TỶ LỆ ĐẠT NỒNG ĐỘ ĐIỀU TRỊ CỦA VANCOMYCIN TRUYỀN TĨNH MẠCH LIÊN TỤC Ở BỆNH NHÂN HỒI SỨC TÍCH CỰC

Abstract

Objective: To determine the rate of achieving target vancomycin plasma concentrations (15–25 mg/L) during continuous intravenous infusion in critically ill patients and to evaluate factors associated with target attainment at the first concentration measurement.

Patients and Methods: A retrospective descriptive study was conducted in adult patients (≥18 years old) admitted to the Intensive Care Unit of Tam Anh General Hospital, Ho Chi Minh City, from December 2023 to December 2024, who received continuous intravenous vancomycin infusion and underwent therapeutic drug monitoring. Exclusion criteria included prior intermittent vancomycin administration, ICU stay of less than 48 hours, and insufficient vancomycin concentration data. Statistical analyses included descriptive analysis of variables related to target attainment, univariate analysis, and multivariate logistic regression to identify factors associated with achieving target concentrations at the first measurement.

Results: A total of 56 patients were included in the analysis. Mean age was 68.48 ± 18.63 years, and median baseline eGFR was 80.31 (50.20–99.05) mL/min/1.73 m². The proportion of patients achieving target vancomycin concentrations at the first measurement was 51.7% and slightly increased to 53.5% after dose adjustment. Multivariate logistic regression analysis showed that baseline eGFR was inversely associated with achieving target concentrations at the first measurement (adjusted OR = 0.22; 95% CI: 0.09–0.54; p < 0.001), whereas loading dose adjusted for body weight was positively associated with target attainment (adjusted OR = 1.57; 95% CI: 1.10–2.25; p = 0.012).

Conclusion: The rate of achieving target vancomycin concentrations during continuous infusion in critically ill patients remained suboptimal, with 51.7% of patients achieving target concentrations at the first measurement and 53.5% after dose adjustment. Baseline eGFR and loading dose adjusted for body weight were independently associated with target attainment at the first measurement.