Chen Jihui, Huang Xiaohui, Lin Zhiyan, Li Chao, Ding Haoshu, Du Junming, Li Lixia
Department of Pharmacy, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Anesthesiology and SICU, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Pharmacol. 2021 Dec 9;12:763575. doi: 10.3389/fphar.2021.763575. eCollection 2021.
There are limited pharmacokinetic (PK) studies on vancomycin in patients treated with continuous renal replacement therapy (CRRT), and the results have been inconsistent. Because of individual differences, proposing a definite recommendation for the clinical regimen is not possible. Rapidly reaching target vancomycin concentrations will facilitate effective treatment for critically ill patients treated with CRRT. In this study, to understand the dynamic change in drug clearance rates , analyze the effect of PK changes on drug concentrations, and recommend loading and maintenance dosage regimens, we monitored the blood concentrations of vancomycin and calculated the area under the curve in two critically ill patients treated with vancomycin and continuous veno-venous hemofiltration (CVVH). On the basis of real-time therapeutic drug monitoring results and PK parameters, an individualized vancomycin regimen was developed for patients with CVVH. Good clinical efficacy was achieved, which provided support and reference for empirical vancomycin therapy in these patients.
对于接受持续肾脏替代治疗（CRRT）的患者，有关万古霉素的药代动力学（PK）研究有限，且结果并不一致。由于个体差异，无法为临床治疗方案提出明确建议。快速达到万古霉素目标浓度将有助于对接受CRRT治疗的重症患者进行有效治疗。在本研究中，为了解药物清除率的动态变化、分析PK变化对药物浓度的影响并推荐负荷剂量和维持剂量方案，我们监测了两名接受万古霉素和持续静脉-静脉血液滤过（CVVH）治疗的重症患者的万古霉素血药浓度，并计算了曲线下面积。基于实时治疗药物监测结果和PK参数，为接受CVVH治疗的患者制定了个体化的万古霉素治疗方案。取得了良好的临床疗效，为这些患者的万古霉素经验性治疗提供了支持和参考。
