Objective: To explore the effects of albumin levels on blood concentration of vancomycin in children with hypoalbuminemia

so as to provide reference for individualized therapy in children with hypoproteinemia. Methods: Clinical data of 65 children with blood concentration monitoring of vancomycin in Sichuan Zigong First People’s Hospital from May 2016 to May 2019 were collected. According to different albumin levels

all patients were divided into the hypoalbuminemia group (30 cases with albumin levels <30 g/L) and the normal control group (35 cases with albumin levels ≥30 g/L). The albumin levels and valley concentration of vancomycin in two groups were observed

and the effects of different ages on the monitoring results of blood concentration of vancomycin and proportion of the fifth drug concentration in the treatment window were recorded. Multiple linear regression was used to analyze the correlation between albumin levels and blood concentration of vancomycin in children

and the occurrence of adverse drug reactions were observed. Univariate analysis and multivariate Logistic regression were used to analyze the factors associated with non-attainment of blood drug concentration. Results: The mean albumin levels and valley concentration of vancomycin in the hypoproteinemia group were lower than those in the normal control group (P<0.05). The difference in valley concentration of vancomycin between two groups of children ≤28 d

from 29 d to 1 year old

>1 to 3 years old

>3 to 6 years old

and >6 to 12 years old was statistically significant (P<0.05). The valley concentration of vancomycin in the hypoalbuminemia group of children >3 to 6 years old

>6 to 12 years old was lower than that in the normal control group (P<0.05). The proportion of valley concentration of vancomycin within the treatment window was 26.67% (8/30) in the hypoalbuminemia group and 42.86% (15/35) in the normal control group

the difference was not statistically significant (P>0.05). Spearman correlation analysis showed the positive correlation between albumin levels and blood concentration of vancomycin in children (P<0.05). There were 7 cases of children had elevated liver enzymes

3 cases of skin rash

and 2 cases of leukopenia. Multivariate logistic regression analysis showed that irrational drug usage and dosage

complicated with underlying diseases were independent risk factors for non-attainment of blood drug concentration of vancomycin (P<0.05). Conclusion: Children with hypoproteinemia are affected by multiple factors

and the blood concentration of vancomycin varies greatly among individuals. Clinical monitoring of blood concentration in children with hypoproteinemia should be actively performed to adjust the administration.