The factors influencing serum trough concentration of vancomycin in pediatric patients with severe gram-positive cocci pneumonia
10.3969/j.issn.1000-3606.2017.06.007
- VernacularTitle:革兰阳性球菌重症肺炎患儿万古霉素血药谷浓度影响因素分析
- Author:
Yuanyuan LI
;
Guangli ZHANG
;
Xiaoyin TIAN
;
Huan MA
;
Lin TANG
;
Qiyu ZHANG
;
Yuntao JIA
;
Zhengxiu LUO
- Keywords:
severe pneumonia;
vancocymin;
serum trough concentration;
child
- From:
Journal of Clinical Pediatrics
2017;35(6):421-424
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors influencing serum trough concentration of vancomycin in pediatric patients with severe gram-positive cocci pneumonia. Methods The general information, the biochemical test results, and plasma concentration of vancomycin were collected from 93 pediatric patients with severe gram-positive cocci pneumonia. The relative factors influencing trough concentration of vancomycin were analyzed retrospectively. Results With the dosage of 40-60 mg/(kg·d), serum trough concentration of vancomycin were between 10-20 mg/L in 26 patients, <10 mg/L in 54 cases, ≥20 mg/L in 13 cases. The ALT, AST, GFR, and γ-GT were significantly different among three groups (P<0.05); the 10-20 mg/L group had the highest levels of AST and γ-GT, the ≥20 mg/L group had the highest level of ALT and the lowest level of GFR. Multiple linear regression analysis showed that GFR was negatively linearly correlated with the serum trough concentration of vancomycin (R2=0.039, P<0.05). The median serum trough concentration of vancomycin in pediatric patients with GFR≥90, 60–90, 30–60 mL/(min·1.73m2) were 8.66, 18.21, 8.45 mg/L respectively, and the difference is statistically significant (P<0.05). Conclusions The serum trough concentration of vancomycin is negatively linearly correlated with GFR in pediatric patients with severe gram-positive cocci pneumonia. The patients with impaired renal function are easier to reach the target serum trough concentration of vancomycin. Clinical use of vancomycin should follow the low doses in the range the guideline recommended, and the serum trough concentration should be closely monitored.
