万古霉素治疗新生儿败血症的血药浓度监测和疗效分析.

Objective:To explore the relationship between clinical efficacy and trough concentration of vancomycin in the treatment of neonatal bacterial sepsis （NBS）. Methods: Clinical medical data of 73 cases of NBS treated with vancomycin in the Department of Neonatology, Suzhou Hospital Affiliated to Nanjing Medical University were collected for the study. Clinical efficacy, bacterial elimination rate and trough concentration data were analyzed. Results: Total clinical effective rate and G+ bacterial elimination rate of vancomycin in the treatment of NBS were 86.30% and 91.78%,respectively. The average trough concentration of vancomycin was （12.57±6.83） mg/L after initial medication, and the rate of reaching the required standards was 41.10%. For the cases with the trough concentration at 10-20 mg/L, G+ bacterial elimination rate and clinical efficacy were significantly higher than those cases with the trough concentration lower than 10 mg/L （P=0.013, P=0.001）. The dosage of 24 cases was adjusted from our clinical experience about serum drug concentration. Further detection after dosage adjustment indicated that the trough concentration in only 13 cases （54.17%） was within the standard range. Conclusion: Clinical efficacy of vancomycin was highly associated with trough concentration of the drug. However, empirical medication could only achieve a low rate of high trough concentration standards. For this reason, dosage adjustment and patient-centered treatment were mandatory for better therapeutic effects. [ABSTRACT FROM AUTHOR]