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首页> 外文期刊>Archives of Internal Medicine >Vancomycin levels, efficacy, and toxicity.
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Vancomycin levels, efficacy, and toxicity.

机译：万古霉素含量、功效和毒性。

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The study by Hidayat et al raises more questions than it answers and fails to directly support the authors' main conclusions. "Target trough" is not explicitly defined in the "Methods" section: does it mean greater than or equal to 4 times the MIC of the infecting strain or 15 mug/mL or greater? "Corrected trough" (Table 3) also is undefined. It is unclear whether attainment of target trough was assessed based on the corrected or unconnected trough and whether such attainment was assessed separately for the initial response (Figure 1, first 72 hours only) and the final response (Figure 2, total treatment course). Because the final outcome of therapy was not significantly associated (and initial response was only marginally associated) with achievement of target trough and outcomes seemingly were not analyzed in relation to achievement of troughs 15 mug/mL or greater, the basis for the stated requirement for "... aggressive empirical vancomycin dosing to achieve a trough greater than 15 ug/mL" is unclear. Since combination and alternative therapy were not assessed, the findings do not support the suggestion that such measures should be considered for strains with elevated MICs. Regarding neph-rotoxicity, it would be important to determine which came first, elevated vancomycin troughs or decreased renal function, because the latter predictably would lead to the former, possibly creating the false impression of vanco-mycin-induced nephrotoxic effects.
机译：希等人的研究提出了更多的问题它的答案并不能直接支持作者的主要结论。明确定义在“方法”部分:这意味着大于或等于4倍麦克风感染株或15杯/毫升或更高?“纠正槽”(表3)是未定义的。目前尚不清楚实现目标槽基于修正或评估无关的槽,是否这样的成就分别评估了最初的反应(图1,第一个72小时)和决赛响应(图2,总疗程)。因为治疗的最终结果不是(和初始响应显著相关只是略微相关)与成就目标槽和结果似乎没有分析与实现槽15杯/毫升或更高版本,的基础要求“…万古霉素剂量达到低谷更大比15 ug /毫升”尚不清楚。另类疗法没有评估,研究结果不支持等建议措施应考虑菌株麦克风升高。将是重要的,以确定哪些是第一位的,万古霉素波谷升高或降低肾函数,因为后者可以预见导致前者,可能创建虚假的印象vanco-mycin-induced对肾脏有害处的效果。

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