MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN THẤT BẠI ĐIỀU TRỊ VANCOMYCIN Ở TRẺ MẮC VIÊM MÀNG NÃO DO PHẾ CẦU

Abstract

Objectives: To identify factors associated with vancomycin treatment failure in children with pneumococcal meningitis (Streptococcus pneumoniae). Methods: A retrospective,  descriptive  study  was  conducted  on  59  pediatric  patients  with pneumococcal meningitis treated with vancomycin at Vietnam National Children’s Hospital in the period of 2020 to 2025. Clinical characteristics, laboratory findings, and vancomycin trough concentrations were analyzed to determine factors associated with failure to achieve target trough levels and treatment failure. Results: The rate of achieving the target vancomycin trough concentration was 18.6%. Factors associated with failure to achieve the target trough level in univariate analysis included higher body weight, Glasgow Coma Scale score < 12, mechanical ventilation at admission, and blood leukocyte count > 15 G/L. Multivariate analysis showed that body weight was an independent factor associated with achieving the target trough concentration (OR = 0.6; p = 0.021). The treatment failure rate was 22.6%. Cerebrospinal fluid protein ≥ 2.5 g/L was an independent factor associated with an increased risk of treatment failure (OR = 7.8; 95%CI: 1.51 - 40.39; p = 0.014). Conclusion: The rate of achieving target vancomycin trough concentrations in children with pneumococcal meningitis remains low. Individualized vancomycin dosing and early therapeutic drug monitoring are necessary to optimize treatment outcomes.