1.郑州大学第一附属医院, a. 药学部, b. 呼吸暨危重症医学科, 郑州 450052; 2.河南省精准临床药学重点实验室, 郑州 450052
Monitoring the Plasma Concentrations and Identifying the Influence Factors in Patients with Severe Infections Treated with Different Dosages of Teicoplanin
JIA Meng-meng1a,2, ZHANG Qi-wen1a,2, QIN Zi-fei1a,2, MA Xiao-xu1b, YANG Jing1a,2*
1a. Department of Pharmacy; 1b. Department of Respiratory and Critical Care medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; 2. Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, 450052, China
Abstract：OBJECTIVE To explore the characteristics of the serum trough concentration (ρmin) and influencing factors of teicoplanin in different dosages patients with severe infections. METHODS Patients (238 cases) who took teicoplanin from December 2018 to May 2020 were enrolled in a retrospective study and divided into standard-dose group (GS) 400 mg, medium-dose group (GM) 600 mg and high-dose group (GH) 800 mg. The serum ρmin of teicoplanin was measured by ultra performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method. Influencing factors of teicoplanin was analyzed by multiple linear regression and stepwise regression. RESULTS Totally 367 samples were collected from 238 patients. The average concentration of teicoplanin ρmin was (16.06±11.81) μg·mL-1 and only 65.4% of teicoplanin ρmin were in the range of therapeutic window. The ρmin of teicoplanin was significantly increased in the order of GS group, GM group and GH group [(12.52±8.41), (16.46±11.74) μg·mL-1 vs. (20.59±14.49) μg·mL-1], P<0.05. The rate of effective serum trough concentration was 48.39%, 68.32% and 84.15% respectively, with statistically significant difference (P<0.001). There was no significant difference in the incidence of adverse drug reactions (P>0.05). Multiple linear regression analysis showed that the dosage, glomerular clearance rate and albumin level were the main factors influencing teicoplanin concentration in patients with severe infection. CONCLUSION The ρmin of teicoplanin in patients with severe infection has great individual differences. Most of the patients are not up to the standard with conventional dosage. The dosage of teicoplanin, glomerular clearance rate and albumin level have influence on the ρmin of teicoplanin. When teicoplanin is used in patients with severe infection, sufficient loading dose of teicoplanin should be given to ensure that the ρmin of teicoplanin is within the treatment window, to improve the effectiveness of teicoplanin treatment.
贾萌萌, 张绮雯, 秦子飞, 马晓旭, 杨晶. 不同剂量替考拉宁治疗重症感染患者的血药浓度监测及其影响因素的探讨[J]. 中国药学杂志, 2021, 56(18): 1524-1529.
JIA Meng-meng, ZHANG Qi-wen, QIN Zi-fei, MA Xiao-xu, YANG Jing. Monitoring the Plasma Concentrations and Identifying the Influence Factors in Patients with Severe Infections Treated with Different Dosages of Teicoplanin. Chinese Pharmaceutical Journal, 2021, 56(18): 1524-1529.
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2021, Vol. 56 
