Cho Hundo, Lee Suna, Sheen Seungsoo, Choi Young Hwa
Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea.
Department of Pharmacy, Ajou University Medical Center, Suwon, Korea.
Infect Chemother. 2020 Mar;52(1):48-58. doi: 10.3947/ic.2020.52.1.48. Epub 2020 Jan 21.
To identify the differences in the vancomycin pharmacokinetics between multiple trauma patients and medically ill patients in the intensive care unit (ICU) stratified by the use of continuous renal replacement therapy (CRRT), and the factors affecting vancomycin clearance ().
All the included patients received at least three consecutive doses of vancomycin, then, therapeutic drug monitoring was conducted. Patients' serum vancomycin trough levels and other clinical variables were identified retrospectively. The vancomycin pharmacokinetics and associated factors were compared and analyzed between trauma ICU (TICU) and medical ICU (MICU) patients.
In the non-dialyzed group, the was higher among the TICU patients than the MICU patients. However, in the continuous renal replacement therapy group, there was no significant difference in the between the multiple trauma and medically ill patients. The only factor associated with in the non-dialyzed group was creatinine clearance; none of the factors was associated with in the CRRT group.
In the case of non-dialyzed patients in the TICU, vancomycin dosages must be adjusted, depending on the patient's actual body weight changes. In the case of patients undergoing CRRT in both ICUs, vancomycin can be infused with fixed doses regardless of the patients' characteristics.
识别重症监护病房（ICU）中多发伤患者和内科疾病患者在使用连续性肾脏替代治疗（CRRT）分层情况下万古霉素药代动力学的差异，以及影响万古霉素清除率的因素。
所有纳入患者接受至少连续三剂万古霉素治疗，然后进行治疗药物监测。回顾性确定患者的血清万古霉素谷浓度及其他临床变量。比较并分析创伤ICU（TICU）和内科ICU（MICU）患者的万古霉素药代动力学及相关因素。
在未进行透析的组中，TICU患者的[此处原文缺失具体指标]高于MICU患者。然而，在连续性肾脏替代治疗组中，多发伤患者和内科疾病患者之间的[此处原文缺失具体指标]无显著差异。在未进行透析的组中，与[此处原文缺失具体指标]相关的唯一因素是肌酐清除率；在CRRT组中，没有因素与[此处原文缺失具体指标]相关。
对于TICU中未进行透析的患者，必须根据患者实际体重变化调整万古霉素剂量。对于两个ICU中接受CRRT的患者，无论患者特征如何，万古霉素均可采用固定剂量输注。
