去甲万古霉素在新生儿败血症患者体内药代动力学及其疗效

 目的:对新生儿败血症患者静脉滴注去甲万古霉素进行药代动力学研究,探讨血药浓度与疗效、不良反应关系。方法:5例新生儿患者静滴去甲万古霉素15mg·kg^-1,进行药代动力学参数测定;观察临床疗效并进行不良反应监测?结果:峰浓度达(34.89±6.23)mg·L^-1,8～12h降至5mg·L^-1以下,药物消除半衰期为(6.08±1.22)h,表观分布容积为(0.44±0.08)L·kg^-1,清除率为(0.089±0.014)L·kg^-1·h^-1?治疗7～14d后,有明显疗效,未出现严重耳、肾毒性。结论:去甲万古霉素15mg·kg^-1静脉滴注后,能够维持有效药物浓度,用药间隔应为8～12h。该药物用于新生儿耐药葡萄球菌感染安全、有效。

Pharmacokinetics and application of demethylvancomycin in treatment of neonatal septicemia

OBJECTIVE：To study the pharmacokinetics of demethylvancomycin after single intravenous infusion in neonates with staphylococal septicaemia,and the relations between serum concentration and clinical efficacy.METHOD:The pharmacokinetic parameters were determined after single intravenous infusion 15mg.kg-1 in 5 neonates.clinical efficacy and adverse reactions were observed.RESULTS:The peak concentrtion was 34.89±6.23mg.L-1,and the concentration after 8～12 hours was below 5mg.L-1.The t1/2β was 6.08±1.22 h.The V(c) was 0.44±0.08L.kg-1,and Cl(s) was 0.089±0.014L.kg-1.h-1.The satisfied effect was observed,no severe ototoxity and nephrotoxity were found.CONCLUSION：Demethylvancomycin could maintain the effective concentration in neonates at the dosage of 15mg*kg-1 and the dosage interval should be 8～12h.