万古霉素对老年人肾功能的影响

目的：观察万古霉素对老年人肾功能的影响。方法：25例老年严重感染患者，每天予万古霉素0.5-2.0g，分1－2次iv gtt，平均疗程9d，治疗前后观察血清肌酐，血尿素氮，尿酸和内生肌酐清除率的变化。结果：24例患者在应用万古霉素前后血清肌酐，血尿素氮，尿酸，内生肌酐清除率的变化无显著性差异（P＞0．05），仅1例患者出现急性肾功能衰竭。结论：老年人应用万古霉素大多数是安全的，应根据内生肌酐清除率调整用药剂量，进行血药浓度监测，谨慎与袢利尿剂合用。

Effects of vancomycin on the renal function in elderly patients

AIM: To observe the effect of vancomycin on the renal function in the aged. METHODS: Twenty five cases of severely infected elderly patients were treated with vancomycin 0 5-2 g once or twice daily intravenously, for qd averagely, the variations of renal function before and after treatment were observed. RESULTS: Among 24 cases there were no changes in blood urea nitrogen, serum creatinine, uric acid, and creatinine clearance before and after treatment with vancomycin. But acute renal failure was occurred in only one case. CONCLUSION: Vancomycin is safe to most of the elderly patients. It is advised to adjust the dosage according to endogenous creatinine clearance, monitor blood concentration of the drug, avoid combination with loop diuretic.