老年重症感染患者使用万古霉素的疗效及安全性分析  

The efficacy and safety of vancomycin in the treatment of old population

作　　者：毕明慧[1] 

机构地区：[1]上海市徐汇区中心医院老年病科,200031

出　　处：《北京医学》2011年第6期491-493,共3页Beijing Medical Journal

摘　　要：目的探讨老年人群合并重症感染的患者应用万古霉素的疗效及安全性。方法对2004年1月-2010年11月期间56例严重感染而应用万古霉素的老年患者进行回顾性分析,探讨其疗效及安全性。结果万古霉素的总有效率为83.9%;疗程结束后细菌总清除率为98%;总体不良反应率14.2%,6例发生急性肾功能不全。结论万古霉素对老年重症感染者的疗效可靠,但要加强对肾功能的监测及防范。只有严格执行抗生素药物的分级管理制度,同时根据Cockeroft公式计算24h内肌酐清除率(CCr)并据此调整剂量,采取血药浓度监测等有效措施,才能保证万古霉素在老年人群的安全有效使用。Objective To evaluate the efficacy and safety of vancomycin in the treatment of people more than sixty-five years old.Methods A retrospective analysis was performed in 56 old people with severe infections who were treated with vancomycin intravenously from Jan.2004 to Nov.2010.The renal functions before and after treatment were compared and the cfficacy and safety data were analyzed.Results Overall,the clinical effective rate of vancomycin and side effects in this group was 83.9% and 14.2% respectively,and the bacterial clearance rate was 98%.But there was statisfically significant difference in serum creatinine and uric acid before and after treatment.In addition,6 cases suffered acute renal insufficiency（ARI） during the treatment,while nobody suffered ARI if dose adjustments according to Cockeroft-Gault formula for computing estimated glomerular filtration rate（GFR）.Conclusions Vancomycin is effective in the treatment of severe infections in old people.But we could not ignore its severe side effects such as nephrotoxicity.Some advisable advice were advocated in order to mimimize the side effects by far.

关 键 词：万古霉素 老年人群 疗效 安全性 

分 类 号：R96[医药卫生—药理学]