Monitoring of Blood Concentration and Clinical Efficacy of Vancomycin in the Treatment of Patients with Critically Ill Infections

Abstract

We attempt to discuss the clinical efficacy and safety of vancomycin in different blood concentrations in patients with critically ill infections. We collected 50 patients who received vancomycin treatment from infectious diseases department in our hospital from June 2017 to June 2021. Monitored the trough concentration of vancomycin and selected the trough concentration after reaching the steady state. We divided patients into three groups according to the minimum blood concentration value i.e. minimum blood concentration <10 mg/l (n=16), minimum blood concentration 10 mg/l~15 mg/l (n=18) and minimum blood concentration >15 mg/l (n=16), compare the clinical effective rate and adverse reactions rate among the three groups of patients. 16 cases, 18 cases and 16 cases were enrolled into the three groups of minimum blood concentration <10, 10-15, >15 mg/l and the clinical cure rates were 68.8 %, 66.7 % and 66.7 % respectively. The differences in effective rates among the groups had no statistical significance (p=0.983); the overall adverse reactions rate in 50 patients was 18 % (9/50) and adverse reactions rate in minimum blood concentration >15 mg/l group was (43.8 %, 7/16), especially it is acute renal dysfunction, which is statistically different from the other two groups (p=0.025). The high blood concentration of vancomycin in patients with critically ill infection does not increase its clinical efficacy, but will increase adverse reactions rate in patients and provide a basis for providing the best vancomycin dose in clinical practice.