ObjectiveTo observe the efficacy of different doses of vancomycin in elderly patients with severe pneumonia and its effect on renal function. MethodsA total of 132 elderly patients with severe pneumonia admitted to our hospital from November 2016 to January 2019 were selected as the research subjects and divided into groups A, B and C according to the random number method, with 44 patients in each group. On the premise of giving basic treatment to patients with severe pneumonia, patients in the three groups were infused different doses vancomycin intravenously, with seven-day treatment courses. The clinical efficacy, vancomycin trough concentration, pre- and post-treatment serum creatinine (Scr), endogenous creatinine clearance (CCR), blood urea nitrogen (BUN), Cystatin C (Cys-C) levels of the three groups were compared. ResultsAfter 7 days of treatment, the total effective rate (90.9%) in group B was significantly higher than that in group A (50.0%) and group C (54.5%), and the difference was statistically significant (P＜0.05). Patients in group B obtained the highest vancomycin trough concentration in the proportion within the effective concentration range (54.5%), which was significantly higher than that in group C (36.4%) and group A (18.2%), with statistically significant difference (P＜0.05). After treatment, the level of Cys-C in group B significantly increased, whereas group C yielded significantly decreased CCR level, and significantly increased BUN and Cys-C levels. The level of Cys-C in group C was significantly higher than that in groups A and B, with statistically significant differences (P＜0.05). ConclusionUsing medium-dose (0.5g/12h) vancomycin in the treatment of elderly patients with severe pneumonia can achieve the best clinical therapeutic effect, and the damage of renal function is minimal.

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