Thực trạng giám sát nồng độ vancomycin trong máu và hiệu chỉnh liều trên bệnh nhân người lớn điều trị tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: Analysis of the current situation of monitoring vancomycin concentrations in adult patients treated at 108 Military Central Hospital. Subject and method: Research data was retrospectively collected through medical records of adult patients with indications for monitoring vancomycin levels from December 2020 to August 2022 at 108 Military Central Hospital. Result: In the study, 114 patients underwent vancomycin concentration monitoring, resulting in 312 concentrations analyzed. Among these, 172 samples were collected during continuous infusion, while the remaining 140 were taken during intermittent infusion. During intermittent infusion, the time from Cpeak sampling to the end of infusion had a median of 1.32 hours (with a range of 1.05 to 1.93 hours), and the median Cpeak concentration was 30.52mg/L. For Ctrough concentration, the median was 11.77mg/L, and the time interval between sampling and the next dose had a median of 0.42 hours (with an interquartile range of 0.3 to 0.69 hours). In the continuous infusion regimen, the sampling time varied from 33.46 to 138 hours (median of 81.26 hours), with a median concentration of 23.92mg/L. The AUC distribution, represented by median and interquartile range, at the first, second, third, and subsequent therapeutic drug monitoring (TDM) sessions was as follows: 511.2 (437.7-710.8), 580.3 (494.2-729.1), 632.5 (505.6-748.8), and 603.8 (484.6-719.2) mg·h/L, respectively. The cumulative AUC target achievement rate improved from 71.4% to 100% after five rounds of TDM. Conclusion: The results affirm the effective adoption of vancomycin concentration monitoring through the Hospital's Vancomycin Monitoring Protocol. The progressive increase in the cumulative AUC target attainment rate culminated at 100% after the 5^th TDM session, underscoring the vancomycin TDM protocol's effectiveness and importance at the hospital.