Clinical Practice of Clinical Pharmacists Participating in Vancomycin Therapeutic Drug Monitoring for Neonates

OBJECTIVE To investigate the role of clinical pharmacists in the clinical practice of vancomycin therapeutic drug monitoring(TDM) for neonates, and provide reference for physicians to adjust the drug administrations. METHODS Thirty one neonates who met the requirements were collected by retrospective analysis. The general conditions, pathogen examinations, results of TDM, influence factors of vancomycin blood drug valley concentrations, clinical efficacy and adverse drug reactions(ADR) were statistically analyzed. RESULTS Among 31 patients, neonatal sepsis accounted for 46.34% in clinical diagnosis; gram-positive bacteria accounted for 88.00% of all the pathogenic examinations, and multi-drug resistant gram-positive bacteria accounted for 77.27%. Only 32.26% cases were monitored within the range of 10-20 μg·mL^-1 in initial blood drug valley concentrations. The compliance rate of vancomycin blood drug valley concentrations could be significantly increased to 83.33% by physicians adopting the clinical pharmacists' intervention suggestions(P<0.05). There was a negative correlation between administration interval and the blood drug valley concentrations(P<0.05). The effective rate of vancomycin was 80.65%, and there was no vancomycin-related ADR occurred in this study. CONCLUSION Vancomycin is effective in treating severe infections caused by gram-positive bacteria in neonates under TDM, however the compliance rates of vancomycin blood drug valley concentrations are low after experiential medication. Physicians' adoption of intervention suggestions from clinical pharmacists and reduction of administration interval can significantly increase vancomycin blood drug valley concentrations, which provide a reference for physicians to adjust the dosage regimen.