Romanian Society of Pharmaceutical Sciences

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PHARMACOKINETIC CHARACTERISTICS OF VANCOMYCIN IN THE TREATMENT OF CRITICALLY ILL PATIENTS WITH PULMONARY INFECTIONS

QINGXIA ZHENG 1, LIPING LIU 1, XIAOWEI MA 1, RUI YANG 1*

1.Critical Care Medicine, Hongqi Hospital of Mudanjiang Medical University, MuDanjiang City, 157011, China

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The aim of this study was to analyse the pharmacokinetics of vancomycin in the anti-infective treatment of critically ill patients from Intensive Care Unit (ICU) with pulmonary infections. The ICU patients were divided according to endogenous creatinine clearance rate (CLCR) into two groups: the normal renal function group (CLCR > 90 mL/min, n = 10) and the renal dysfunction group (CLCR < 90mL/min, n = 10). The endogenous creatinine clearance rate (CLCR) was calculated by determining the serum creatinine. The liver and kidney function, circulatory system function, infection index, age and body weights of patients were analysed. The pharmacokinetic parameters were calculated using DAS2.0 software. The pharmacokinetic parameters obtained were t1/2α = 0.38 h, Vd = 0.41 L/kg, t1/2β = 9.81 h, CL = 0.059 L/min, the peak concentration of treatment was 42.69 mg/L, and the lowest concentration was 11.97 mg/L. The pharmacokinetic parameters of the normal renal function group were t1/2α = 0.26 h, t1/2β = 7.68 h, Vd = 0.28 L/kg, CL = 0.065 L/min. The pharmacokinetic parameters of the renal dysfunction group were t1/2α = 0.43 h, t1/2β = 11.41 h, Vd = 0.42 L/kg, CL = 0.058 L/min. Creatinine clearance showed that the initial dose of vancomycin administered to the patients could not reach the treatment goal, so a new dose is needed to be administered in order to improve the treatment compliance. ICU patients have high drug metabolism and high circulating dynamic state, the age and renal function being the main factors that influence the drug metabolism.