Pharmaceutical Care of One Pregnant Woman with Immune Abnormality and Listeria Monocytogenes Bloodstream Infection during Anti-infection Treatment
Objective:To analyze the pharmaceutical care process of one pregnant woman with immune abnormality and Listeria monocytogenes bloodstream infection during anti-infection treatment,and provide reference for the clinical treatment of pregnant women complicated with Listeria monocytogenes infection.Methods and Results:A pregnant woman(31 years old,16+4 weeks of menelipsis)was admitted to the hospital due to fever for 6 days;after admission,bilateral blood culture was performed and cefuroxime was given for empirical anti-infection treatment.On the next day,Listeria monocytogenes was detected from the blood culture,which was sensitive to penicillin,ampicillin and meropenem.Since ampicillin was not available in the hospital and piperacillin-tazobactam sodium was speculated to be effective based on the bacterial drug susceptibility results and the antibacterial spectrum of antibacterial drugs,the anti-infection treatment regimen was switched to piperacillin-tazobactam sodium.After 2 days,the patient had no fever,but Listeria monocytogenes was still detected from the blood culture.About 2 weeks later,the patient had fever again,the influenza A virus antibody IgM was detected positive and the influenza B virus antibody IgM was detected weakly positive.The patient and her family decided to terminate the pregnancy in view of the patient's complex conditions.After induced abortion,the patient received infusions of piperacillin-tazobactam sodium for 3 times and developed symptoms such as muscle soreness,which was suspected to be related to piperacillin-tazobactam sodium,so penicillin was used instead;4 days later,amoxicillin-clavulanate potassium was taken orally,but the patient had rash and itching after administration,which were considered as drug-induced rash.Because the patient had terminated the pregnancy,compound sulfamethoxazole was used instead;the patient's condition improved soon and she was discharged from the hospital.The clinical pharmacist recommended continued treatment with compound sulfamethoxazole and regular follow-up visits.Conclusion:For special populations such as pregnant women with Listeria monocytogenes infection,clinical pharmacists should fully consider patients'specific conditions,assist doctors in formulating a more personalized treatment regimen and adjust it in a timely manner with the disease condition changes,to ensure the safe medication and treatment effects for patients.
Listeria monocytogenesbloodstream infectionpregnant womenpharmaceutical carerational use of drugs
万方数据
维普
