Am J Pharmacol | Volume 3, Issue 1 | Research Article | Open Access
Ma Qinglin3, Zhao Menghua1,2, Liu Jing1, Zhou Jian1, Li Yuhua1, Yang Yuan1, Zhou Ying1, Li Guoqing3, Li Hongyan3, Chen Yuxin3, Zhang Yuting3, Chen Xuemei3, Cao Li1* and Wen Jinhua1*
1Department of Pharmacy, The First Affiliated Hospital of Nanchang University, China
2College of Pharmacy, Nanchang University, China
3College of Medicine, Nanchang University, China
*Correspondance to: Wen Jinhua
Fulltext PDFObjective: To investigate the clinical application of vancomycin plasma concentration monitoring in critically ill patients and the influence of age, gender and the ABCB1 gene mutation on vancomycin drug concentrations to guide clinically rational vancomycin usage. Methods: The vancomycin concentration monitoring data on critically ill patients in our hospital from November 2016 to March 2017 were analyzed. Sixty-eight patients who received the same dosages of vancomycin were subjected to ABCB1 genotyping. Results: Among the 141 critically ill patients, 68 (48.22%) showed sub-target concentrations of vancomycin, averaging 5.58 μg.ml-1 ± 2.54 μg.ml-1; 29 patients (20.56%) had higher than target concentrations, with an average value of 33.01 μg.ml-1 ± 9.38 μg.ml-1; and 44 cases (31.21%) were in the normal concentration range, with an average of 14.72 μg.ml-1 ± 2.75 μg.ml-1. Ninety-eight male patients had average vancomycin concentrations of 13.14 μg.ml-1; 43 female patients had average vancomycin concentrations of 16.19 μg.ml-1. Vancomycin concentrations in critically ill patients aged 60 years or older were significantly higher than those in patients younger than 60 years (19.71 μg.ml-1 ± 13.35 μg.ml-1 vs. 10.57 μg.ml-1 ± 6.67 μg.ml-1); among the over-60-year-old patients, women had significantly higher concentrations than men (25.4 μg.ml-1 ± 14.89 μg.ml-1 vs.17.53 μg.ml-1 ± 12.21 μg.ml-1). No significant difference in concentration was found between male and female patients younger than 60 years. Genotyping was performed on 68 patients treated with the same vancomycin dosage. The results showed that the vancomycin concentrations in 1236TT-genotype patients were significantly higher than those of the 1236CC and 1236CT-genotype patients. The concentrations in the 2677AA-genotype patients were significantly higher than those in the 2677AT, 2677CA, 2677CC and 2677CT patients. Vancomycin concentrations in 3435TT patients were significantly higher than those in 3435CC, but slightly lower than those in 3435CT patients. Conclusion: Age and gender may greatly influence vancomycin concentrations in severely ill patients. The ABCB1 1236C>T, 2677C>T/A and 3435C>T gene mutations may affect vancomycin concentrations.
Vancomycin; Drug concentration monitor; Age; Gender; ABCB1
Qinglin M, Menghua Z, Jing L, Jian Z, Yuhua L, Yuan Y, et al. Analysis of Vancomycin Blood Concentrations in Critically Ill Patients and Effects of Age, Gender and the ABCB1 Mutation on Blood Concentrations. Am J Pharmacol. 2020; 3(1): 1024.