目的 分析临床药师参与1 例腹股沟疝修补术后切口感染偶发分枝杆菌患者的治疗方案及药学监护过程.方法 经临床药学、检验科、院感办等多学科会诊后考虑偶发分枝杆菌感染,临床药师查询循证医学证据,协助医生制定及调整偶发分枝杆菌抗感染方案,并针对长疗程联合使用的抗菌药物进行疗效、不良反应及院外随访等药学监护.结果 临床药师首次会诊予以阿米卡星注射液0.6 g qd(维持剂量0.4 g)+莫西沙星氯化钠注射液0.4 g qd+亚胺培南西司他丁1 g q12h+多西环素注射液0.1 g q12h(首剂0.2 g)抗感染治疗,后续根据药品不良反应及循证学证据对方案进行优化调整,患者好转出院.结论 临床药师参与抗感染多学科会诊,通过查阅循证医学证据,协助医生制定抗感染方案及实施全程药学监护,不仅能提高患者治疗效果,还有助于提升临床药师抗感染会诊水平.
Treatment analysis and pharmaceutical care of a case of mycobacterium fortuitum infection after inguinal herniorrhaphy
Objective To analyze the treatment regimen and pharmaceutical care process involved by a clinical pharmacist for a patient with mycobacterium fortuitum infection in the incision after inguinal hernia repair.Methods After the multi-disciplinary consultation on mycobacterium fortuitum with clinical pharmacy,laboratory,and the hospital infection office,clinical pharmacists assisted doctors in formulating and adjusting anti-infection protocols for treating mycobacterium fortuitum,and conducted pharmaceutical care for the efficacy,adverse reactions and out-of-hospital follow-up of antibiotics used in combination for a long course of treatment,on the basis of evidence-based medicine.Results Clinical pharmacists were given amikacin injection 0.6 g qd(maintenance dose 0.4 g)+moxifloxacin sodium chloride injection 0.4 g qd+imipenem cilastatin 1 g q12h+doxycycline injection 0.1 g q12h(first dose 0.2 g)for anti-infection treatment in the first consultation,and then the scheme was optimized and adjusted according to adverse drug reactions and evidence-based medicine.Finally,the patient got better and was discharged.Conclusion Clinical pharmacists participating in multi-disciplinary consultation of anti-infection,and assisting doctors to formulate anti-infection plans and implement whole-process pharmaceutical care by consulting evidence-based evidence can not only improve the treatment effect on patients,but also help improve the anti-infection consultation capability of clinical pharmacists.
万方数据
维普
