替考拉宁临床应用及药学监护横断面调查

Cross-sectional Survey on Clinical Practice and Pharmaceutical Care of Teicoplanin

关键词:  替考拉宁  药学监护  血药谷浓度  横断面调查

Key words:  teicoplanin  pharmaceutical care  plasma trough concentration  cross-sectional survey

摘要:

目的 替考拉宁是用于治疗革兰氏阳性菌感染的糖肽类抗菌药物，掌握住院患者替考拉宁临床应用及其药学监护情况，为完善药学监护方案提供参考。方法 采用横断面调查方法，针对中日友好医院2018年1月1日—12月31日出院，且在住院期间接受替考拉宁治疗的全部183例住院患者的药学监护数据进行分析。结果 183例患者以肺部感染为主，占71.58%。97例（53.01%）患者给予了负荷剂量；维持给药方案采用最多的为0.4 g qd （32.24%）。共有35例（19.13%）患者监测替考拉宁血药谷浓度，共监测40例次，平均血药谷浓度（7.77±4.31）mg·L^-1；血药谷浓度>10 mg·L^-1的只有11例次，占总例次的27.50%；不同维持剂量下的平均血药谷浓度有随给药剂量增大而升高的趋势，但各维持剂量组血药谷浓度值之间没有统计学差异（P=0.122）。结论 住院患者的替考拉宁治疗剂量整体不足，大部分谷浓度没有达到有效阈值，这可能是临床感染性指标改善欠佳的主要原因。

Abstract:

OBJECTIVE Teicoplanin is a glycopeptide antibiotic used to treat severe infections caused by Gram-positive bacteria. Through the analysis of monitoring data of drug use in inpatients, this paper optimizes pharmaceutical care and provides a method for rational use of teicoplanin in clinical practice. METHODS The cross-sectional survey was designed to collect the clinical data of 183 inpatients treated with teicoplanin in China-Japan Friendship Hospital in 2018 January 1-December 31. RESULTS One hundred and eighty-three cases were finally included in this study and the administration of teicoplanin in 71.58% cases were for the treatment of pulmonary infection. Ninety-seven patients(53.01%) were given loading dosage in the initial treatment. The maintained regimen was 0.4 g qd(32.24%). There were 35 patients(19.13%) monitored the serum trough concentration of teicoplanin for 40 times. The average plasma trough concentration was (7.77±4.31)mg·L^-1. There were only 11 cases of plasma trough concentration >10 mg·L^-1, accounting for 27.50% of the total cases. There was a tendency that the average plasma trough concentration under different maintenance doses increased with the increase of dosage, but there was no significant difference(P=0.122). CONCLUSION The overall treatment dose of teicoplanin in hospitalized patients is insufficient. Most of the plasma trough concentration did not reach the target concentration. These problems may be the main reason why there was no significant change in infectious markers before and after administration in survey.