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| Relationship between serum trough concentration of Vancomycin and renal injury and clinical efficacy in children with severe infection |
| ZHU Desheng1 ZENG Fangling2 YAO Zhenya1 ZHOU Wu1 |
1.The Second Department of Critical Care Medicine, Hu′nan Children′s Hospital, Hu′nan Province, Changsha 410007, China;
2.the Second Department of Emergency Comprehensive, Hu′nan Children′s Hospital, Hu′nan Province, Changsha 410007, China |
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Abstract Objective To investigate the relationship between serum trough concentration of Vancomycin and renal injury and clinical efficacy in children with severe infection. Methods A total of 158 children with severe infection admitted to the Hu′nan Children′s Hospital from May 2017 to May 2018 were enrolled. They were divided into group A (n = 52, <5 mg/L), group B (n = 53, 5-10 mg/L) and group C (n = 53, >10 mg/L) according to the serum concentration of Vancomycin. The clinical efficacy, bacteriological efficacy, and renal function related indexes of the three groups were compared. The incidence of adverse reactions during the treatment of the three groups was recorded. Results There was significant difference in the total clinical effective rate among the three groups (P < 0.05). The total clinical effective rate of group B and group C was significantly higher than that of group A, and group B was higher than that of group C, the differences were statistically significant (P < 0.05). The total effective rate of bacteriology in group B and group C was significantly higher than that in group A, and group B was higher than that in group C, the differences were statistically significant (P < 0.05). Urea nitrogen (BUN), serum creatinine (Scr) and cystatin-C (Cys-C) increased after treatment in three groups, and BUN, Scr and Cys-C in group C were higher than those in group A and group B, the differences were statistically significant (P < 0.05), but there was no significant difference in BUN, Scr and Cys-C between two groups after treatment (P > 0.05). There was no significant difference in mortality among the three groups (P > 0.05). Conclusion The different serum concentrations of Vancomycin have different clinical total effective rate and total bacteriological efficiency. Among them, the serum concentration of 5-10 mg/L Vancomycin is better, and the effect on kidney injury is lighter. It will not increase the mortality rate of children and has certain clinical application value.
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