The relationships between different doses of vancomycin with blood drug trough concentration and renal dysfunction in children with severe infection in ICU

Abstract

Objective To investigate the relationships between different doses of vancomycin with blood drug trough concentration and renal dysfunction in children with severe infection in intensive care unit (ICU). Methods 100 children with severe infection treated with vancomycin from January 2018 to November 2018 in the Ⅱ Department of Critical Care Medicine of Hunan Children's Hospital were studied, according to the dosage, they were divided into high-dose group [15 mg/(kg·time), 57 cases] and low-dose group [15 mg/(kg·time), 43 cases]. At the same time, according to the condition of renal dysfunction, children were divided into normal renal function group (42 cases), mild injury group (43 cases), moderate injury group (15 cases). The blood drug trough concentration was measured, and its relationship with serum creatinine (Scr), serum urea nitrogen (BUN), and renal dysfunction was analyzed. At the same time, the therapeutic effects of different doses of vancomycin were evaluated. Results The cure rate and blood drug trough concentration of children with severe infection in high-dose group were significantly higher than those in low-dose group (P<0.05), and the time to reach effective blood drug trough concentration was significantly shorter than that in low-dose group (P<0.05); the levels of serum Scr and BUN in low-dose group and high-dose group were significantly lower than those before treatment (P< 0.05); the blood drug trough concentration and the proportion of reaching the target trough concentration in mild injury group were significantly higher than those in normal group and moderate injury group (P<0.05); the dose of vancomycin in mild injury group and moderate injury group was significantly higher than that in normal group (P<0.05), and the course of treatment in mild injury group and moderate injury group was lower than that in normal group (P<0.05). Conclusions The high dose of vancomycin 15 mg/(kg/time) is effective in the treatment of ICU children with severe infection. the blood drug trough concentration and renal dysfunction should be monitored and individualized treatment plan should be formulated. Key words: Vancomycin; Drug dosage; Plasma concentration; Renal dysfunction; Infection; Child