Analysis Of The Serum Concentration Distribution And Clinical Therapeutic Effect On Children With Severe Pneumonia Infected By Gram-positive Cocci With The Treatment Of Vancomycin

Objective To analyze the characteristics of serum vancomycin concentrations and the relationships between vancomycin concentrations and clinical therapeutic effects.Methods To analyze the serum vancomycin concentrations of 59 children diagnosed with severe pneumonia caused by gram-positive cocci and treated with vancomycin retrospectively. Analyzed the data of concentrations, biochemical values and disease status.Results(1)The serum vancomycin concentrations of severe pneumonia children accompanied by acyanotic congenital heart disease was significantly higher than those who don`t have congenital heart disease,(12.12 mg/L vs 7.76 mg/L, P=0.008).(2)The therapeutic effect of 40-60mg/(kg?d) dosage group was distinctly higher than that <40mg/(kg?d) group(89.47% vs 46.15%, P=0.004), while the therapeutic effect was similar between 40-60mg/(kg?d) and >60mg/(kg?d) dosage group.(3) Acute liver function damage and moderate/severe anemia may be risk factors for vancomycin poor theraputic effects to severe G+ cocci pneumonia children(P<0.05). Conclusion Severe G+ cocci pneumonia children accompanied by acyanotic congenital heart disease may lead to the high serum concentration. The therapeutic effect of 40-60mg/(kg?d) dosage group can reach a satisfactory level. Besides, for children with acute liver function damage and moderate/severe anemia, the pediatricians should strictly supervise the state of illness so as to prevent the adverse prognosis.