Pharmaceutical care in a patient with severe pneumonia and augmented renal clearance based on therapeutic drug monitoring of vancomycin
10.13699/j.cnki.1001-6821.2024.23.019
- VernacularTitle:基于万古霉素治疗药物监测的重症肺炎伴肾功能亢进患者的药学监护
- Author:
Yan-ying HAN
1
;
Na HE
;
Ying-qiu YING
;
Yi-peng DU
;
Jia-jia ZHENG
;
Ning SHEN
Author Information
1. 北京大学第三医院,药学部,北京 100191;北京大学,治疗药物监测和临床毒理中心,北京 100191;国家药品监督管理局仿制药研究与评价重点实验室,北京 100191
- Publication Type:Journal Article
- Keywords:
vancomycin;
therapeutic drug monitoring;
severe pneumonia;
augmented renal clearance;
pharmaceutical care
- From:
The Chinese Journal of Clinical Pharmacology
2024;40(23):3458-3461
- CountryChina
- Language:Chinese
-
Abstract:
A case of a patient with severe pneumonia was detected Staphylococcus aureus(carrying the mecA gene)by both blood and sputum metagenomic next-generation sequencing.The initial treatment regimen was vancomycin 1 g,q12 h,intravenous infusion,which failed to achieve the desired therapeutic effect,steady state trough vancomycin serum concentration was 1 μg·mL-1.After consultation with a clinical pharmacist,it was considered that the patient's augmented renal clearance led to increased drug clearance,resulting in a low blood concentration of vancomycin at conventional doses.After elevating the dosage to 1 g q6 h,the patient achieved target serum concentrations and marked clinical improvement.Continuous monitoring of serum vancomycin concentration and optimization of dosing regimen were performed.Ultimately,the patient's condition improved significantly and was discharged from the hospital.
