替考拉宁在老年和非老年人群中血药浓度的影响因素研究

目的分析替考拉宁在不同患者人群中的血药浓度达标率、安全性和有效性。方法回顾性分析南京鼓楼医院2016年6月—2018年1月使用替考拉宁的195例患者,按患者人群特点分为老年人和非老年人组,分析两组人群血药浓度达标情况、临床疗效、细菌清除率和影响谷浓度的主要相关因素。结果 195例患者共302例次血药谷浓度监测结果,其中老年人113例,谷浓度达标率34.58%,临床有效率75.22%;非老年人82例,谷浓度达标率13.16%,临床有效率71.95%;两组间谷浓度达标率差异具有统计学意义(P0.05),而临床有效率差异无统计学意义。此外,内生肌酐清除率(CCr)是影响老年人谷浓度达标的主要因素;血肌酐和是否合并其他抗菌药是影响非老年人谷浓度达标的主要因素。结论按替考拉宁说明书进行给药,老年患者目标谷浓度更易达标,且要根据患者CCr来调整给药剂量;非老年患者可根据血肌酐或减少合用影响替考拉宁代谢的抗菌药来提高替考拉宁的谷浓度。

Influencing factors of plasma teicoplanin concentration of in elderly and non-elderly population

Objective To evaluate the serum trough concentration, safety, and efficacy of teicoplanin in different populations. Methods Patients (195 cases) who took teicoplanin from June 2016 to January 2018 were enrolled in a retrospective study and were divided into elderly and non-elderly groups according to patient characteristics, then analyze the serum trough concentration, clinical efficacy, bacterial clearance rate, and the main factors affecting the serum concentration. Results A total of 302 cases of serum trough concentration and 113 patients were elderly. The rate of effective serum trough concentration of the elderly was 34.58%, clinically effective rate was 75.22%. And 82 patients were non-elderly, and the rate of effective serum trough concentration was 13.16%, clinically effective rate was 71.95%. There was a statistically significant difference in the rate of serum trough concentration between the two groups (P<0.05), but the difference in clinical effective rate was not statistically significant. In addition, creatinine clearance (CCr) was the main factor affecting the serum trough concentration of the elderly. Serum creatinine and whether or not combined with other antibacterials were the main factors affecting the serum trough concentration of the non-elderly. Conclusion According to the instructions of the teicoplanin, the target trough concentration is more easily achieved in the elderly, and the dosage should be adjusted according to the patient''s CCr. The non-elderly can adjust the dosage regimen based on serum creatinine or reduce the use of antibacterial agents that affects the metabolism of teicoplanin.