Freeman C D, Quintiliani R, Nightingale C H
Department of Pharmacy Practice, School of Pharmacy, Southwestern Oklahoma State University, Weatherford 73096.
Ann Pharmacother. 1993 May;27(5):594-8. doi: 10.1177/106002809302700514.
To review the literature and assess the validity of obtaining vancomycin serum drug concentrations in patients.
A MEDLINE search of the English literature and a bibliographic review of articles pertaining to vancomycin serum concentrations, their use, and the rationale of cited therapeutic ranges.
Studies pertaining to the use of vancomycin concentrations in the clinical setting, methods for predicting these concentrations, and studies that reported efficacy or toxicity associated with vancomycin use and possible correlation of serum concentrations.
The usefulness of vancomycin serum concentrations, the determination of a therapeutic range of values, and their correlation to antibacterial efficacy and drug toxicity in the clinical setting are controversial. Old reports of toxicities need to be critically examined due to lack of information and the actual frequency of toxic reactions. The efficacy of vancomycin's antibacterial effect and its correlation with reported therapeutic ranges may advocate obtaining a vancomycin trough concentration in certain groups of patients.
Determination of serum vancomycin concentrations in the clinical setting and their usefulness in patient care is questionable and unnecessary in the majority of patients.
回顾文献并评估在患者中获取万古霉素血清药物浓度的有效性。
对英文文献进行MEDLINE检索，并对与万古霉素血清浓度、其应用以及引用的治疗范围依据相关的文章进行文献综述。
有关临床环境中万古霉素浓度使用的研究、预测这些浓度的方法，以及报告万古霉素使用相关疗效或毒性及血清浓度可能相关性的研究。
万古霉素血清浓度的有用性、治疗值范围的确定及其在临床环境中与抗菌疗效和药物毒性的相关性存在争议。由于缺乏信息以及毒性反应的实际发生率，旧的毒性报告需要严格审查。万古霉素抗菌作用的疗效及其与报告的治疗范围的相关性可能支持在某些患者群体中获取万古霉素谷浓度。
在临床环境中测定血清万古霉素浓度及其在患者护理中的有用性值得怀疑，并且在大多数患者中是不必要的。
