摘要
1例62岁男性患者,主因"腹痛伴发热2 d"入院。入院后经验性给予美罗培南抗感染,体温降至正常。入院第10天再次高热,考虑为耐碳青霉烯类肠杆菌科细菌(CRE)肺部感染,加用替加环素100 mg,q 12 h,ivgtt。药师全程参与患者治疗,认真查阅相关指南、文献,结合患者个体特点,建议行联合药敏试验优化抗感染治疗方案。入院第11天依据联合药敏试验结果停用美罗培南,给予亚胺培南/西司他丁1.0 g,q 8 h,ivgtt。继续监测抗感染疗效欠佳,于入院第14天建议将亚胺培南/西司他丁的给药方式调整为延长滴注3 h,医生予以采纳。2 d后患者体温降至正常。此后患者病情平稳,共住院28 d出院。
A 62-year-old male patient was admitted to the hospital mainly because of abdominal pain with fever for 2 days.After admission,meropenem was empirically given to him and his body temperature dropped to normal.On the 10th day of admission,the patient developed high fever and was considered as CRE pulmonary infection.And then,tigecycline(100 mg,q 12 h,ivgtt)was given to him.Pharmacists participated in the whole course of the treatment,carefully consulted the relevant guidelines and literature,and suggested performing combined chemosensitivity test in order to optimize antibiotic therapy based on his individual information.On the 11th day of admission,meropenem was replaced by imipenem/cilastatin(1.0 g,q 8 h,ivgtt)according to the results of combined chemosensitivity test.But the efficacy of anti-infection was not good.So on the 14th day of admission,the administration of imipenem/cilastatin was adjusted to extended infusion for 3 h,every 8 hours according to the advice of pharmacist.The patient’s temperature dropped to normal 2 days later.His condition was stable and he was discharged on the 28 th day.
作者
王东晓
淳于柳爽
董立
古今
WANG Dong-xiao;CHUNYU Liu-shuang;DONG Li;GU Jin(Department of Pharmacy,Peking University Shougang Hospital,Beijing 100144,China;Taian Central Hospital,Taian 271000,China)
出处
《中国药物应用与监测》
CAS
2020年第6期370-374,共5页
Chinese Journal of Drug Application and Monitoring
作者简介
通信作者:古今,女,主任药师,主要从事医院药学工作。E-mail:gujin301@163.com;王东晓,女,副主任药师,主要从事临床药学工作。E-mail:baixiao301@163.com。
