中国临床药学杂志2024，Vol.33Issue(3)：185-192,8.DOI:10.19577/j.1007-4406.2024.03.004
万古霉素谷浓度范围对新生儿抗感染疗效及安全性影响的Meta分析
Meta-analysis of clinical efficacy and safety of vancomycin trough concentration range on neonates with infectious diseases
摘要
Abstract
AIM To evaluate the impact of different vancomycin trough serum concentrations on clinical efficacy and safety in neonates and determine its optimal range.METHODS PubMed,Web of Science,Embase and other databases were searched with keywords of"Vancomycin","Infant,newborn","Drug monitoring"and"Trough concentration"from inception to May 2023.The target trough concentrations were grouped as[10,20)μg·mL-1,＜10μg·mL-1 and ≥ 20 μg·mL-1.RevMan5.3 software was used for the Meta-analysis.RESULTS A total of 16 studies involving 1 581 neonates were included.Compared with neonates with vancomycin trough concentrations＜10 μg·mL-1,those with trough concentrations ranging from 10 to less than 20 μg·mL-1 had higher clinical efficacy rates[OR=4.78,95％CI(2.58,8.85),P＜0.01]and higher microbial clearances[OR=10.14,95％CI(4.84,21.24),P＜0.01],while there was no difference in incidence of nephrotoxicity,hepatotoxicity and ototoxicity.Compared with neonates with vancomycin trough concentrations ≥ 20 μg·mL-1,trough concentrations ranging from 10 to less than 20 μg·mL-1 had lower incidence of nephrotoxicity[OR=0.21,95％CI(0.10,0.45),P＜0.01],while there was no difference in clinical efficacy rate,microbial clearance,incidence of hepatotoxicity and ototoxicity(P＞0.05).CONCLUSION A vancomycin trough concentration ranging from 10 to less than 20 μg mL-1 can improve clinical efficacy in neonates,while trough concentrations ≥ 20 μg·mL-1 may increase the incidence of nephrotoxicity.关键词
万古霉素/谷浓度/药物监测/药物不良反应/Meta分析Key words
vancomycin/trough concentration/therapeutic drug monitoring/adverse drug reaction/Meta-analysis引用本文复制引用
刘天阳,吴运芹,于锋,李霁..万古霉素谷浓度范围对新生儿抗感染疗效及安全性影响的Meta分析[J].中国临床药学杂志,2024,33(3):185-192,8.基金项目
中央高校基本科研专项资金(编号3010010004) （编号3010010004）
