万古霉素的肾毒性研究进展

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (5): 597-600.

• 综述与讲座 • 上一篇

万古霉素的肾毒性研究进展

孙潇潇^1,2, 邵华², 王友群¹

¹中国药科大学,南京 210009, 江苏;
²东南大学附属中大医院药剂科,南京 210009, 江苏

收稿日期:2013-10-16 修回日期:2014-05-20 出版日期:2014-05-26 发布日期:2014-06-05
通讯作者: 邵华,女,博士,副主任药师,研究方向:临床药学。Tel: 025-83262632 E-mail: gycsh@163.com 王友群,男,硕士,副教授,研究方向:心血管药理及临床药学。Tel: 13851803484 E-mail: wyqfbox@163.com
作者简介:孙潇潇,女,硕士研究生,研究方向:临床药学。Tel: 15850572293 E-mail: yh567@foxmail.com

Research progress of vancomycin nephrotoxicity

SUN Xiao-xiao^1,2, SHAO Hua¹, WANG You-qun²

¹China Pharmaceutical University, Nanjing 210009,Jiangsu, China;
²Department of Clinical Pharmacy, Department of Pharmacy, Zhongda Hospital of Southeast University, Nanjing 210009,Jiangsu,China

Received:2013-10-16 Revised:2014-05-20 Online:2014-05-26 Published:2014-06-05

摘要/Abstract

摘要： 万古霉素是治疗严重革兰氏阳性菌感染的重要药物,同时也具有一定的肾毒性。目前的指南均推荐提高万古霉素的谷浓度,以确保临床疗效。但这种高谷浓度给药方案对患者肾功能的影响颇具争议。本文对万古霉素的肾毒性研究进展作一综述,重点阐述谷浓度和肾毒性的关系。

关键词: 万古霉素, 肾毒性, 谷浓度

Abstract: Vancomycin is an essential antibiotic to treat serious gram-positive bacterial infections, which is also linked to some extent of nephrotoxicity. The contemporary guidelines all promote to shift the vancomycin trough level to ensure the clinical efficacy. However, there is much debate that the high trough regimen may influence the renal function of patients. This article reviews the research progress of vancomycin-associated nephrotoxicity and mainly describes the relationship between trough levels and nephrotoxicity.

Key words: vancomycin, trough levels, nephrotoxicity

中图分类号:

孙潇潇, 邵华, 王友群. 万古霉素的肾毒性研究进展[J]. 中国临床药理学与治疗学, 2014, 19(5): 597-600.

SUN Xiao-xiao, SHAO Hua, WANG You-qun. Research progress of vancomycin nephrotoxicity[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(5): 597-600.

参考文献

[1] 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-e55.
[2] 陈佰义, 管向东, 何礼贤. 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.
[3] Rybak M,Lomaestro B,Rotschafer JC,et al.Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists[J].Am J Health Syst Pharm,2009,66(1):82-98.
[4] Arimura Y, Yano T, Hirano M, et al. Mitochondrial superoxide production contributes to vancomycin-induced renal tubular cell apoptosis[J].Free Radic Biol Med, 2012, 52(9): 1865-1873.
[5] Gupta A, Biyani M, Khaira A. Vancomycin nephrotoxicity: myths and facts[J].Neth J Med,2011,69(9):379-383.
[6] Lodise TP, Lomaestro B, Graves J, et al. Larger vancomycin doses (at least four grams per day) are associated with an increased incidence of nephrotoxicity[J].Antimicrob Agents Chemother,2008,52(4): 1330-1336.
[7] Wong-Beringer A, Joo J, Tse E, et al. Vancomycin-associated nephrotoxicity: a critical appraisal of risk with high-dose therapy[J]. Int J Antimicrob Agents,2011,37(2): 95-101.
[8] Jeffres MN, Isakow W, Doherty JA, et al. A retrospective analysis of possible renal toxicity associated with vancomycin in patients with health care-associated methicillin-resistant Staphylococcus aureus pneumonia[J].Clin Ther,2007,29(6):1107-1115.
[9] Pritchard L, Baker C, Leggett J, et al. Increasing vancomycin serum trough concentrations and incidence of nephrotoxicity[J]. Am J Med,2010, 123(12):1143-1149.
[10] Elyasi S, Khalili H, Dashti-Khavidaki S, et al. Vancomycin-induced nephrotoxicity: mechanism, incidence, risk factors and special populations. A literature review[J]. Eur J Clin Pharmacol,2012,68(9): 1243-1255.
[11] Hall RG, Hazlewood KA, Brouse SD, et al. Empiric guideline-recommended weight-based vancomycin dosing and nephrotoxicity rates in patients with methicillin-resistant Staphylococcus aureus bacteremia: a retrospective cohort study[J]. BMC Pharmacol Toxicol,2013, 14(1):12.
[12] Lodise TP, Patel N, Lomaestro BM, et al. Relationship between initial vancomycin concentration-time profile and nephrotoxicity among hospitalized patients[J]. Clin Infect Dis, 2009, 49(4): 507-514.
[13] Van Hal SJ, Paterson DL, Lodise TP. Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter[J]. Antimicrob Agents Chemother,2013, 57(2):734-744.
[14] Kullar R, Davis SL, Levine DP, et al. Impact of vancomycin exposure on outcomes in patients with methicillin-resistant Staphylococcus aureus bacteremia: support for consensus guidelines suggested targets[J].Clin Infect Dis,2011,52(8): 975-981.
[15] Cano EL, Haque NZ, Welch VL, et al. Incidence of nephrotoxicity and association with vancomycin use in intensive care unit patients with pneumonia: retrospective analysis of the IMPACT-HAP database[J]. Clin Ther,2012,34(1): 149-157.
[16] Wunderink RG, Niederman MS, Kollef MH, et al. Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study[J]. Clin Infect Dis,2012, 54(5):621-629.
[17] Davies SW, Guidry CA, Petroze RT, et al. Vancomycin and nephrotoxicity:Just another myth[J] ？ J Trauma Acute Care Surg, 2013, 75(5): 830-835.
[18] van Hal SJ, Fowler VG. Is It Time to Replace Vancomycin in the Treatment of Methicillin-Resistant Staphylococcus aureus Infections[J] ？ Clin Infect Dis,2013,56(12):1779-1788.
[19] Bosso JA, Nappi J, Rudisill C, et al. Relationship between vancomycin trough concentrations and nephrotoxicity: a prospective multicenter trial[J]. Antimicrob Agents Chemother,2011,55(12):5475-5479.
[20] 黄原原,张浩,易斌,等.慢性肾功能不全对药动学影响研究进展[J].中国临床药理学与治疗学,2012,17(006):715-720.
[21] 陈湘平,林风辉,刘钦华,等.老年患者肾功能分期对万古霉素血清谷浓度的影响[J].医药前沿,2012 (29).
[22] Panwar B, Johnson VA, Patel M, et al. Risk of Vancomycin-induced Nephrotoxicity in the Population With Chronic Kidney Disease[J]. Am J Med Sci,2013,345(5):396-399.
[23] Kullar R, Davis SL, Taylor TN, et al. Effects of targeting higher vancomycin trough levels on clinical outcomes and costs in a matched patient cohort[J]. Pharmacotherapy,2012,32(3):195-201.
[24] Ye ZK, Tang HL, Zhai SD. Benefits of Therapeutic Drug Monitoring of Vancomycin: A Systematic Review and Meta-Analysis[J]. PLoS One,2013, 8(10):e77169.

万古霉素的肾毒性研究进展

Research progress of vancomycin nephrotoxicity

PDF (PC)

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	吴莉莉, 梁至, 黄思咏, 王妍. 肾功能亢进对感染性心内膜炎患者万古霉素药动学的影响及有效性与安全性研究[J]. 中国临床药理学与治疗学, 2023, 28(10): 1139-1145.
[2]	王新丽, 许霞青, 方寒冰, 郭玉忠. 佛波酯增强顺铂的抗肿瘤活性及降低其肾毒性的作用研究[J]. 中国临床药理学与治疗学, 2022, 27(5): 535-543.
[3]	林良沫, 符祥俊, 钟莉莉, 王和芳, 吴琼诗, 肖坚. 中性粒细胞缺乏患者万古霉素群体药代动力学模型的建立[J]. 中国临床药理学与治疗学, 2021, 26(9): 1014-1022.
[4]	符祥俊, 黄莉, 郭丽, 林良沫. 万古霉素AUC/MIC在多重耐药革兰阳性菌致重症感染中的应用分析[J]. 中国临床药理学与治疗学, 2021, 26(7): 775-781.
[5]	吴懿, 方芳, 陈瑛, 樊军卫. 供受体CYP3A5基因型对肝移植术后早期他克莫司谷浓度的影响作用及其临床意义[J]. 中国临床药理学与治疗学, 2021, 26(6): 631-639.
[6]	郭仙忠, 林荣芳, 林玮玮. 基于群体药动学模型的万古霉素个体化给药软件研制及应用[J]. 中国临床药理学与治疗学, 2021, 26(1): 30-39.
[7]	朱敏，张翠锋，过怿赟，祝子明. 万古霉素在老年感染患者体内的群体药代动力学研究[J]. 中国临床药理学与治疗学, 2019, 24(2): 158-163.
[8]	蔡名敏，姚澜，张经纬，周芳，王广基. 基于线粒体损伤机制的药物性急性肾损伤研究进展[J]. 中国临床药理学与治疗学, 2018, 23(5): 578-585.
[9]	陈曜曜，史道华，刘光华，牛培广，刘柏晨. OCT2、MDR1基因多态性与婴幼儿万古霉素血药浓度及临床疗效的相关性研究[J]. 中国临床药理学与治疗学, 2018, 23(2): 154-158.
[10]	丁志荣，蔡晓祯，曾海文，林天来. 万古霉素在神经外科开颅术后患者颅内的群体药代动力学[J]. 中国临床药理学与治疗学, 2018, 23(11): 1252-1257.
[11]	俞华军，黄凯，张展，郭峭峰，张晓文，张春. 探讨万古霉素硫酸钙联合超短波治疗创伤性骨髓炎临床疗效及安全性[J]. 中国临床药理学与治疗学, 2017, 22(5): 556-559.
[12]	赵水瑜，刘红霞，郑青山，许羚. 五酯胶囊对器官移植病人他克莫司稳态谷浓度影响的定量分析[J]. 中国临床药理学与治疗学, 2016, 21(10): 1132-1136.
[13]	连燕娜，高丽萍. 益气补肾方药对顺铂致大鼠肾毒性及顺铂抗肿瘤活性的影响[J]. 中国临床药理学与治疗学, 2016, 21(1): 50-54.
[14]	孙晨, 奇锦峰, 余文浩, 王永辉, 林梅, 张娜. 肉桂等八种中药对小鼠肾脏三种主要有机阴离子转运体的影响[J]. 中国临床药理学与治疗学, 2015, 20(9): 985-992.
[15]	金婉冰. 葛根素对庆大霉素致大鼠肾毒性的保护作用[J]. 中国临床药理学与治疗学, 2013, 18(8): 864-867.