万古霉素个体化给药方法与临床结局相关性的Meta分析

发布时间：2018-03-25 14:39

本文选题：万古霉素　切入点：个体化给药　出处：《中国临床药理学杂志》2015年13期

【摘要】：目的评价万古霉素个体化给药方法与临床结局之间的相关性。方法检索Pub Med、EMBase、中国知网等数据库,收集有关个体化给药方法的研究。用Cochrane系统评价方法筛选文献,评价纳入文献的质量,并提取有效资料进行系统评价。结果共纳入6篇文献,研究对象651例。与传统方法相比,按与实际人群相符的群体药代动力学初始给药可显著提高血药浓度达标率及细菌清除率(P0.05),死亡率、临床治愈率、肾毒性发生率差异无统计学意义(P0.05)。与非治疗药物监测组相比,根据治疗药物监测结果调整给药可显著提高血药浓度达标率(P0.05)。结论与传统方法组相比,按与实际人群相符的群体药代动力学组的万古霉素初始给药患者死亡率、临床治愈率、肾毒性发生率差异无统计学意义,但可提高患者血药浓度达标率及细菌清除率。根据治疗药物监测结果调整给药剂量可提高患者血药浓度达标率。
[Abstract]:Objective to evaluate the correlation between vancomycin individualized administration method and clinical outcome. Methods to search the database of Pub MedemBase, China knowledge Network, and collect the research of individual administration method. The literature was screened by Cochrane system evaluation method. The quality of literature was evaluated, and effective data were extracted for systematic evaluation. Results six articles were included, 651 cases were studied. Compared with traditional methods, The initial pharmacokinetics according to the population pharmacokinetics in accordance with the actual population could significantly increase the blood drug concentration to the standard rate and the bacterial clearance rate (P 0.05), mortality, clinical cure rate, and renal toxicity rate. There was no significant difference in the incidence of renal toxicity between the two groups, compared with the non-therapeutic drug monitoring group, there was no significant difference between the control group and the non-therapeutic drug monitoring group. According to the results of drug monitoring, adjusting the administration of vancomycin can significantly improve the blood drug concentration to reach the standard. Conclusion compared with the traditional method group, according to the group pharmacokinetic group, the mortality rate and the clinical cure rate of the initial vancomycin administration group are in accordance with the actual population, and the clinical cure rate is higher than that of the traditional method group. There was no significant difference in the incidence of nephrotoxicity, but it could increase the blood drug concentration reaching the standard rate and the bacterial clearance rate, and adjust the dosage according to the therapeutic drug monitoring results to improve the blood drug concentration reaching the standard rate of the patients.
【作者单位】：北京大学第三医院药剂科;北京大学药学院药事管理与临床药学系;
【分类号】：R96

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