Analysis of blood concentration, medication orders, and clinical behavior of patients during application of vancomycin

Abstract

Objective To observe the blood concentration of patients during the application of vancomycin, the medication orders, and the relevant clinical medication, and to provide some references for the clinical application of vancomycin. Methods The blood samples of 36 patients taking vancomycin from January, 2015 to December, 2016 and willing to accept the blood concentration monitoring were collected as research objects. HPLC method was used to determine the serum concentration of vancomycin. The drug concentration value, medical advice, medication orders, and related clinical situation were analyzed, so as to provide some references for the reasonable application of vancomycin in clinic. Results Among the 36 cases, 33 were cured, accounting for 91.7%; 3 failed, accounting for 8.3%; and 2 (5.6%) got adverse reactions. The minimum concentration of patients with normal renal function beyond the normal value range accounted for 63.5%, and that of the patients with renal insufficiency beyond the normal range accounted for 100.0%, with a statistical difference (P<0.05). All the patients with normal renal function’s peak concentration was within the normal range, but 43.5% of the patients with renal insufficiency’s beyond, with a statistical difference (P<0.05). The medication way of the patients with normal renal function was different from that of the patients with renal insufficiency (P<0.05). Among the 36 cases, 28 (77.8%) had inappropriate medication; and among the 28, 5 (13.9%) had inappropriate indications, 20 (55.6%) inappropriate solvents, 2 (5.6%) inappropriate usage, and 1 (2.8%) inappropriate treatment course. Conclusion it is necessary to strengthen the monitoring of the serum concentration of vancomycin in clinical application, so as to realize the rational use of drugs in clinical practice. Key words: Vancomycin; Blood concentration monitoring; Medication orders; Clinical medication