基于新指南的新生儿万古霉素谷浓度达标率分析

Compliance Rate of Vancomycin Trough Concentrations in Neonates Based on New Guideline

目的:评估新生儿在不同指南推荐目标谷浓度下万古霉素谷浓度分布情况及达标率,探讨提高达标率的可能性,为临床调整给药方案提供参考。方法:回顾性分析2016年11月至2021年3月厦门大学附属妇女儿童医院新生儿科接受万古霉素治疗的128例新生儿临床资料,评估不同给药方案及给药间隔的万古霉素谷浓度达标率。结果:128例患儿中,万古霉素目标谷浓度为5~15 mg/L时达标率56.25%(72例),目标谷浓度为10~20 mg/L时达标率50.78%(65例)。早产儿和足月儿万古霉素谷浓度达标率比较差异无统计学意义。按药品说明书推荐方案给药和其他给药方案万古霉素血药谷浓度达标率比较差异无统计学意义。万古霉素目标谷浓度为5~15 mg/L时,给药间隔12小时组达标率(68.18%)高于给药间隔8小时组(43.55%)。结论:基于新指南推荐的新生儿万古霉素目标谷浓度为5~15 mg/L,既往新生儿经验给药方案可能需重新调整以提高目标谷浓度达标率。

Objective:To evaluate the distribution and compliance rate of vancomycin trough concentrations in neonates under different guidelines recommended,explore the possibility of improving the compliance rate,so as to provide references for clinical adjustment of dosing regimens.Methods:Clinical data of 128 neonates received vancomycin treatment admitted into the Neonatology Department of Women and Children’s Hospital Affiliated to Xiamen University from Nov.2016 to Mar.2021 were retrospectively analyzed,and the compliance rate of vancomycin trough concentrations in different dosing regimens and dosing intervals was evaluated.Results:Among 128 infants,when the goal trough concentration of vancomycin was from 5 to 15 mg/L,the compliance rate was 56.25%(72 cases),and when the goal trough concentration was from 10 to 20 mg/L,the compliance rate was 50.78%(65 cases).There was no significant difference in compliance rate of vancomycin trough concentrations between premature and term neonates.There was no significant difference in compliance rate of vancomycin trough concentrations between dosing regimen recommended according to the drug instructions and other dosing regimens.When the goal trough concentration of vancomycin was from 5 to 15 mg/L,the compliance rate of 12-h interval group(68.18%)was significantly higher than that of 8-h interval group(43.55%).Conclusion:Based on the goal trough concentration of vancomycin in neonates recommended by the new guideline(from 5 to 15 mg/L),the previous empiric dosing regimens for neonates may need to be readjusted to improve the compliance rate of goal trough concentration.