| JPKD软件在颅脑术后肾功能亢进病人万古霉素应用中的指导价值 |
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| 引用本文： | 刘晓玲,孙振国,胡冰.JPKD软件在颅脑术后肾功能亢进病人万古霉素应用中的指导价值[J].中国临床神经外科杂志,2022,27(12):974-976. |
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| 作者姓名： | 刘晓玲 孙振国 胡冰 |
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| 作者单位： | 221009江苏，徐州市中心医院药学部（刘晓玲、胡冰），神经外科（孙振国） |
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| 摘 要： | 目的 探讨JPKD群体药代动力学软件在颅脑术后肾功能亢进病人中的应用价值。方法 2021年1月至2022年1月前瞻性收治12例颅脑术后怀疑颅内感染且肾功能亢进病人，常规剂量（1 g，12 h/次）万古霉素治疗48 h，测定血药谷浓度，如果血药谷浓度<10 mg/L，则应用JPKD软件调整用药。结果 调整前，12例万古霉素稳态血药谷浓度<10 mg/L，根据JPKD软件调整用药，1例调整为利奈唑胺；其余11例调整后万古霉素稳态血药谷浓度为（15.93±1.30）mg/L。JPKD软件预估血药浓度为（14.12±2.13）mg/L，WRES值为14.49%，预测价值良好。JPKD软件调整给药后，8例治疗有效，1例治疗无效，1例应用万古霉素12 d病情平稳时转至当地医院治疗，1例因广泛耐药鲍曼不动杆菌感染停用万古霉素而改为多粘菌素B治疗。结论 常规剂量万古霉素（1 g，12 h/次）不适用颅脑术后肾功能亢进病人，JPKD软件可较好地协助调整万古霉素给药方案。
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| 关 键 词： | 颅脑手术 肾功能亢进 万古霉素 JPKD软件 血药浓度 |
Application of JPKD software to vancomycin treatment for patients with suspected intracranial infection associated with augmented renal clearance secondary to craniotomy |
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| LIU Xiao-ling,SUN Zhen-guo,HU Bing.Application of JPKD software to vancomycin treatment for patients with suspected intracranial infection associated with augmented renal clearance secondary to craniotomy[J].Chinese Journal of Clinical Neurosurgery,2022,27(12):974-976. |
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| Authors: | LIU Xiao-ling SUN Zhen-guo HU Bing |
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| Affiliation: | 1. Department of Pharmacy, Xuzhou Central Hospital, Xuzhou 221009, China; 2. Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou 221009, China |
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| Abstract: | Objective To explore the application value of JPKD software to vancomycin treatment for patients with suspected intracranial infection associated with augmented renal clearance (ARC) secondary to craniotomy. Methods Twelve patients with suspected intracranial infection associated with ARC secondary to craniotomy were prospectively selected. The serum minimum concentration of vancomycin was determined 48 h after the use of vancomycin treatment with a conventional dose (1 g, 12 h/time). If the serum minimum concentration was less than 10 mg/L, JPKD software was used to adjust the medication of vancomycin. Results Before adjustment, the serum minimum concentration of vancomycin was less than 10 mg/L in all the patients. One patient was adjusted to linezolid according to JPKD software. The concentration of vancomycin was (15.93±1.30) mg/L in the other 11 patients, whose serum concentration was (14.12±2.13) mg/L predicted by JPKD software, and the WRES value was 14.49% which showed good predictive value. Of 11 patients treated with vancomycin, 8 patients were cured, 1 was ineffective, 1 was transferred to a local hospital after vancomycin treatment for 12 days with a stable condition, and 1 was treated with polymyxin B instead of vancomycin due to extensively drug-resistant Acinetobacter baumannii infection. Conclusions The routine dose of vancomycin (1 g, 12 h/ time) is not suitable for patients with suspected intracranial infection associated with ARC secondary to craniotomy hyperrenal function after cranial. JPKD software can help to adjust the administration of vancomycin. |
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| Keywords: | Craniotomy Vancomycin JPKD software Augmented renal clearance Blood drug concentration |
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