Factors influencing plasma vancomycin concentrations and effect of clinical pharmacist intervention on the clinical outcome
LIAN Yufei1, YANG Yupeng2, WANG Yanze3, ZHANG Yue1, QIU Xuejia1, FANG Lingzhi1, LIU Hongtao1
1. Department of Pharmacy; 2. Department of Stomatology,Hebei Provincial People's Hospital,Shijiazhuang 050051,China; 3. Hebei Drug Evaluation and Certification Service Center, Shijiazhuang 050000,China
Abstract：Objective To investigate the factors that influence plasma vancomycin concentrations and the effect of clinical pharmacist intervention on the therapeutic effect. Methods The clinical data of 120 cases of patients who received vancomycin concentration monitoring in our hospital between July 2018 and July 2019 was retrospectively analyzed. The influencing factors of vancomycin plasma concentrations were determined by Pearson single factor analysis and multiple Logistic regression analysis before the cases were randomly divided into the intervention group and the non-intervention group.The effect of intervention by clinical pharmacists was analyzed. Results (1) The influencing factors of plasma vancomycin concentrations included age, BMI, plasma albumin levels, creatinine clearance rate, moderate and severe peripheral edema, abnormal liver function and pre-existing diseases according to univariate analysis(P<0.05). (2) The above-mentioned factors with statistically significant differences by univariate analysis were put into the multiple Logistic regression model, and the results showed that age, moderate and severe peripheral edema, abnormal renal function and BMI were factors that affected the plasma concentration of vancomycin (P<0.05). (3) The compliance rate of serum drug concentrations, 30d mortality rate and incidence of adverse reactions in the intervention group were 62.79%, 2.33% and 6.98% respectively, which were significantly different from those of the control group [34.88%, 9.30% and 18.60% respectively] (P<0.05). Conclusions The influencing factors of blood concentrations of vancomycin include age, moderate and severe peripheral edema, abnormal renal function and BMI. Therefore, clinical pharmacists should strengthen the blood concentration intervention to improve the drug effect.
Moffett B S, Hilvers P S, Dinh K, et al. Vancomycinassociated kidney injury in pediatric cardiac intensive care patients[J]. Congenit Heart Dis, 2015, 10(1): E6-E10.
2020, Vol. 31 
