Correlation between vancomycin blood concentration and adverse reactions in adult patients with severe pneumonia
Sun Guoping
Zhao Mingming
Luo Xuanxiang
Hong Guojun
Abstract：Objective To analyze the relationship between vancomycin blood concentration and adverse drug reactions in adult patients with severe pneumonia.Methods A retrospective analysis was conducted on 92 patients with severe pneumonia who were treated with vancomycin at Nanjing Gaochun People's Hospital from January 2023 to May 2025.The patients were grouped based on their blood concentration levels:according to trough concentrations,they were divided into<10 mg·L-1 group,10-15 mg·L-1 group,>15 mg·L-1 group;and according to peak concentrations,they were divided into<25 mg·L-1 group,25-40 mg·L-1 group,>40 mg·L-1 group.After vancomycin trough and peak concentrations reached steady state,ultra-performance liquid chromatography-tandem mass spectrometry was used to measure blood concentrations,aiming to explore the relationship between vancomycin blood concen-trations and adverse drug reactions in adult patients with severe pneumonia.Results In adult patients with severe pneumonia,the vancomycin blood trough concentration was(12.86±3.51)mg·L-1,and the peak concentration was(30.54±6.28)mg·L-1.The trough concentration range was 3.53-23.04 mg·L-1,and the peak concentration range was 15.21-45.62 mg·L-1.Among the patients,33 cases(35.87%)had a trough concentration below 10 mg·L-1,43(46.74%)had a trough concentration between 10-15mg·L-1,and 16(17.39%)exceeded 15 mg·L-1.Among the patients,28 cases(30.43%)had peak concentrations of less than 25 mg·L-1;51 cases(55.43%)had peak concentrations between 25 and 40 mg·L-1;and 13 cases(14.13%)had peak concentrations greater than 40 mg·L-1.Among the 92 patients,a total of 27 patients experienced adverse drug reactions,with an adverse reaction incidence rate of 29.35%.Among these,there were 11 cases of nephrotoxicity,with an incidence rate of 11.96%;5 cases of rash and pruritus,with an incidence rate of 5.43%;7 cases of Red Man Syndrome,with an incidence rate of 7.61%;and 4 cases of other adverse reactions,accounting for 4.35%.The intergroup comparison of blood trough concentration showed a statistically significant difference(χ2=25.464,P<0.05):patients with trough concentrations>15 mg·L-1 had higher adverse reaction rates than those with trough concentrations<10 mg·L-1 or 10-15 mg·L-1(all P<0.05).Similarly,peak blood drug concentration levels showed a significant difference(χ2=11.286,P<0.05):patients with peak concentrations>40 mg·L-1 had higher adverse reaction rates than those with peak concentration<25 mg·L-1 and 25-40 mg·L-1(all P<0.05).Pearson correlation analysis revealed a positive correlation between vancomycin blood trough concentration,peak concentration,and the incidence of adverse drug reactions(P<0.05).Conclusion In adult patients with severe pneumonia,there is a correlation between vancomycin blood concentration and adverse drug reactions.Under the premise of ensuring therapeutic efficacy,the blood concentration can be reduced by adjusting the dosage,so as to reduce the occurrence of adverse reactions.
Keywords：Severe pneumoniaVancomycinBlood concentrationAdverse reactionsCorrelation Analysis
Publication Date：2025-09-25
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：4( 1169-1172 )