优化万古霉素给药方案的研究.

Objective ： To evaluate the value of quantitative pharmacological software in the development of personalized dosage regimen of vancomycin for critically ill patients．Methods ：By combining advanced vancomycin pharmacokinetics tool and Java PK for desktop ，the initial dosage of vancomycin was calculated for the initial predicted trough concentration of vancomycin based on patient’s information ，including gender ，age ，height ，weight ，serum creatinine and disease state ．Then ，actual drug doses and predicted serum steady trough concentration （Css ，min） of vancomycin were calculated by Bayesian ．The serum concentration of vancomycin became stable after ５ half-life ．Blood samples were taken ３０ min before injection of the drug ．The fluorescence polarization immunoassay was used to determine the concentration of actual vancomycin （Css ，min） ．The correlation of actual （Css ，min） and predicted （Css ，min） was analyzed statistically by means of bivariate ．Results ：Sixty three blood samples with serum trough concentration of vancomycin were collected from sixty patients ．The predicted value of （Css ，min） was （１４ ．０２ ± ５ ．１１） μg／ml and the actual value of （Css ，min） was （１３ ．３０ ± ６ ．２２） μg／ml ．The serum trough concentration deviation value was （０ ．７３ ± ３ ．７９） μg／ml ． The predicted （Css ，min） of vancomycin was significantly related to the actual value （ r ＝０ ．７９４ ，P＜ ０ ．００１） ．The overall actual success rate was ６８ ．３％ （４３ ／６３ ） ．Conclusion ：Classic pharmacokinetic and population pharmacokinetics software could provide individualized dosage regimen of vancomycin in critically ill patients ，and display good blood drug concentration prediction ． [ABSTRACT FROM AUTHOR]