| 摘要: |
| 治疗药物监测是维持万古霉素疗效和预防不良反应的重要手段，并有助于制定个体化的给药剂量方案。随着中国和美国指南关于治疗药物监测指标的更新，以24 h药-时曲线下面积（AUC24 h）引导的治疗药物监测逐渐成为热点。与谷浓度引导的治疗药物监测相比，AUC24 h引导的治疗药物监测能够降低万古霉素引起的急性肾损伤的发生率。临床上可以通过贝叶斯法和线性药代动力学方法来实施AUC24 h引导的治疗药物监测，这2种方法均可以实现AUC24 h的预测，达到早期干预的目的。各医疗机构有必要根据机构实际情况选择合适的监测方法。 |
| 关键词: 万古霉素 治疗药物监测 药-时曲线下面积 谷浓度 |
| DOI：10.16781/j.CN31-2187/R.20230432 |
| 投稿时间：2023-08-01修订日期：2023-11-23 |
| 基金项目:国家自然科学基金青年项目（82300017），海军军医大学（第二军医大学）第一附属医院“十四五”学科固海计划（GH145-38）. |
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| Therapy drug monitoring of vancomycin: focus and progress |
| FAN Shupan,DING Nan,CHEN Meiqi,WANG Zhuo* |
(Department of Pharmacy, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Therapeutic drug monitoring (TDM) is crucial for preserving vancomycin efficacy and avoiding adverse effects, and it is helpful to develop individualized dosing regimens. With the update of China and US criteria for TDM indexes, the TDM guided by the area under the 24 h drug-time curve (AUC24 h) has gradually become a focus. Compared with trough concentration-guided TDM, AUC24 h-guided TDM can decrease the incidence of vancomycin-induced acute kidney injury. Clinical implementation of AUC24 h-guided TDM is possible using Bayesian and linear pharmacokinetic techniques. Both approaches can achieve AUC24 h prediction and provide early intervention. It is essential for healthcare organizations to select appropriate methods of monitoring based on their actual situation. |
| Key words: vancomycin therapeutic drug monitoring area under the drug-time curve trough concentration |
