目的：调查眼科万古霉素使用情况，并对超说明书用药进行评价，为临床提供参考。方法 ：采用回顾性分析法，选取郑州市第二人民医院2022年1月1日—2024年12月眼科使用万古霉素的159例住院患者为研究对象，对患者基本信息、万古霉素的使用情况、微生物送检情况及超说明书用药情况等进行评价分析。结果：159例患者中男性占比76.1%，主要分布在眼底病病区，致病因素主要为眼外伤（102/159，64.15%），其次为手术源性（36/159，22.64%）。给药途径主要为玻璃体腔注射，以治疗用药为主，多联合头孢他啶治疗眼内感染。病原菌送检率为75.47%，标本检出率为35.07%。其中革兰阳性菌33例，占80.49%，主要为表皮葡萄球菌；革兰阴性菌5例，占12.20%，有大肠埃希菌、铜绿假单胞菌等；真菌4例，占9.76%，主要为曲霉菌。超说明书用药包括玻璃体腔注射、眼内灌洗及超适应证用于眼内炎的预防。玻璃体腔注射超说明书用药推荐等级及证据强度高于眼内灌洗和超适应证。结论 ：万古霉素在眼科临床应用广泛，应严格掌握适应证和用法用量。对于超说明书用药，应在充分评估其合理性和安全性后谨慎使用。本研究对万古霉素的规范化使用及药品说明书修订和个体化治疗具有重要的临床价值和现实意义。

Objective: To investigate the use of vancomycin in ophthalmology department and evaluate its off-label drug use, thereby providing references for clinical practice. Methods: A retrospective analysis was conducted, selecting 159 inpatients who received vancomycin treatment in the Department of Ophthalmology of our hospital from January 1, 2022 to December 31, 2024. The basic information of the patients, details of vancomycin, microbial testing results, and off-label drug use were evaluated and analyzed. Results: Among the 159 patients, male patients accounted for 76.1%, and there were mainly distributed in the fundus disease area. The primary pathogenic factor was ocular trauma (102/159,64.15%), followed by surgical causes (36/159,22.64%). The main route of vancomycin administration was intravitreal injection, primarily for therapeutic purposes. It was often combined with ceftazidime to treat intraocular infections. The submission rate of pathogenic bacteria was 75.47%, and the specimen detection rate was 35.07%. There were 33 cases of gram-positive bacteria, accounting for 80.49%, mainly Staphylococcus epidermidis; 5 cases of gram-negative bacteria, accounting for 12.20%, including Escherichia coli, Pseudomonas aeruginosa, etc.; and 4 cases of fungi, accounting for 9.76%, mainly Aspergillus. Off-label drug use included intravitreal injections, intraocular lavage, and the use of drugs highly suitable for the preventing endophthalmitis. Endogenous infections were mainly caused by gram-negative bacteria. The evidence-based medicine support for vancomycin intravitreal injection in the treatment of endophthalmitis is strong. The recommended grade and evidence strength of off-label use of intravitreal injection are higher than those of intraocular lavage and off-label use. Conclusions: Vancomycin is widely used in ophthalmology, and its indications, usage, and dosage should be strictly controlled. Off-label drug use should be used with caution after a comprehensive evaluation of its rationality and safety. This study holds significant clinical value and practical significance for the standardized use of vancomycin, the revision of drug instructions, and individualized treatment.