切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2021, Vol. 07 ›› Issue (03): 263 -267. doi: 10.3877/cma.j.issn.2096-1537.2021.03.012

综述 上一篇    下一篇

万古霉素在成人危重症患者中的应用进展
张慧芳 1, 王瑞兰 1 , ( )   
  1. 1. 201620 上海交通大学附属第一人民医院急诊危重病科
  • 收稿日期:2021-05-07 出版日期:2021-08-28
  • 通信作者: 王瑞兰
  • 基金资助:
    申康市级医院新兴前沿技术联合攻关项目(SHDC 12020106)

Vancomycin in adult critically ill patients

Huifang Zhang 1, Ruilan Wang 1 , ( )   

  1. 1. Department of Critical Care Medicine, Shanghai General Hospital, Shanghai 201620, China
  • Received:2021-05-07 Published:2021-08-28
  • Corresponding author: Ruilan Wang

万古霉素是糖肽类杀菌剂,主要用于治疗耐药金黄色葡萄球菌和肠球菌等革兰氏阳性菌引起的严重感染。重症患者由于生理屏障被破坏,感染发生率高,而且常常合并耐药菌感染,但危重症患者因为毛细血管渗漏和器官功能障碍等使得药物在体内的药动学发生极大的改变,因此万古霉素在重症患者中的使用还需要结合具体实际情况。现就在重症患者中正确合理使用万古霉素作一综述,为优化特殊人群给药提供新思路。

Vancomycin is a glycopeptide bactericidal agent mainly used to treat serious infections caused by Gram-positive bacteria such as drug-resistant Staphylococcus aureus and Enterococcus. In critically ill patients, the incidence of infection is high due to the destruction of physiological barriers, and drug-resistant bacteria infections are common. In critically ill patients the pharmacokinetics of vancomycin is greatly altered by capillary leakage and organs dysfunction, so it is wise to use it individually in different critical situations. Literatures on the proper and rational use of vancomycin in critically ill patients is reviewed to provide ideas for optimizing the administration of this agent in these special populations.

1
Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019 [EB/OL].

URL    
2
Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children [J]. Clin Infect Dis, 2011, 52(3): e18-55.
3
Tunkel AR, Hasbun R, Bhimraj A, et al. 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis [J]. Clin Infect Dis, 2017, 64(6): e34-e65.
4
Quagliarello VJ, Ma A, Stukenbrok H, et al. Ultrastructural localization of albumin transport across the cerebral microvasculature during experimental meningitis in the rat [J]. J Exp Med, 1991, 174(3): 657-672.
5
Scheld WM, Dacey RG, Winn HR, et al.Cerebrospinal fluid outflow resistance in rabbits with experimental meningitis. Alterations with penicillin and methylprednisolone [J]. J Clin Invest, 1980, 66(2): 243-253.
6
von Wedel-Parlow M, Wolte P, Galla HJ. Regulation of major efflux transporters under inflammatory conditions at the blood-brain barrier in vitro [J]. J Neurochem, 2009, 111(1): 111-118.
7
Nau R, Sorgel F, Eiffert H. Penetration of drugs through the blood-cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections [J]. Clin Microbiol Rev, 2010, 23(4): 858-883.
8
Ziai WC, Lewin JJ. Improving the role of intraventricular antimicrobial agents in the management of meningitis [J]. Curr Opin Neurol, 2009, 22(3): 277-282.
9
Cruciani M, Navarra A, Di Perri G, et al. Evaluation of intraventricular teicoplanin for the treatment of neurosurgical shunt infections [J]. Clin Infect Dis, 1992, 15(2): 285-289.
10
Erritouni M, Ktaich N, Rahal JJ, et al. Use of daptomycin for the treatment of methicillin-resistant coagulase-negative staphylococcal ventriculitis [J]. Case Rep Med, 2012, 2012: 593578.
11
Mueller SW, Kiser TH, Anderson TA, et al. Intraventricular daptomycin and intravenous linezolid for the treatment of external ventricular-drain-associated ventriculitis due to vancomycin-resistant Enterococcus faecium [J]. Ann Pharmacother, 2012, 46(12): e35.
12
Anand N, Kollef MH. The alphabet soup of pneumonia: CAP, HAP, HCAP, NHAP, and VAP [J]. Semin Respir Crit Care Med, 2009, 30(1): 3-9.
13
Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society [J]. Clin Infect Dis, 2016, 63(5): e61-e111.
14
Lodise TP, Drusano GL, Butterfield JM, et al. Penetration of vancomycin into epithelial lining fluid in healthy volunteers [J]. Antimicrob Agents Chemother, 2011, 55(12): 5507-5511.
15
Mimoz O, Rolland D, Adoun M, et al. Steady-state trough serum and epithelial lining fluid concentrations of teicoplanin 12 mg/kg per day in patients with ventilator-associated pneumonia [J]. Intensive Care Med, 2006, 32(5): 775-779.
16
Conte JE Jr , Golden JA, Kipps J, et al. Intrapulmonary pharmacokinetics of linezolid [J]. Antimicrob Agents Chemother, 2002, 46(5): 1475-1480.
17
Boselli E, Breilh D, Rimmele T, et al. Pharmacokinetics and intrapulmonary concentrations of linezolid administered to critically ill patients with ventilator-associated pneumonia [J]. Crit Care Med, 2005, 33(7): 1529-1533.
18
Kollef MH, Rello J, Cammarata SK, et al. Clinical cure and survival in Gram-positive ventilator-associated pneumonia: retrospective analysis of two double-blind studies comparing linezolid with vancomycin [J]. Intensive Care Med, 2004, 30(3): 388-394.
19
Peyrani P, Wiemken TL, Kelley R, et al. Higher clinical success in patients with ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus treated with linezolid compared with vancomycin: results from the IMPACT-HAP study [J]. Crit Care, 2014, 18(3): R118.
20
Pinholt M, Ostergaard C, Arpi M, et al. Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006-2009: a population-based cohort study [J]. Clin Microbiol Infect, 2014, 20(2): 145-151.
21
Bishara J, Goldberg E, Leibovici L, et al. Healthcare-associated vs. hospital-acquired Staphylococcus aureus bacteremia [J]. Int J Infect Dis, 2012, 16(6): e457-463.
22
Cosgrove SE, Sakoulas G, Perencevich EN, et al. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis [J]. Clin Infect Dis, 2003, 36(1): 53-59.
23
Saliba P, Hornero A, Cuervo G, et al. Mortality risk factors among non-ICU patients with nosocomial vascular catheter-related bloodstream infections: a prospective cohort study [J]. J Hosp Infect, 2018, 99(1): 48-54.
24
Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America [J]. Clin Infect Dis, 2009, 49(1): 1-45.
25
Mermel LA, Farr BM, Sherertz RJ, et al; Infectious Diseases Society of America; American College of Critical Care Medicine; Society for Healthcare Epidemiology of America. Guidelines for the management of intravascular catheter-related infections [J]. Clin Infect Dis, 2001, 32(9): 1249-1272.
26
Udy AA, Varghese JM, Altukroni M, et al. Subtherapeutic initial beta-lactam concentrations in select critically ill patients: association between augmented renal clearance and low trough drug concentrations [J]. Chest, 2012, 142(1): 30-39.
27
He N, Su S, Ye Z, et al. Evidence-based guideline for therapeutic drug monitoring of Vancomycin: 2020 update by the division of therapeutic drug monitoring, Chinese pharmacological society [J]. Clin Infect Dis 2020, 71(Suppl 4): S363-S371.
28
Cataldo MA, Tacconelli E, Grilli E, et al. Continuous versus intermittent infusion of vancomycin for the treatment of Gram-positive infections: systematic review and meta-analysis [J]. J Antimicrob Chemother, 2012, 67(1): 17-24.
29
Hanrahan T, Whitehouse T, Lipman J, et al. Vancomycin-associated nephrotoxicity: A meta-analysis of administration by continuous versus intermittent infusion [J]. Int J Antimicrob Agents, 2015, 46(3): 249-253.
30
Rybak MJ, Le J, Lodise TP, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists [J]. Am J Health Syst Pharm, 2020, 77(11): 835-864.
31
黄仲义, 肖永红, 张菁, 等. 万古霉素临床应用中国专家共识(2011版) [J]. 中国新药与临床杂志, 2011, 30(8): 561-573.
32
Ariano RE, Fine A, Sitar DS, et al. Adequacy of a vancomycin dosing regimen in patients receiving high-flux hemodialysis [J]. Am J Kidney Dis, 2005, 46(4): 681-687.
33
Freitas FM, Zamoner W, Reis PFD, et al. Vancomycin for dialytic therapy in critically ill patients: Analysis of its reduction and the factors associated with subtherapeutic concentrations [J]. Int J Environ Res Public Health, 2020, 17(18): 6861.
34
Rider TR, Silinskie KM, Hite MS, et al. Pharmacokinetics of Vancomycin in critically ill patients undergoing sustained low-efficiency dialysis [J]. Pharmacotherapy, 2020, 40(10): 1036-1041.
35
Allawati H, Dallas L, Nair S, et al. A pharmacokinetic study comparing the clearance of Vancomycin during haemodialysis using medium cut-off membrane (theranova) and high-flux membranes (revaclear) [J]. Toxins (Basel), 2020, 12(5): 317.
36
Lewis SJ, Mueller BA. Development of a vancomycin dosing approach for critically ill patients receiving hybrid hemodialysis using Monte Carlo simulation [J]. SAGE Open Med, 2018, 6: 2050312118773257.
37
Launay-Vacher V, Izzedine H, Mercadal L, et al. Clinical review: use of vancomycin in haemodialysis patients [J]. Crit Care, 2002, 6(4): 313-316.
38
Ponce D, Zamoner W, Freitas FM, et al. Vancomycin removal during high-volume peritoneal dialysis in acute kidney injury patients: A prospective cohort clinical study [J]. Kidney Int Rep, 2019, 4(1): 112-118.
39
Park SJ, Yang JH, Park HJ, et al. Trough concentrations of vancomycin in patients undergoing extracorporeal membrane oxygenation [J]. PLoS One, 2015, 10(11): e0141016.
40
Donadello K, Roberts JA, Cristallini S, et al. Vancomycin population pharmacokinetics during extracorporeal membrane oxygenation therapy: a matched cohort study [J]. Crit Care, 2014, 18(6): 632.
41
Cristallini S, Hites M, Kabtouri H, et al. New regimen for continuous infusion of Vancomycin in critically ill patients [J]. Antimicrob Agents Chemother, 2016, 60(8): 4750-4756.
[1] 王利宏, 冯亚东, 张小伟, 金龙, 周方伦, 徐国红. 美罗培南骨水泥体外生物力学及洗脱特性研究[J]. 中华关节外科杂志(电子版), 2021, 15(01): 64-70.
[2] 钟小玲, 舒敏. 儿童屎肠球菌脑膜炎的诊断和治疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2021, 17(04): 387-392.
[3] 王惠颖, 苏敏, 高翔羽. 新生儿急性肾损伤生物标志物研究现状[J]. 中华妇幼临床医学杂志(电子版), 2021, 17(01): 7-14.
[4] 何勇, 叶剑锋, 简盛生. 万古霉素复合型抗菌药物骨水泥植入治疗22例骨科术后感染者的疗效[J]. 中华实验和临床感染病杂志(电子版), 2020, 14(02): 163-166.
[5] 郭旭锋, 刘勇军, 高宏伟, 赵养学, 马丁. 万古霉素复合型抗菌药物骨水泥植入术疗法对骨科术后感染的疗效[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(02): 189-192.
[6] 万正利, 李壹, 李亚梅, 安云飞, 严琳, 白杨娟, 王兰兰, 石运莹. 他克莫司个体内变异及其相关因素对移植后肾功能不全的影响[J]. 中华移植杂志(电子版), 2021, 15(02): 71-76.
[7] 石晓萍, 方洁, 王婷, 许青, 吕迁洲. 肝移植受者万古霉素治疗药物监测现状分析及群体药代动力学软件的临床验证[J]. 中华移植杂志(电子版), 2021, 15(01): 15-19.
[8] 房文通, 顾艳宏. 伴有合并症的结直肠癌治疗的药物选择[J]. 中华结直肠疾病电子杂志, 2018, 07(05): 420-430.
[9] 彭晓燕, 宁小元, 徐家云. 静脉补铁与口服补铁治疗非透析慢性肾功能不全患者贫血效果比较的Meta分析[J]. 中华肾病研究电子杂志, 2019, 08(02): 67-72.
[10] 娄元华, 马化芹. 鞘内注射万古霉素治疗重型颅脑外伤开颅术后MRSA颅内感染的临床研究[J]. 中华神经创伤外科电子杂志, 2019, 05(06): 370-372.
[11] 吴江松, 赵宏胜, 崔晓莉. 肾脏相关生物标志物在脓毒症急性肾损伤早期评价中的临床意义[J]. 中华重症医学电子杂志, 2019, 05(02): 132-138.
[12] 范春炜, 陈璟, 车春香, 王巧铃, 林衔亮. BNP/NT-proBNP在老年心力衰竭患者心功能评估中的应用价值[J]. 中华临床医师杂志(电子版), 2020, 14(06): 439-443.
[13] 王劭亮, 陈蓉, 王明欢. 运动性横纹肌溶解症37例诊治分析[J]. 中华临床医师杂志(电子版), 2020, 14(01): 35-38.
[14] 白杨娟, 石运莹, 邹远高, 唐江涛, 李亚梅, 王兰兰. 霉酚酸浓度监测对肾移植受者移植后感染的预测价值初探[J]. 中华临床实验室管理电子杂志, 2018, 06(04): 212-215.
[15] 刘宁, 洪玉才, 章仲恒. 超声造影在急危重症中的应用[J]. 中华诊断学电子杂志, 2018, 06(02): 80-83.
阅读次数
全文


摘要