Effect of dynamic monitoring based on renal function indexes on the efficacy and safety of vancomycin in the treatment of MRSA pneumonia in elderly patients

Abstract

Objective: To explore the feasibility of dynamic monitoring based on renal function indexes to evaluate the efficacy and safety indexes of vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in elderly patients, and to provide reference for the evaluation of the feasibility of vancomycin pharmaceutical care. Methods: 118 elderly patients with MRSA pneumonia treated from March 2017 to February 2020 were divided into routine treatment group (n=56) and intervention group (n=62). Patients in the routine treatment group were treated with routine vancomycin, while patients in the intervention group flexibly adjusted the dosage of vancomycin according to the dynamic monitoring of endogenous creatinine clearance (CCR), blood creatinine (SCR) and urea nitrogen (BUN). The changes of CCR, SCR and BUN and the difference of vancomycin serum. Valley concentration were compared between the two groups before and after vancomycin treatment, and the correlation between the changes of CCR, SCR and BUN and vancomycin serum. Valley concentration was analyzed to explore the difference of clinical efficacy and adverse reaction rate between the two groups after treatment. Results: Two factor analysis of variance showed that the serum trough concentrations of SCR, bun and vancomycin in the intervention group were significantly lower than those in the routine treatment group, but the CCR value was significantly higher than that in the routine treatment group (P<0.05). Pearson correlation analysis showed that the serum. Valley concentration of vancomycin was negatively correlated with CCR (r=-0.473), but positively correlated with SCR (r=0.537) and bun (r=0.619) (P < 0.05) more.