Rationality Evaluation Of Linezolid In Patients With Critical Infection And The Correlation Analysis Of The Factors Which Significantly Affect Plasma Drug Concentrations

Objective Analysing the clinical application of linezolid and monitoring the concentration of linezolid in the critically ill patients to explore the relationship between plasma concentration and pharmacodynamics,which ultimately provide a reference for more safe and effective use of linezolid.Methods Investigating the Clinical records of linezolid injection from January 2015 to November 2016 to fill out the table of investigation of patients with linezolid and evaluation criteria for the rational application of antibiotics for analyze the factors that affect the therapeutic effect and adverse reactions.The concentration of linezolid in plasma was determined by high performance liquid chromatography(HPLC)and the effect of renal function on the concentration of linezolid was analyzed.The correlation between the concentration of linezolid and the thrombocytopenia was also investigated.Results A total of 128 cases of clinical medical records were collected in which 102 patients were identified as effective group whose bacteria were completely cleared at the end of treatment and 26 patients were selected as the treatment ineffective group whoes bacteria were partially cleared,not cleared,flora alternately.The highest rate ofbacterial clearance is respiratory medicine department(95.24%)and the lowest is the department of oncology(64.29%).In these 128 clinical cases,68 cases(53.13%)were rationally treated,34 cases(26.56%)were partly rational cases,26 cases(20.31%)were irrational drug use cases.There were significant differences in the number of days of medication,liver function,and adverse reactions.A total of 20 patients with adverse drug reactions,which 11 cases of thrombocytopenia adverse reactions occur,the incidence of adverse reactions may be related to medication days,combined medication,renal dysfunction related.A total of 89 patients were enrolled in the plasma linezolid concentration,renal dysfunction in patients with normal renal function of patients with linezolid plasma concentration was significantly different,and renal dysfunction in patients with linezolid plasma concentration of individual differences,The plasma concentration of linezolid can reach the highest 8.70 μg·ml-1 and the lowest only 0.94μg·ml-1.A total of 9 patients had a minimal inhibitory concentration(MIC)level of linezolid was less than 2 μg·ml-1.Conclusion In this paper we established the linezolid detection method is accurate and reliable and easy to operate and have high sensitivity,which can be used for clinical linezolid plasma concentration detection.The main irrational phenomenon of the use of linezolid injection including medication without indications and medication treatment is too short or too long and combining with no evidence.The concentration of linezolid in patients with severe renal dysfunction is large,and the concentration of linezolid is the risk factor for thrombocytopenia.Therefore,the platelet count should also be concerned with changes in renal function,to provide advice and reference combining with the above factors in order to further standardize the rational use of linezolid and develop a personalized dosing regimen.