神经外科术后患者静脉输注去甲万古霉素后血清及脑脊液药物浓度
作者:
作者单位:

作者简介:

王强

通讯作者:

中图分类号:

R978.1

基金项目:

国家科技支撑计划基金资助项目( 2012EP001004)


Drug concentrations in the serum and cerebrospinal fluid of patients with intravenous drip of norvancomycin after neurosurgery procedure
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 文章评论
    摘要:

    目的了解神经外科术后患者静脉输注去甲万古霉素后血清及脑脊液内药物浓度变化特点。方法选择2014年某院神经外科手术后留置术区/脑室引流管的患者,按给药方式不同分为2组,各12例,常规给药组:去甲万古霉素0.8 g,泵入60 min,12 h重复给药;持续给药组:去甲万古霉素0.8 g,泵入60 min,再0.4 g泵入11 h,后以0.4 g持续泵入12 h,于给药后不同时间点采集患者血清和脑脊液标本,测定去甲万古霉素浓度。结果常规给药组与持续给药组去甲万古霉素血清峰浓度分别为(55.52±26.04)、(59.22±41.88) mg/L,给药24 h血清浓度分别为(8.21±6.04)、(9.11±5.09)mg/L;脑脊液峰浓度分别为(16.31±11.15)、(8.82±8.91)mg/L,给药24 h脑脊液浓度分别为(6.12±2.34)、(5.71±4.72)mg/L。常规给药组药物脑脊液穿透率以药物浓度曲线下面积比计算(AUC脑脊液/AUC血清)0~12 h为63.3%,12~24 h为59.0%;持续给药组0~12 h为25.4%,0~24 h为47.4%。以目标细菌MRSA  95%的最低抑菌浓度(MIC90)为2 mg/L计算,常规给药组AUC0-24/MIC90为192,持续给药组AUC0-24/MIC90为184。结论神经外科术后患者早期使用标准剂量去甲万古霉素,常规及持续给药脑脊液内药物浓度均可达目标细菌的MIC90。

    Abstract:

    ObjectiveTo understand the changing characteristics of drug concentration in the serum and cerebrospinal fluid(CSF) after intravenous (IV) drip of norvancomycin in patients after neurosurgery procedure. MethodsPatients with surgical cavity/ventricular drainages after neurosurgery procedure in a hospital in  2014 were selected, and they were divided into 2 groups according to the administration modes (12 in each group), conventional administration group: 0.8 g  norvancomycin IV drip for 60 minutes, repeated every 12 hours; continuous administration group, 0.8 g norvancomycin, IV drip for 60 minutes, followed by 0.4 g of IV drip for 11 hours, then 0.4 g for 12 hours, serum and CSF specimens were collected at different time points after administration, concentration of norvancomycin was determined. ResultsSerum norvancomycin concentration reached a peak of (55.52±26.04) and (59.22±41.88) mg/L in conventional administration group and continuous administration group respectively, 24hour serum concentration were (8.21±6.04) and (9.11±5.09)mg/L respectively;CSF norvancomycin concentration reached a peak of (16.31±11.15) and (8.82±8.91)mg/L in conventional administration group and continuous administration group respectively, 24hour CSF concentration were (6.12±2.34)and (5.71±4.72)mg/L respectively; CSF penetration rate of conventional administration group was calculated by ratio of area under curve (AUCCSF/AUCserum), at 0-12 and 12-24 h hour were 63.3% and 59.0% respectively;in continuous administration group were 25.4% and 47.4% respectively. According to 95% of the minimum inhibitory concentration (MIC90) 2 mg/L of target bacteria methicillinresistant Staphylococcus aureus (MRSA), AUC0-24/MIC90 in conventional administration group and continuous administration group were 192 and 184 respectively. ConclusionFor patients who receives early use of standard dose of norvancomycin after neurosurgery procedure, CSF drug concentration after convention and continuous administration of norvancomycin can both reach MIC90 against target bacteria.

    参考文献
    相似文献
引用本文

武元星,康建磊,王强,等.神经外科术后患者静脉输注去甲万古霉素后血清及脑脊液药物浓度[J]. 中国感染控制杂志,2017,16(5):393-398. DOI:10.3969/j. issn.1671-9638.2017.05.001.
WU Yuanxing, KANG Jianlei, WANG Qiang, et al. Drug concentrations in the serum and cerebrospinal fluid of patients with intravenous drip of norvancomycin after neurosurgery procedure[J]. Chin J Infect Control, 2017,16(5):393-398. DOI:10.3969/j. issn.1671-9638.2017.05.001.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2016-08-24
  • 最后修改日期:2016-11-23
  • 录用日期:
  • 在线发布日期: 2017-05-26
  • 出版日期: