OBJECTIVE To compare the monitoring results of vancomycin steady-state trough concentration(C_min) and 24 h area under the curve(AUC_0-24h) , and analyze the influencing factors of C_min and AUC_0-24h exceeding the upper limit of the target range.

METHODS Patients who received vancomycin treatment in General Hospital of Eastern Theater Command from September 2021 to March 2023 and measured the steady-state peak and trough concentrations at the same time were divided into two groups according to whether C_min was greater than 20 mg·L⁻¹ and AUC_0-24h was greater than 650 mg·h·L⁻¹, and the related influencing factors were analyzed respectively.

RESULTS The 68 patients were included in the study, and 103 pairs of peak and trough concentrations of vancomycin were collected. The proportions of C_min and AUC_0-24h exceeding the upper limit of the target range were 48.54% and 49.51%, respectively; there was a good linear correlation between C_min and AUC_0-24h (correlation coefficient r=0.9492, P<0.05). The presence of acute kidney injury or chronic kidney disease during hospitalization(OR 7.18, 95%CI 1.41−36.53, P<0.05) and the adjustment of dosage regimen after concentration determination(OR 10.61, 95%CI 3.33−33.78, P< 0.05) were independent influencing factors for C_min>20 mg·L⁻¹, while adjusting the dosage regimen after concentration determination(OR 6.15, 95% CI 2.05−18.45, P<0.05) was the independent influencing factor for AUC_0-24h>650 mg·h·L⁻¹.

CONCLUSION The incidence of vancomycin C_min and AUC_0-24h exceeding the upper limit of the target range in clinical practice is approximately 50%. Although most of them have adjusted the dosage regimen after concentration determination, it is recommended that the initial dose administered should be appropriately reduced when the patients are critically ill with concurrent acute kidney injury or chronic kidney disease.