药物流行病学杂志2024,Vol.33Issue(3) :355-360.DOI:10.12173/j.issn.1005-0698.202305061

1例颅内动脉瘤术后发热患者的抗感染治疗分析

Case analysis of anti-infection treatment for fever after intracranial aneurysm operation

程淑琴 吕露 王伟
药物流行病学杂志2024,Vol.33Issue(3) :355-360.DOI:10.12173/j.issn.1005-0698.202305061

1例颅内动脉瘤术后发热患者的抗感染治疗分析

Case analysis of anti-infection treatment for fever after intracranial aneurysm operation

程淑琴 1吕露 1王伟1
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作者信息

  • 1. 鄂州市中心医院药学部(湖北鄂州 436000)
  • 折叠

摘要

本文报道临床药师参与1例颅内动脉瘤患者术后发热的抗感染治疗经过.患者初期为蛛网膜下腔出血导致的发热,属于非感染性发热.之后出现颅内感染,根据临床相关指南及抗菌药物血脑屏障通透性,优化万古霉素及美罗培南静脉给药方案.后期脑脊液培养提示大肠埃希菌,降阶梯使用头孢他啶,患者颅内感染治愈.住院期间患者出现脱髓鞘性脊髓炎不良事件,考虑与庆大霉素鞘内给药单次剂量过大有关,及时停用鞘内给药方案,最终患者肌力恢复良好.治疗过程中,临床药师协助医师制定并优化个体化治疗方案,为患者安全、有效使用抗菌药物提供参考.

Abstract

This article reported that clinical pharmacists participated in the anti-infection treatment process of a patient with fever after intracranial aneurysm operation.The initial fever in the patient caused by arachnoid hemorrhage was non-infectious fever.Then followed by intracranial infections,the intravenous regimen of vancomycin and meropenem was optimized according to clinically relevant guidelines and the blood-brain barrier permeability of antimicrobials.Later,Escherichia coli was reported via the cerebrospinal fluid culture,and the patient with intracranial infection was cured by step-down therapy with ceftazidime.During hospitalization,the patient experienced an adverse event of demyelinating myelitis,which was considered to be related to the excessive single dose of intrathecal gentamicin.The intrathecal administration was promptly discontinued,and eventually the patient recovered well in muscle power.Throughout the entire treatment process,clinical pharmacists assisted physicians in providing patient with an individualized treatment plan and provided reference for the safe,effective,and rational use of antibiotics.

关键词

颅脑手术/颅内感染/大肠埃希菌/庆大霉素鞘内注射/脱髓鞘性脊髓炎

Key words

Intracranial operation/Intracranial infection/Escherichia coli/Intrathecal gentamicin/Demyelinating myelitis

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出版年

2024
药物流行病学杂志
中国药学会 武汉医药(集团)股份有限公司

药物流行病学杂志

CSTPCD
影响因子:0.746
ISSN:1005-0698
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