PDF(Pubmed)
Abstract：
Vancomycin is a frequently used antibiotic in intensive care units, and the patient\'s renal clearance affects the pharmacokinetic characteristics of vancomycin. Several advantages have been reported for vancomycin continuous intravenous infusion, but studies on continuous dosing regimens based on patients\' renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient\'s renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin administration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomycin serum concentration. Vancomycin serum concentration was affected by vancomycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = -1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R2 = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regimen for vancomycin.
摘要：
万古霉素是重症监护病房中经常使用的抗生素，患者的肾脏清除率影响万古霉素的药代动力学特征。已经报道了万古霉素连续静脉输注的几个优点，但基于患者肾清除率的连续给药方案研究不足.这项研究的目的是通过考虑患者的肾脏清除率来建立万古霉素血清浓度预测模型。在2021年7月1日至2022年7月31日期间进入我们机构并有连续输注万古霉素记录的儿童被纳入研究。性,年龄,高度,体重,万古霉素的重量剂量，从万古霉素给药开始到治疗药物监测采样的时间间隔，采用混合效应模型线性回归分析万古霉素血药浓度。使用万古霉素血清浓度作为因变量进行单变量回归分析。结果表明，万古霉素剂量（p<0.001）和血清肌酐（p=0.007）是对万古霉素血清浓度影响最大的因素。万古霉素血药浓度受万古霉素剂量(p<0.001)和血肌酐(p=0.001)影响有统计学意义,得到多元回归模型如下:万古霉素血清浓度(mg/l)=-1.296+0.281×万古霉素剂量(mg/kg)+20.458×血清肌酐(mg/dl)(调整后的测定系数,R2=0.66）。该预测模型有望有助于建立最佳的万古霉素连续输注方案。
