复杂性腹腔感染继发侵袭性真菌感染患者抗感染治疗的药学监护

doi:10.19803/j.1672-8629.2020.02.08

中国药物警戒 ›› 2020, Vol. 17 ›› Issue (2): 106-110.
DOI: 10.19803/j.1672-8629.2020.02.08

复杂性腹腔感染继发侵袭性真菌感染患者抗感染治疗的药学监护

周冉¹, 陈璋璋^2*

1中国科学技术大学附属第一医院/安徽省立医院,安徽合肥 230001;
2复旦大学附属中山医院,上海 200233

收稿日期:2019-02-12 修回日期:2020-06-22 出版日期:2020-02-15 发布日期:2020-02-26
通讯作者: ^*陈璋璋,女,硕士,副主任药师,临床药学与医院药学。E-mail:zzchenwork@163.com
作者简介:周冉,女,硕士,主管药师,临床药学与医院药学。

Pharmacists' Participation in the Treatment of a Patient with Complicated Abdominal Infection Secondary to Invasive Fungal Infection

ZHOU Ran¹, CHEN Zhangzhang^2*

1Division of Life Sciences and Medicine, the First Affiliated Hospital of University of Science and Technology of China, Hefei Anhui 230001, China;
2Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Received:2019-02-12 Revised:2020-06-22 Online:2020-02-15 Published:2020-02-26

摘要/Abstract

摘要： 目的探讨临床药师在胃肠术后复杂性腹腔感染药物治疗中的作用。方法临床药师参与1例复杂性腹腔感染继发侵袭性真菌感染患者的治疗过程,通过结合万古霉素治疗药物监测准确找出患者急性肾损伤的原因,及时调整给药剂量,针对患者继发的念珠菌菌血症,比较抗真菌药三唑类、棘白菌素类、多烯类药代药动学特点,并参考国内外最新指南建议调整抗真菌治疗方案,医师采纳其意见。结果改用该方案治疗7天后,患者血培养转阴,临床药师建议降阶梯后转回普通病房继续治疗。结论临床药师在临床治疗团队中充分运用其扎实的药学知识,协助医师调整用药方案,提高临床药物治疗水平。

关键词: 复杂性腹腔感染, 侵袭性真菌感染, 临床药师, 药学监护

Abstract: Objective To investigate the role of clinical pharmacists in the medication of a patient with complicated intra-abdominal infection after gastrointestinal surgery. Methods By participating in the medication of a patient with complicated abdominal infection secondary to invasive fungal infection, clinical pharmacists were able to find the causes of acute kidney injury of the patient and adjusted the dosage of vancomycin immediately according to the result of treatment with vancomycin. Then, these clinical pharmacists suggested adjusting the therapeutic regimen after comparing the pharmacodynamics and pharmacokinetics of such antifungal agents as triazole, echinocandins and polyene in line with the latest guidelines before the clinicians took the advice. Results After seven days of treatment with this regimen, the blood culture of the patient was negative, so clinical pharmacists suggested that the patient be returned to an ordinary ward for further treatment. Conclusion Clinical pharmacists can assist clinicians in adjusting the drug regimen and improve the level of clinical medication by making full use of their knowledge of pharmacy.

Key words: complicated intra-abdominal infection, invasive fungal infection, clinical pharmacist, pharmaceutical care

中图分类号:

R915

周冉, 陈璋璋. 复杂性腹腔感染继发侵袭性真菌感染患者抗感染治疗的药学监护[J]. 中国药物警戒, 2020, 17(2): 106-110.

ZHOU Ran, CHEN Zhangzhang. Pharmacists' Participation in the Treatment of a Patient with Complicated Abdominal Infection Secondary to Invasive Fungal Infection[J]. Chinese Journal of Pharmacovigilance, 2020, 17(2): 106-110.

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复杂性腹腔感染继发侵袭性真菌感染患者抗感染治疗的药学监护

Pharmacists' Participation in the Treatment of a Patient with Complicated Abdominal Infection Secondary to Invasive Fungal Infection

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