万古霉素血药浓度监测与临床用药行为分析

目的:评价我院在应用万古霉素期间接受血药浓度监测患者的血药浓度、用药医嘱及相关临床用药行为指标,为临床合理用药提供参考。方法:通过临床药学工作站调取电子病历并结合手工检索原始病历的方式,分析我院2007年7月～2008年10月万古霉素血药浓度监测结果及相关用药信息。结果:76例/次血药浓度监测结果中,由于医师标本留取行为不规范导致无临床参考价值的血药浓度监测结果占总例/次的32.89%;肾功能不全组峰浓度高于有效血药浓度范围的占44.46%。应用万古霉素期间平均每例患者联用药物21.85种,均以静脉给药为主。万古霉素临床有效率为65.00%。结论:万古霉素血药浓度监测必须密切联系临床,正确留取标本,综合考虑患者的特殊病理生理状态及合并用药等因素,及时调整给药方案。

Analysis on Blood Concentration Monitoring of Vancomycin and Clinical Administration Behavior

OBJECTIVE：To analyze the blood drug monitoring results of vancomycin and clinical administration behavior and then to provide a clinical reference for its rational utilization. METHODS：We retrospectively collected the blood drug monitoring results of vancomycin and drugrelated information from July 2007 to October 2008 in our hospital. These data were from the electronic clinical pharmacy workstation and initial written case history. RESULTS：Among the 76 cases,non-clinical significant results due to doctor’s irregular manipulation in collecting blood sample accounted for 32.89%. In renal failure group,the rate of peak concentration above the effective blood concentration range was 44.46% . Every patient was averagely administered 21.85 kinds of drugs mainly by intravenous injection during vancomycin application. Clinical response rate of vancomycin was 65.00%. CONCLUSION：During the blood concentration monitoring of vancomycin,we should take clinical need into consideration,collect blood samples rightly,consider the factors such as special pathophysiologic status of patients,drug combination,and adjust the dosage timely.