ObjectiveTo compare the therapeutic effects, blood drug concentration and prognosis between empirical and non-empirical use of vancomycin in patients with severe Gram-positive(G+) cocci infection, and analyze the clinical related factors of affecting patient death.
MethodsAccording to the exact etiological evidence, the patients without etiological evidence were treated with vancomycin, and set as the group E; the patients with etiological evidence were treated with vancomycin, and set as the group P.The valley concentration, cure rate of 7 d anti-infection, 28 d survival rate, renal function and curative effects were compared between two groups.The clinical related factors of death in two groups were analyzed using multivariate logistic regression.
ResultsAmong 60 patients with severe infection, 39 cases in group E and 21 cases in group P were identified.There was no statistical significance in age, body mass, biochemical index, disease severity and valley concentration between two groups(P>0.05), but the differences of body temperature and 28 d survival rate between two groups after 72 h of tretament with vancomycin were statistically significant(P < 0.05).The results of multivariate logistic regression analysis of related clinical factors showed that the cocci infection was associated with patient death confirmed by ancomycin valley concentration, urea nitrogen and culture.
ConclusionsCompared with the non-experimental use of vancomycin, the empirical use of vancomycin can decrease the 28 d survival rate, and affect the patient's anti-infection efficacy, while there is not difference in blood drug concentration between two groups.The clinical patient's kidney function, urea nitrogen and culture confirm that the cocci infection is related to the poor prognosis and death of patients, so it is recommended that vancomycin be administered after the diagnosis of G+ cocci infection, and that renal function should be monitored.
DownLoad: