【摘要】 1例重症肺炎患者血和痰宏基因下一代测序均检测到金黄色葡萄球菌（携带mecA基因）,初始给予万古霉素（1 g,q12 h,静脉滴注）疗效不佳，稳态谷浓度为1μg·mL^-1,临床药师会诊后考虑患者肾功能亢进，导致药物清除增加，使得在常规剂量下万古霉素的血药浓度偏低，通过上调药物剂量至1 g q6 h后，患者血药浓度达标且感染症状减轻，经过持续监测药物浓度并评估优化给药方案。最终患者病情明显改善，好转出院。更多还原

【Abstract】 A case of a patient with severe pneumonia was detected Staphylococcus aureus（carrying the mecA gene）by both blood and sputum metagenomic next-generation sequencing. The initial treatment regimen was vancomycin 1 g, q12 h, intravenous infusion, which failed to achieve the desired therapeutic effect, steady state trough vancomycin serum concentration was 1 μg·mL^-1. After consultation with a clinical pharmacist, it was considered that the patient’s augmented renal clearance led to increased drug clearance, resulting in a low blood concentration of vancomycin at conventional doses. After elevating the dosage to 1 g q6 h, the patient achieved target serum concentrations and marked clinical improvement. Continuous monitoring of serum vancomycin concentration and optimization of dosing regimen were performed. Ultimately, the patient’s condition improved significantly and was discharged from the hospital.更多还原