LIU Yunning, LI Xiaofeng, TANG Jianhua, et al. Blood Trough Concentration Monitoring and Efficacy of Vancomycin in the Treatment of Methicillin-Resistant Staphylococcus aureus Infection. [J]. 22(9):1093-1097(2022)
DOI:
LIU Yunning, LI Xiaofeng, TANG Jianhua, et al. Blood Trough Concentration Monitoring and Efficacy of Vancomycin in the Treatment of Methicillin-Resistant Staphylococcus aureus Infection. [J]. 22(9):1093-1097(2022) DOI: 10.14009/j.issn.1672-2124.2022.09.016.
Blood Trough Concentration Monitoring and Efficacy of Vancomycin in the Treatment of Methicillin-Resistant Staphylococcus aureus Infection
OBJECTIVE: To explore the blood trough concentration monitoring and efficacy of vancomycin in the treatment of methicillin-resistant Staphylococcus aureus(MRSA) infection
and to probe into the relationship between blood trough concentration and clinical efficacy. METHODS: Totally 362 patients with MRSA infection admitted into this hospital from Jan. 2020 to Aug. 2021 were selected and treated with vancomycin
the distribution of the first measurement of blood trough concentration was collected
the influencing factors of blood trough concentration of vancomycin was analyzed
the efficacy and incidence of adverse drug reactions in patients with different blood trough concentrations were compared
the medication regimen was adjusted according to the blood trough concentration of vancomycin. RESULTS: Of the 362 patients with MRSA infection treated with vancomycin
40.33%(146 cases)of the first detection of blood trough concentration were in the target concentration range; results of the orderly multi-classification logistic regression model analysis showed that age
body mass index
renal insufficiency
menstruum of 0.9% sodium chloride injection
combined application of meropenem
and the rationality of therapeutic regimen were the influencing factors of blood trough concentration of vancomycin in patients with MRSA infection(P<0.05); with the increase of blood trough concentration
the treatment efficiency tended to increase
and the treatment efficiency of those with blood trough concentration >20 mg/L was higher than that of those with blood trough concentration <10 mg/L
with statistically significant difference(P<0.05); with the increase of blood trough concentration
the incidence of adverse drug reactions tended to increase
and the incidence of those with blood trough concentration >20 mg/L was higher than that of those with blood trough concentration <10 mg/L and 10-20 mg/L
with statistically significant difference(P<0.05)
and the difference in the incidence of renal impairment was particularly significant. 31 patients with blood trough concentration of vancomycin <10 mg/L and ineffective treatment who had adjusted the medication regimen were retested
of which 26 patients had reached the target trough concentration; 21 patients with trough concentrations >20 mg/L and effective treatment who had adverse drug reactions were relieved after withdrawl
16 patients with trough concentrations >20 mg/L and ineffective treatment who were given other drugs. CONCLUSIONS: The treatment of MRSA infection with ancomycin varies significantly on individual basis
especially for special groups such as children
elderly
obese
and renal insufficiency
blood concentration monitoring needs to be strengthened
and the medication regimen should be adjusted according to the blood concentration monitoring results
so as to improve the therapeutic effect while ensuring therapeutic safety.