Antifungal Medication of Refractory Cryptococcal Meningoencephalitis:A Case Report
Objective To provide a basis for the rational use of antifungal drugs for refractory cryptococcal meningoencephalitis.Methods The antifungal treatment of a patient with refractory cryptococcal meningoencephalitis admitted to the Sichuan Provincial People's Hospital was retrospectively analyzed.After admission,the patient received the intravenous drip of Fluconazole and Sodium Chloride Injection(0.4 g/d)combined with Amphotericin B Cholesteryl Sulfate Complex for Injection(100 mg/d).However,she experienced shivering and high fever(39.8℃)10 min after initial use of the latter one,which were considered to be the infusion reactions,the electrolyte was rechecked and hypokalemia was diagnosed after 10 d of medication.After consultation,the pharmacists suggested that dexamethasone or antihistamines should be used for pretreatment 20-30 min before medication;Fluconazole and Sodium Chloride Injection should be replaced by flucytosine;the dosage of Amphotericin B Cholesteryl Sulfate Complex for Injection should be increased from 100 mg/d to 200 mg/d based on the relevant guidelines and the patient's condition,then increased to 300 mg/d after two weeks;symptomatic treatments such as cooling and potassium supplementation should be given.Physicians adopted the above suggestions.Results The adjustment of the antifungal treatment plan was effective,the patient was better and discharged.Conclusion The participation of clinical pharmacists in the antifungal treatment of refractory cryptococcal meningoencephalitis can provide rational pharmaceutical care and ensure the safety and effectiveness of antifungal medication.
clinical pharmacistrefractory cryptococcal meningoencephalitisantifungal treatmentpharmaceutical carerational drug use
国家科技期刊平台
NSTL
万方数据
