ABSTRACT
Objective To analyze the relationship between plasma concentration and efficacy , adverse drug reactions by monitoring vancomycin serum concentrations for appropriately treating the infections caused by methicillin‐resistant Staphylococcus aureus or other gram‐positive cocci .Methods Vancomycin concentration was monitored in the patients with indications for vancomycin therapy .Blood sample was taken after vancomycin was administered for at least 4 doses .The blood sample collected within 30 minutes before dosing was used to determine the trough blood concentration .The samples were taken within 30 minutes to 1 hour after infusion of vancomycin were used to estimate the peak concentration by fluorescence polarization immunoassay .The clinical data were collected at the same time to analyze clinical efficacy and safety .Results Vancomycin trough concentration ranged from 3 .22 mg/L to 50 .79 mg/L in 25 patients ,specifically ,＜ 5 mg/L in 3 cases ,5‐＜10 mg/L in 11 cases ,10‐15 mg/L in 3 cases ,and > 15 mg/L in 8 csaes .Peak concentration ranged from 13 .57 mg/L to 60 .47 mg/L ,specifically ,＜ 25 mg/L in 14 cases ,25‐40 mg/L in 7 cases ,and > 40 mg/L in 4 cases .The infection was cured in 80 .0% (20/25) of the patients .The gram‐positive cocci were eradicated in 87 .5% (21/24) of the patients .The dosage of vancomycin was adjusted in 13 patients according to the results of blood concentration monitoring .Majority of these patients (12/13 ,92 .3% ) were cured .Renal impairment was observed in 4 patients .Conclusions Vancomycin is safe and effective in treatment of methicillin‐resistant Staphylococcus aureus and other gram‐positive bacterial infections . Vacomycin concentration varies from person to person . Serum concentration monitoring is required to achieve best outcomes and the goal of individualized treatment of vancomycin.
ABSTRACT
Objective To explore the diagnosis and treatment of abdominal cocoon. Methods The clinical data of 16 patients with abdominal cocoon were analyzed retrospectively . Result All the 16 patients with abdominal cocoon were treated and confirmed by operation. Before operation, 11 patients were misdiagnosed as mechanical intestinal obstruction, 4 as chronic appendicitis, and 1 as abdominal tumor.All patients were operated on and postoperative complications were found in 2 patients. All patients were curred clinically and followed up for 1-10years. 2 patients were died of relapsing intestinal obstruction 1,5 years after operation. 2 occurred relapsing incomplete intestinal obstruction accompaning with malnutrition, 12 patients were good during the follow up period. Conclusions Preoperative diagnosis of abdominal cocoon is difficult. The diagnosis mainly depends on the upper gastrointestinal radiography, B-ultrasonography and CT. Removal of the membrane and releasing the intestine adhesions is an effective method in treating this disease.