我院万古霉素临床合理使用评价及血药浓度监测分析
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篇名: 我院万古霉素临床合理使用评价及血药浓度监测分析
TITLE:
摘要: 目的:为万古霉素临床合理使用提供参考。 方法:收集我院2015年1月-2016年6月使用万古霉素的299例患者的病历资料,对用药情况、用药合理性、病原学检查结果、万古霉素血药浓度、疗效、不良反应等指标进行统计分析。结果:我院住院患者应用万古霉素多为治疗用药,且以经验性治疗用药为主(90.30%);用药前样本送检率为61.82%,有52例(28.42%)患者检出特异病原菌。万古霉素用药不合理的有69例(23.08%),均为药物浓度不适宜。万古霉素血药浓度监测率为43.33%,谷浓度维持在10~20 mg/L的占40.00%;治疗有效率为79.39%;治疗后急性肾损伤的发生率为5.41%。结论:我院住院患者应用万古霉素前样本送检率和血药浓度监测率均偏低,有效血药谷浓度的患者比例亦低。医院应加强万古霉素的应用管理,促进临床个体化用药。
ABSTRACT: OBJECTIVE: To provide reference for rational use of vancomycin. METHODS: The medical records of 299 patients receiving vancomycin in our hospital during Jan. 2015-Jun. 2016 were collected and analyzed statistically in respects of drug use, medication rationality, etiological test results, blood concentration of vancomycin, therapeutic efficacy, adverse drug reaction, etc. RESULTS: Vancomycin was mostly used as therapy drug in our hospital, mainly empiric treatment (90.30%); detection rate of samples before medication was 61.82%, and specific pathogens were detected in 52 cases (28.42%). There were 69 cases of irrational drug use (23.08%), which were unsuitable drug concentration. Monitoring rate of vancomycin concentration was 43.33%; trough concentration remained at 10-20 mg/L, accounting for 40.00%. Response rate was 79.39%. The incidence of acute kidney injury was 5.41% after treatment. CONCLUSIONS: The examination rate before medication and blood concentration monitoring rate of vancomycin are in low level in our hospital. The patients with effective trough blood concentration accounts for low proportion. Clinical application management of vancomycin should be strengthened to promote individual medication.
期刊: 2017年第28卷第29期
作者: 刘小华,李茜,罗璨,任正
AUTHORS: LIU Xiaohua,LI Qian,LUO Can,REN Zheng
关键字: 万古霉素;疗效;谷浓度;肾损害
KEYWORDS: Vancomycin; Therapeutic efficacy; Trough concentration; Kidney injury
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