Guo Bo, Chen Hui, Song Xiao, Wei Zeyang, Zhao Kai, Liu Zhen-Guo
Department of Pharmacy, Northwest Women's and Children's Hospital, Xi'an, People's Republic of China.
Infect Drug Resist. 2025 Sep 6;18:4777-4787. doi: 10.2147/IDR.S537052. eCollection 2025.
Low initial trough concentrations of vancomycin (TCV) are prevalent among neonatal patients receiving this medication. Prior research has identified significant correlations between initial TCV and various clinical parameters, including postnatal age, gestational age, body weight, estimated glomerular filtration rate (eGFR), and serum albumin levels. However, few studies have addressed the relationship between C-reactive protein (CRP) and initial TCV in neonates. This study aimed to explore the correlation between CRP and initial TCV in a Chinese neonatal population.
A retrospective observational study was conducted on neonates who received intravenous vancomycin at Northwest Women's and Children's Hospital, China, from October 2018 to December 2023. Clinical characteristics and laboratory data were extracted from medical records, focusing on data obtained within 24 hours prior to the first vancomycin administration. The primary outcomes measured were CRP levels and initial TCV.
A total of 112 neonates with available therapeutic drug monitoring (TDM) data for intravenous vancomycin treatment were included. After adjusting for potential confounders, a non-linear relationship between CRP and initial TCV was identified, with an inflection point at 88.28 mg/L. The effect sizes and corresponding confidence intervals for the regions below and above this inflection point were 0.036 (95% CI: -0.005 to 0.078) and -0.084 (95% CI: -0.142 to -0.027), respectively.
A non-linear relationship between CRP and initial TCV was identified, with a negative correlation when CRP levels exceed 88.28 mg/L.
在接受万古霉素治疗的新生儿患者中，初始谷浓度（TCV）较低的情况很普遍。先前的研究已经确定初始TCV与各种临床参数之间存在显著相关性，包括出生后年龄、胎龄、体重、估计肾小球滤过率（eGFR）和血清白蛋白水平。然而，很少有研究探讨新生儿中C反应蛋白（CRP）与初始TCV之间的关系。本研究旨在探讨中国新生儿群体中CRP与初始TCV之间的相关性。
对2018年10月至2023年12月在中国西北妇女儿童医院接受静脉注射万古霉素的新生儿进行回顾性观察研究。从医疗记录中提取临床特征和实验室数据，重点关注首次使用万古霉素前24小时内获得的数据。测量的主要结局是CRP水平和初始TCV。
共纳入112例有静脉注射万古霉素治疗可用治疗药物监测（TDM）数据的新生儿。在调整潜在混杂因素后，确定了CRP与初始TCV之间的非线性关系，拐点为88.28mg/L。该拐点以下和以上区域的效应大小及相应置信区间分别为0.036（95%CI：-0.005至0.078）和-0.084（95%CI：-0.142至-0.027）。
确定了CRP与初始TCV之间的非线性关系，当CRP水平超过88.28mg/L时呈负相关。
