基于PK/PD理论临床药师参与临床万古霉素治疗血流感染患者的药学实践  

Clinical Pharmacists Participated in Pharmaceutical Practice of Clinical Vancomycin Medication in Patients with Bloodstream Infection based on PK/PD Theory

作　　者：张乃菊[1] 黄睿[2] 陈重[2] 张帆[2] 夏娟[2] 严晓敏[2] 刘金春[2] ZHANG Nai-ju;HUANG Rui;CHEN Zhong;ZHANG Fan;XIA Juan;YAN Xiao-min;LIU Jin-chun(The First Affiliated Hospital ofBengbu Medical College,Bengbu Anhui 233004,China;Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medicine School,Nanjing 210008,China)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004 [2]南京大学医学院附属鼓楼医院,南京210008

出　　处：《抗感染药学》2021年第2期267-270,共4页Anti-infection Pharmacy

基　　金：蚌埠医学院自然科学类重点项目(编号:BYKY2019054ZD)。

摘　　要：目的:探究万古霉素日剂量和日给药频次在治疗革兰阳性球菌败血症中对血药(谷)浓度的影响程度。方法:临床药师分别通过参与1例万古霉素日剂量不变、增加给药频次治疗粪肠球菌败血症的治疗实践和1例万古霉素增加日剂量、减少给药频次治疗人葡萄球菌败血症的治疗实践,观察日剂量和给药频次对万古霉素血药(谷)浓度的影响程度。结果:万古霉素日剂量不变,增加给药频次后血药谷浓度呈近3倍升高;增加万古霉素日剂量,减少给药频次后血药谷浓度却明显下降。结论:临床药师基于PK/PD理论参与临床万古霉素治疗方案的制定及调整,发现万古霉素PK/PD参数评价指标更倾向于t>MIC。Objective:To investigate the influence extent of vancomycin daily dose and daily administration frequency on blood drug concentration in the treatment of Gram-positive Coccus Sepsis.Methods:Clinical pharmacists by participating in a case of vancomycin daily dose were constant,increasing dosing frequency and treatment of sepsis in enterococcus practice case of vancomycin to increase daily dose,reduce dosing frequency treatment of staphylococcus aureus septicemia practice,to observe the daily dose and dosing frequency of vancomycin the influence extent of the blood drug concentration(valley).Results:The daily dose of vancomycin remained the same,and the blood concentration of vancomycin increased nearly 3 times after increasing the frequency of administration.After increasing the daily dose of vancomycin and decreasing the frequency of administration,the serum concentration of vancomycin decreased obviously.Conclusion:Clinical pharmacists based on PK/PD theory in clinical practice to participate in the formulation and adjustment of vancomycin treatment regimen,and it was found that the PK/PD parameters of vancomycin should be more inclined to t>MIC.

关 键 词：万古霉素 日剂量 日给药频次 血药浓度 PK/PD 

分 类 号：R969.3[医药卫生—药理学]