A Clinical Study On Factors Affecting The Plasma Concentration Of Vancomycin In Serum For Newborn Infants

Purpose:To monitor the serum concentration of vancomycin in newborn,and evaluate factors affecting the through concentration of vancomycin to guide rational clinical use.Methods:43 newborn infants,who were prescribed vancomycin for an anti-infection treatment in Maternal and Child Health Hospital of WuXi City,were included in this study.The determination of vancomycin serum concentration was carried out on an automatic FLC two-dimensional chromatography.The steady-state valley concentration of vancomycin was extracted half an hour before the fifth administration,and the steady-state peak concentration was extracted 1 h after the fifth administration.The valley concentrations in the range of 10 ?g·mL-1 to 20 ?g·mL-1 were up to the standard.Clinical data including general information(gender,gestational age,weight et al.),therapeutic scheme(first dose,single dosage,dosage frequency et al.)and vancomycin serum concentration(the first through concentration,peak concentration et al.)was collected.A SPS.23 software was applied for data statistics.Results:1.According to empirical antibiotics treatment,only 27.9%patients reached the standard for vancomycin serum concentration,after dosage adjustment 58.1%patients reached the standard in total.2.The average bacteria clearance days for newborn infants whose through concentration of vancomycin was between 10 to 20 ?g·mL-1 were shorter than those whose through concentration was less than 10 ?g·mL-1.3.After the anti-infection therapy of vancomycin,there was a significant decrease in BUN,SCR,CsyC and increase in ALT.No significance was found in AST and no adverse drug reaction happened.4.The correlation between weight,daily dosage and the first through concentration of vancomycin was revealed.Combined with the data after dosage adjustment,the main intervals.Birthday weight also affected the concentration of vancomycin.5.The drug combination of amoxicillin clavulanate potassium,spironolactone and vancomycin would affect the through concentration of vancomycin.No drug interaction was found between caffeine,vitamin D,Meropenem and vancomycin.6.Although there was no significance between the breast feeding group,formula milk powder feeding group and parenteral nutrition group,the average bacteria clearance days for breast feeding group was shorter than the parenteral nutrition group.Conclusion:It is necessary for newborn infants to accept therapeutic drug monitoring if vancomycin was prescribed.In conclusion,the main factors affecting the serum concentration included weight,daily dosage and gestational age.The level of serum creatinine and treatment intervals also affected the concentration of vancomycin.Although there was no relationship between breast feeding and the serum concentration of vancomycin,it is recommend for newborn infants because breast feeding would improve immunity and prognosis.