribute to vancomycin low blood concentrations in some specific populations were summarized, and recommendations were provided for dose adjustment. In general, vancomycin administration can be optimized by giving individualized loading doses, performing follow-up administration such as shortening the interval of administration or continuous infusion, and monitoring AUC by Bayesian method.