Therapeutic drug monitoring of vancomycin in children after liver transplantation
10.3760/cma.j.issn.1673-4912.2021.09.007
- VernacularTitle:肝移植术后患儿万古霉素浓度监测
- Author:
Jing BAI
1
;
Jin LIN
;
Mengya ZHAO
;
Haizhou ZHUANG
;
Meili DUAN
Author Information
1. 首都医科大学附属北京友谊医院重症医学科 100050
- Keywords:
Vancomycin;
Liver transplantation;
Children;
Therapeutic drug monitoring
- From:
Chinese Pediatric Emergency Medicine
2021;28(9):777-780
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the vancomycin dose, therapeutic drug monitoring(TDM) situation and therapeutic effect of children after liver transplantation.Methods:A retrospective analysis of the data of 98 children who received intravenous vancomycin treatment after liver transplantation were conducted in the Department of Critical Care Medicine of Beijing Friendship Hospital from January 2017 to June 2019, including demographic data, vancomycin dose, serum trough concentration, drug-related adverse reactions and clinical outcome data.Results:A total of 98 children received intravenous vancomycin treatment and at least one steady-state TDM blood sample was collected.Among them, 53 cases (54.1%) were male, and the median age was 9 months(5 months to 14 years old). The median first daily dose of vancomycin treatment was 50(30-60)mg/(kg·d), and the median duration of treatment was 14(3-54)days.Only 27.5%(27/98)of the children′s initial trough concentration reached the target concentration (10-20 mg/L), while 26 cases(26.5%) did not reach the target after adjusting the treatment.Six children(6.1%)had renal toxicity caused by vancomycin, and two children had skin rash.The effective treatment rate accounted for 51.7%(15/29). The initial trough concentrations of vancomycin in the effective and ineffective groups were(5.92±3.82)mg/L and(10.43±5.37)mg/L, respectively.The difference was statistically significant ( P=0.041). Conclusion:The rate of intravenous vancomycin in children after liver transplantation is low, and the dose needs to be adjusted individually.
