Correlation of the steady-state minimal concentration with AUC24/MIC of vancomycin and analysis of risk factors for treatment failure in pediatric patients
- VernacularTitle:儿童患者万古霉素稳态血药浓度谷值与AUC24/MIC的相关性及治疗失败的危险因素分析
- Author:
Jinxiang LIN
1
;
Youhong WANG
1
;
Zhifeng XIAO
1
;
Jing WANG
1
;
Ying SONG
1
;
Ningfang CAI
1
;
Xiuping WU
1
Author Information
1. Dept. of Pharmacy，Xiamen Children’s Hospital/Children’s Hospital of Fudan University at Xiamen，Fujian Xiamen 361006，China
- Publication Type:Journal Article
- Keywords:
vancomycin;
steady-state minimal concentration;
24 h area under the drug concentration-time curve;
minimal
- From:
China Pharmacy
2025;36(9):1093-1098
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.
