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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Comparison of continuous and intermittent IV infusion of vancomycin: Systematic review
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Comparison of continuous and intermittent IV infusion of vancomycin: Systematic review

机译：万古霉素连续和间歇静脉输注的比较：系统评价

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摘要

Background: There is some evidence that administration of vancomycin by continuous infusion has pharmacokinetic and pharmacodynamic advantages over traditional intermittent dosing. Whether these advantages translate into clinical efficacy remains controversial. Objective: To review the literature comparing continuous infusion of vancomycin and conventional intermittent IV dosing in terms of efficacy and safety. Methods: A literature search was conducted in the PubMed/MEDLINE and Embase databases and the Cochrane Central Register of Controlled Trials, and by means of the Google search engine, and the reference lists of pertinent articles were searched manually. All human studies published in English or French that evaluated vancomycin given by continuous and intermittent IV infusion were reviewed. Articles that did not include a comparator arm and those that assessed continuous and intermittent intraperitoneal infusions were excluded. The level of evidence of each study was categorized according to the US Preventive Services Task Force rating scale. Results: In total, 9 studies were identified: 1 in a pediatric population and 8 in adult populations. Of the 3 studies with the highest quality of evidence (level I), one demonstrated pharmacodynamic advantages with continuous infusion of vancomycin. Of the 6 studies representing a moderate level of evidence (level II), 3 also favoured continuous infusion in terms of pharmacokinetic and pharmacodynamic outcomes, but the findings in terms of clinical outcomes were mixed. Conclusions: Current evidence evaluating the pharmacokinetic and pharmacodynamic advantages and clinical efficacy of continuous versus intermittent vancomycin infusions is inconsistent and does not support the routine use of continuous infusion for the treatment of multidrugresistant gram-positive infections.
机译：背景：有证据表明，与传统的间歇给药方式相比，通过连续输注给药万古霉素具有药代动力学和药效学优势。这些优势是否转化为临床疗效仍存在争议。目的：回顾就持续性万古霉素和常规间歇静脉给药的有效性和安全性进行比较的文献。方法：在PubMed / MEDLINE和Embase数据库以及对照试验的Cochrane中央登记册中进行文献检索，并借助Google搜索引擎，手动搜索相关文章的参考文献清单。回顾了所有以英语或法语发表的评估连续和间歇静脉输注万古霉素的人体研究。不包括没有比较器组的文章和评估连续和间歇性腹膜内输注的文章。每项研究的证据水平根据美国预防服务工作队的评分量表进行分类。结果：总共鉴定出9项研究：儿科人群1项，成人人群8项。在3项证据质量最高的研究中（I级），其中一项显示了持续输注万古霉素的药效学优势。在代表中等证据水平（II级）的6项研究中，有3项在药代动力学和药效学结果方面也赞成连续输注，但就临床结果而言，结果是喜忧参半。结论：目前评估连续或间歇性万古霉素输注的药代动力学和药效学优势以及临床疗效的证据不一致，并且不支持将常规输注用于多药耐药革兰氏阳性感染的常规使用。

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