临床药师参与一例过敏体质患者泛耐药鲍曼不动杆菌感染的治疗实践
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摘要
目的探讨临床药师在药物治疗实践中的作用。方法以1例过敏体质患者泛耐药鲍曼不动杆菌(XDRAB)肺部感染的治疗过程为例,临床药师根据患者病情变化协助医师制定治疗方案,确定采取降阶梯的治疗策略,初始给予广谱、强效的抗感染治疗,而后针对细菌培养结果调整为针对XDRAB的治疗方案,进一步结合患者病情变化进行用药调整,治疗过程中就不良反应的发生与监护提出建议,并就用药争议点与临床医生充分探讨。结果采用上述方案治疗后,患者感染指标趋于正常,病情逐渐好转。结论临床药师在治疗过程中发挥自己的专业特长,对提高疗效、保障患者用药安全有着积极的作用。
Objective To explore the role of clinical pharmacist in drug therapy practice. Methods Clinical pharmacists participated in the treatment of extensively drug-resistant Acinetobacter baumannii infection for an allergic patient to assist physicians in formulating treatment strategies based on the changes in the patient's condition, taking deescalating strategy and giving broad spectrum antibiotic for initial treatment and giving anti-XDRAB treatment based on the result of bacterial culture and symptoms of the patient. In the treatment, clinical pharmacists gave suggestions about the adverse drug reaction and discussed the controversy with physicians. Results After treatment, the infection indicators of the patient returned to normal and the condition was improved. Conclusion Clinical pharmacists take advantage of their professional expertise,which has a positive effect in improving the efficacy and safety of drug use in thepatients.
Objective To explore the role of clinical pharmacist in drug therapy practice. Methods Clinical pharmacists participated in the treatment of extensively drug-resistant Acinetobacter baumannii infection for an allergic patient to assist physicians in formulating treatment strategies based on the changes in the patient's condition, taking deescalating strategy and giving broad spectrum antibiotic for initial treatment and giving anti-XDRAB treatment based on the result of bacterial culture and symptoms of the patient. In the treatment, clinical pharmacists gave suggestions about the adverse drug reaction and discussed the controversy with physicians. Results After treatment, the infection indicators of the patient returned to normal and the condition was improved. Conclusion Clinical pharmacists take advantage of their professional expertise,which has a positive effect in improving the efficacy and safety of drug use in thepatients.
引文
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[7]陈先华,宫海燕,许思权,等.硫酸庆大霉素雾化吸入佐治急性支气管炎的临床疗效观察[J].中华肺部疾病杂志:电子版,2012,5(2):133-136.
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[10]Fishbain J,Peleg AY.Treatment of acinetobacter infections[J].Clin Infect Dis,2010,51:79-84.
[11]党红星,许峰.鲍曼不动杆菌对常用抗菌药物耐药机制[J].中国小儿急救医学,2016,23(1):5-9,22.
[12]张传军,鲁惠敏.依替米星与阿米卡星临床疗效及安全性比较[J].医药论坛杂志,2008,29(2):4-6.
[2]慢性气道炎症性疾病气道黏液高分泌管理中国专家共识编.慢性气道炎症性疾病气道黏液高分泌管理中国专家共识[J].中华结核和呼吸杂志,2015,38(10):723-729.
[3]中华医学会重症医学分会.中国重症加强治疗病房危重患者营养支持指导意见(2006)[J].中华外科杂志,2006,44(17):1167-1177.
[4]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则:2015年版[M].北京:人民卫生出版社,2015.
[5]Bakuridze LA,Andreu V,Bakuridze AD,et al.Development of inhalation pow der formulation of gentamicin sulphate[J].Georgian M ed New s,2008,(158):52-55.
[6]李飞娥,杜光.雾化吸入庆大霉素注射液的临床应用综述[J].中国药房,2016,27(3):430-432.
[7]陈先华,宫海燕,许思权,等.硫酸庆大霉素雾化吸入佐治急性支气管炎的临床疗效观察[J].中华肺部疾病杂志:电子版,2012,5(2):133-136.
[8]易冬玲.抗菌药物降阶梯治疗特点及临床应用[J].重庆医学,2011,40(21):2162-2164.
[9]刘春峰.鲍曼不动杆菌感染的治疗进展[J].中国小儿急救医学,2016,23(1):10-13.
[10]Fishbain J,Peleg AY.Treatment of acinetobacter infections[J].Clin Infect Dis,2010,51:79-84.
[11]党红星,许峰.鲍曼不动杆菌对常用抗菌药物耐药机制[J].中国小儿急救医学,2016,23(1):5-9,22.
[12]张传军,鲁惠敏.依替米星与阿米卡星临床疗效及安全性比较[J].医药论坛杂志,2008,29(2):4-6.