The Concentration Monitoring Of Vancomycin In Human Serum And Its Analysis On Clinical Application

Objective: To establish a method belonging to our hospital of monitoring vancomycin concentration in serum,and to service for patients by means of this method,especially for the patients in need.Based on the results in our hospital to analyse the issues related to vancomycin clinical application.Discussing the importance of clinical pharmacists in promoting rational drug using.Methods: Using high performance liquid chromatography(HPLC)to establish a method belonging to our hospital of monitoring vancomycin concentration in serum.According to statistical software such as Excel and SPSS.21 analysing the results of monitoring from curative effect,adverse reactions and the factors affecting setum concentration in different aspects.From case by case analysis reflect the positive role of clinical pharmacists.Results: The concentrations of vancomycin in serum from 4 to 100 mg·L-1showed a good linearity in the serum samples.The regression equation is y = 3511.4 +7264.9 x,r = 0.9981.Quantitative limit and detection limit are the standard curve of the lowest concentration point 4 mg·L-1.Serum samples placed 10 h,2d,3 d,4 d,and twice repeated freezing and thawing under the condition of-20?cryopreserved 8 days is stable,and RSD is less than 9.48%.RSD of one day <9.8%,RSD in different days < 11.4%.Absolute recovery > 96%,repeatability RSD< 6.1%.The methodology test meet the requirements.From January 2016 to January2017,a total of 44 patients examined 89 times of monitoring vancomycin concentration.Including 12 times of 9 patients monitoring peak concentration and monitoring trough concentration for 44 patients 77 times.Safe and effective treatment of trough concentration conforms to the result of the guidelines recommend which is 10-20 mg·L-1.Patients with renal insufficiency can increase the trough concentration of vancomycin(P = 0.019).The influence of serum concentration by the blood purification treatment has large individual differences.Clinical pharmacists through the analysis of the test results,communicating with the doctor in time,make the application of vancomycin more safe and reasonable.Conclusion: Vancomycin individual difference is too big,the factors of affecting serum drug concentration are overmuch..Simple calculation method can't meet all groups of people,therefore,both in terms of efficacy or safety monitoring vancomycin concentration in serum is auxiliary treatment means that the medical institutions must employ,especially for the patients who is newborn,renal dysfunction,or undergoing blood purification treatment.Clinical pharmacists play a key role focusing patients as the center,in order to promote clinical rational drug use.