Vancomycin (Van) is the preferred drug for clinically treating severe infections caused by Gram-positive bacteria, especially in the intensive care unit (ICU). However, due to safety concerns, strict management and administration of Van are required in clinical practice. Hence, there is a need to develop a rapid and accurate method for determining the concentration of Van. In this study, a cyanostilbene-based fluorescent probe, Cy-KAA, is designed for the rapid, highly sensitive and selective detection of Van. In the probe, the L-Lys-D-Ala-D-Ala polypeptide moiety can interact with Van, resulting in a rapid fluorescence response that reaches a plateau within 2 minutes. Cy-KAA can be employed for the detection of Van in clinical ICU samples, demonstrating a strong correlation with the traditional HPLC method (consistency up to 0.99). These findings highlight the high accuracy and potential utility of Cy-KAA as a powerful tool for real-time monitoring of Van levels in clinical practice, thereby providing valuable guidance for precise drug administration.

万古霉素（Van）是临床上治疗由革兰氏阳性菌引起的严重感染的首选药物，尤其是在重症监护室（ICU）。然而，由于安全方面的考虑，在临床实践中需要对万古霉素进行严格的管理和给药。因此，有必要开发一种快速且准确的方法来测定万古霉素的浓度。本研究设计了一种基于氰基茋类的荧光探针Cy-KAA，用于快速、高灵敏度和选择性地检测万古霉素。在该探针中，L-Lys-D-Ala-D-Ala多肽部分可以与Van相互作用，从而导致2分钟内达到稳态的快速荧光响应。Cy-KAA可用于检测临床ICU样本中的Van，并且其结果与传统的HPLC方法具有很强的相关性（一致性高达0.99）。这些发现强调了Cy-KAA在临床上作为实时监测万古霉素水平的强大工具所具有的高准确性和潜在实用性，从而为精确给药提供有价值的指导。