新生儿患者中临床药师开展万古霉素血药浓度干预的研究  

Investigation of Therapeutic Drug Monitoring of Vancomycin by Clinical Pharmacists in Neonates

作　　者：陶兴茹 段彦彦[1] 刘晓玲 裴保方 吕萌 TAO Xing-ru;DUAN Yan-yan;LIU Xiao-ling;PEI Bao-fang;LU Meng(Department of Pharmacy,Children′s Hospital Affiliated to Zhengzhou University,Children′s Hospital of Henan Province,Children′s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院药学部,河南郑州450000

出　　处：《海峡药学》2020年第9期100-102,共3页Strait Pharmaceutical Journal

基　　金：常州四药临床药学科研基金立项科研项目(编号:CZSYJJ16014)。

摘　　要：目的探讨我院新生儿万古霉素使用现状以及临床药师对其干预的作用。方法对比分析临床药师干预新生儿万古霉素的治疗方案前后我院新生儿万古霉素的使用情况。结果干预前后对比,新生儿应用万古霉素进行血药浓度监测的患儿比例由46.15%上升至74.55%(P<0.05)。血药浓度监测(TDM)的平均时间由原来的给药后(8.32±4.45)d降为(3.98±2.23)d(P<0.05)。谷浓度达标率从干预前38.60%上升到56.29%。经验治疗比例由78.96%下降至59.68%(P<0.05)。临床有效率从86.84%升至90.42%。不良反应发生率干预前(3.51%)与干预后(2.99%)不良反应发生率无统计学差异(P>0.05)。结论通过临床药师的干预,我院新生儿万古霉素的临床使用基本合理,但目前针对新生儿患者的TDM谷浓度推荐范围还有待进一步研究。OBJECTIVE To investigate the current status of neonatal vancomycin use in our hospital and the intervention effect of clinical pharmacist on vancomycin application.METHODS Clinical pharmacists participated in the treatment of vancomycin in our hospital.To compare the usage of vancomycin in neonates before and after intervention by clinical pharmacists.RESULTS After the intervention of clinical pharmacists,the proportion of therapeutic drug monitoring in neonates with vancomycin used in our hospital raised from 46.15%to 74.55%(P<0.05).The average TDM time reduced from(8.32±4.45)d to(3.98±2.33)d(P<0.05).The ratio of the trough concentration to the standard increased from 38.60%to 56.29%.The proportion of experience treatment decreased from 65.96%to48.57%(P<0.05).Clinical efficiency increased from 86.84%to 90.42%.The incidence of adverse reactions was not statistically different(P>0.05)between before(3.51%)and after the intervention(2.99%).CONCLUSION Through the intervention of clinical pharmacists,the clinical use of vancomycin in neonate in our hospital is basically reasonable.However,the current recommended range of TDM trough concentrations for neonatal patients remains to be further studied.

关 键 词：新生儿 临床药师 万古霉素 治疗药物监测 

分 类 号：R969.4[医药卫生—药理学]