Investigation Of The Clinical Application Of Vancomycin In Children

Objective:Vancomycin resistant strains have appeared as theincreasing clinical application of vancomycin. To correct understandingand reasonable application of vancomycin has important clinicalsignificance and value. This study analyzed the present situation of the druguse and its rationality by investigating the clinical applicationof vancomycin in our hospital, and provided theoretical basis andreference to further reasonable application of the vancomycin in childclinical.Methods: Retrospectively collected and analyzed vancomycin clinicaldata of hospitalized children in our hospital for6months from Juneto November,2012, including general condition, clinical diagnosis,etiological examination, dosage, treatment course, therapeutical drugmonitoring, rational use of drugs and adverse drug reaction.Results:(1)In the199cases of medical record using vancomycin,including150cases of pediatric medicine and49cases of pediatric surgery,the average length of hospital stay was78days, the shortest hospitalizationdays is1day and the longest hospitalization days is150days. Agedistribution is given priority to infant less than1year old, accounting for 55%, followed by toddler, accounting for17%.(2)Among them, most ofthe clinical diagnoses were pneumonia and septicemia, taking up a total of66%.(3)194cases of199were took pathogenic examination. Specimensmainly come from aseptic chamber, accounting for72.68%. Positivecultivation of specimens accounts for145cases, while negative accountsfor49cases. Among them, the most common pathogenic bacteria isStaphylococcus aureus, a total of35cases, followed by Epidermisstaphylococcus aureus, a total of19cases.(4) There were84cases out of145case sensitive to vancomycin in the drug sensitivity assay.(5)The mostdaily total dose of drug was40mg/kg，accounting for49%, while the mostfrequency of drug use was q6h, accounting for54%.84of199cases haddrug concentration monitoring.96cases were combined use withantibiotics.(6)The clinical efficacies mostly were effectivity, accountingfor44.22%and6cases of adverse reactions occured.Conclusion: In conclusion, the application of vancomycin in ourhospital is basically rational. Our hospital pays attention to the etiologyevidence finding before vancomycin treatment, and treat based on thecharacteristics of etiology. In our hospital, vancomycin adverse reactionsmonitoring is well-conceived. However, there are still some deficiencies.Vancomycin sensitive examination before use should be strengthened. Dueto vancomycin’s serious nethrotoxicity, ototoxicity and strict controlledmedical treatment, we should strictly control its period of treatment and application indications of combined antibiotic. The blood concentration ofvancomycin is affected by many factors, such as the severity of the disease,obesity and kidney function. Our hospital should pay attention to the initialdosage of vancomycin and monitor the drug concentration in order toadjust the dosage in time. In the same time, we should strict to theindications and further standardize the use of vancomycin, which wouldcontribute to improve the therapeutic efficacy of vancomycin, the level ofrational drug use and adverse reactions presentation.