Thực trạng sử dụng vancomycin tại Khoa Hồi sức tích cực - chống độc, Bệnh viện Đa khoa Vĩnh Phúc

Abstract

Objective: To describe the usage of vancomycin in intensive care patients (ICU) at Vinh Phuc General Hospital. Subject and method: Retrospective descriptive study based on data obtained from medical records of intensive care patients at Vinh Phuc General Hospital during the period from 01/10/2023 to 30/9/2024 treated with vancomycin intravenously for at least 24 hours. Result: The median age of the patients was 65 years old, men accounted for 64.83%. In 92.41% of cases, vancomycin was used empirically. The rate of patients undergoing microbiological culture was 97.93%, of which 64.79% of patients had positive results. Among 179 specimens with positive results, Staphylococcus aureus was isolated in 10 cases, with MRSA detected in 6 of them (approximately 60%) A loading dose regimen was applied in 88.28% of patients, with an average weight-based loading dose of 27.01mg/kg. Among patients not receiving renal replacement therapy, the common maintenance doses were 1000mg/12h (36.97%), 1500mg/12h (31.09%) and 1000mg/24h (23.53%). The rate of patients experiencing nephrotoxicity was 17.24%. Conclusion: Vancomycin was mainly used empirically in the ICU; however, even with optimized dosing, nephrotoxicity occurred in 17.24% of patients. Clinical guidelines and therapeutic drug monitoring for vancomycin are required to improve efficacy and reduce toxicity.