Kết quả bước đầu giám sát nồng độ vancomycin trong máu và hiệu chỉnh liều trên bệnh nhân người lớn truyền tĩnh mạch ngắt quãng tại Bệnh viện Hữu nghị Việt Tiệp

Abstract

Objective: Analysis of the results of implementing vancomycin concentrations monitoring in adult patients receiving intermittent infusion at Viet Tiep Friendship Hospital. Subject and method: Research data was retrospectively collected through medical records of adult patients with indications for monitoring vancomycin levels from December 2023 to July 2025 at Viet Tiep Friendship Hospital. Result: In the study, 174 patients underwent vancomycin concentration monitoring, resulting in 334 concentrations analyzed. The majority of patients received a loading dose (98.3%), and the commonly used maintenance dose was 2g/day (44.3%). Regarding the sampling method, most patients underwent TDM sampling at the second dose (43.7%) and the third dose (36.8%), which ensured timely vancomycin dose adjustment. The time from Cpeak sampling to the end of infusion had a median of 1.27 hours (with a range of 1.03 to 1.85 hours). For Ctrough concentration, the time interval between sampling and the next dose had a median of 0.55 hours (with an interquartile range of 0.25 to 0.67 hours). The AUC target achievement rate improved from 44.8% to 100% after three rounds of TDM. The incidence of nephrotoxicity during vancomycin therapy was 2.3%, representing a significant decrease compared to the period before TDM implementation. 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 3^rd TDM session, underscoring the vancomycin TDM protocol's effectiveness and importance at the hospital.