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我院ICU 298例次万古霉素血药浓度监测与临床用药分析
引用本文:时友忠,安洪亮,李泰平,程 敏. 我院ICU 298例次万古霉素血药浓度监测与临床用药分析[J]. 药学与临床研究, 2012, 20(6): 541-543
作者姓名:时友忠  安洪亮  李泰平  程 敏
作者单位:上海梅山医院药剂科,江苏南京,210039
摘    要:
目的:评价我院住院患者尤其是长期住院、反复感染及重症感染者万古霉素血药浓度监测及其临床用药情况。方法:采用HPLC法测定万古霉素血药浓度,并结合住院患者的临床资料(基础疾病、细菌学培养结果、万古霉素血药浓度值、疗效、肾功能情况等),对我院ICU 2007年1月~2011年12月间86例患者共298例次万古霉素血药浓度监测结果进行回顾性分析。结果:我院ICU住院患者应用万古霉素的总有效率为79.07%;合理使用率44.19%,基本合理使用率34.88%;药物利用指数(DUI)为0.66。血药浓度监测首次达标率45.35%。出现6例不良反应,其中2例为严重不良反应。结论:我院ICU住院患者万古霉素的使用基本合理,其血药浓度监测具有重要的临床意义;根据监测结果及时调整剂量,实现个体化给药,减少其不良反应发生率。

关 键 词:万古霉素  血药浓度监测  用药分析
收稿时间:2012-09-12
修稿时间:2012-09-19

Tharapeutic Drug Monitoring and Analysis of Clinical Vancomycin Using in 298 Cases
SHI You-zhong,AN Hong-liang,LI Tai-ping and CHENG Min. Tharapeutic Drug Monitoring and Analysis of Clinical Vancomycin Using in 298 Cases[J]. Pharmacertical and Clinical Research, 2012, 20(6): 541-543
Authors:SHI You-zhong  AN Hong-liang  LI Tai-ping  CHENG Min
Affiliation:Pharmacy Department of Shanghai Meishan Hospital,Nanjing,Jiansu 210039,China
Abstract:
Objective: To evaluate the serum concentration monitoring of vancomycin in our hospitalized patients especially with long-stay, repeated infection and/or serious illness and analyze their clinical drug use. Methods: Basic diseases, pathologic examinations, therapeutic efficacy, renal function, combined medication and side effects of 85 patients in our intensive care units (ICU) from 2007 to 2009, in addition to their 298 times of vancomcin serum concentration determinations by high performance liquid chromatography, were analyzed retrospectively. Results: The total effective rate of patients using vancomycin in ICUs was 81.40%. The rate of rational use was 44.19%. The drug utilization index (DUI) was 0.66. The rate of target vancomycin serum concentrations reached at first monitoring was 44.35%. There were six cases of adverse reactions, including two cases of serious adverse reactions. Conclusion: The utilization of vancomycin in this hospital generally met the requirement of related regulations. Whatever, therapeutic drug monitoring and adjusting the dosage according to the serum concentration, is necessary to realize personalized medicine and reduce the incidence of adverse reactions.
Keywords:Vancomycin   Therapeutic drug monitoring   Drug analysis
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