Consistency evaluation of steady-state blood trough concentration of vancomycin and area under blood concentration time curve/minimum inhibitory concentration
10.3760/cma.j.cn114015-20240701-00502
- VernacularTitle:万古霉素稳态血药谷浓度与血药浓度-时间曲线下面积/最小抑菌浓度的一致性评价
- Author:
Yuyan LIU
1
;
Li JIANG
1
;
Ran LOU
1
;
Meiping WANG
1
Author Information
1. 首都医科大学宣武医院重症医学科，北京 100053
- Publication Type:Journal Article
- Keywords:
Vancomycin;
Area under curve;
Drug monitoring;
Acute kidney injury;
Plasma concentration;
Minimum inhibitory concentration
- From:
Adverse Drug Reactions Journal
2025;27(7):403-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the consistency of steady-state blood trough concentration of vancomycin and minimum inhibitory concentration to the area under the serum concentration-time curve (AUC/MIC) and promote the rational use of vancomycin.Methods:It was a single center retrospective study. The clinical data of patients admitted to Xuanwu Hospital, Capital Medical University from January 1, 2019 to December 31, 2020, who were treated with vancomycin and met the inclusion criteria, were collected. Vancomycin calculator was used to calculate AUC/MIC. According to the steady-state blood trough concentration and AUC/MIC standards, the patients were divided into not meeting standard group, meeting standard group, and exceeding standard group, respectively. The standard-reaching status of steady-state blood trough concentration and AUC/MIC in each group was evaluated, as well as the consistency in patients under the 2 different grouping methods. The patients who met the AUC/MIC standard were divided into not meeting standard group, meeting standard group, and exceeding standard group based on steady-state blood trough concentration. The anti-infection efficacy and incidence of vancomycin-associated acute kidney injury (VA-AKI) were evaluated between the different groups to assess clinical effectiveness and safety.Results:A total of 153 patients were included in the study. Among them, 98 (64.1%) patients were male, with age of 61.0 (53.0, 73.0) years, body mass index of 23.9 (21.5, 27.0) kg/m 2, creatinine clearance rate of 107.2 (84.1, 147.0) ml/min, and acute physiology and chronic health evaluationⅡscore of 9.0 (6.0, 14.0) points. Among the 153 patients, the AUC/MIC and steady-state blood trough concentration did not meet standards in 86 cases, met the standards in 17 cases, and exceeded the upper limit of the standards in 14 cases; the results were consistent in 117 cases for both methods, and the consistency rate was 76.5%; the results were inconsistent in 36 patients (23.5%). Among the 36 patients, the steady-state blood trough concentration did not meet the standard in 34 cases [with initial steady-state blood trough concentration of 13.9 (12.8, 14.4) mg/L], while the AUC/MIC met the standard [437 (420, 471)]. AUC/MIC met the standard in 51 patients (33.3%), of which 34 had the steady-state blood trough concentration of less than 15.0 mg/L, and 17 had the concentration of 15.0-20.0 mg/L; the efficacy of anti-infection was 88.2% and 13/17, respectively, the incidence of VA-AKI was 2.9% and 1/17, respectively; the difference was not significant (all P>0.05). No patients had the steady-state blood trough concentration over than 20.0 mg/L. Conclusions:The consistence between steady-state trough concentration of vancomycin and AUC/MIC is 76.5%, which is acceptable. For those who meet the AUC/MIC standard for vancomycin, even if the steady-state blood trough concentration is less than 15.0 mg/L, as long as the AUC/MIC meets the standard, the efficacy and safety can be guaranteed.
