摘要
一例老年男性COPD患者,反复咳嗽、咳痰20余年,多次住院治疗。此次因活动后喘憋4年余,加重15 d入院。住院期间,患者痰培养为铜绿假单胞菌、泛耐药鲍曼不动杆菌、少量曲霉菌,同时患者喘憋严重,入院前给予甲强龙平喘治疗。入院后,根据该患者既往敏感药物信息及痰培养结果,同时监测患者抗生素疗效,在美罗培南加依替米星治疗效果不佳的情况下,换用左氧氟沙星、头孢哌酮/舒巴坦及米诺环素抗菌治疗。考虑患者真菌感染,曲霉菌不除外,在使用伊曲康唑出现严重静脉刺激后,换用两性霉素B脂质体,并对其使用方法给出药学建议。同时对糖皮质激素的减量提出个体化建议。
One case of elderly male patient with COPD,coughed repeatedly with sputum more than 20 years.He was hospitalized several times these years.This time,he was hospitalized because of asthmatic suffocation after activity for more than 4 years and the symptoms getting worse in 15 days ago.During the hospitalization,the results of sputum culture showed pseudomonas aeruginosa,pan-resistant acinetobacter baumannii and a small amount of aspergillus.Because of the symptoms of severe asthmatic suffocation,the patient was given methylprednisolone prior to hospitalization.After hospitalization,according to the previous antibiotic sensitive information of this patient,the results of the sputum culture and the eff icacy of antibiotics of this patient,clinical pharmacists switched to levo？ oxacin,cefoperazone/sulbactam and minocycline,when combination use of meropenem plus etimicin had a poor effect.Considering the fungal infections and serious vein stimulation induced by itraconazole,liposomal amphotericin B was used.Clinical pharmacists provided professional advices and pharmaceutical care on use of liposomal amphotericin B and individual recommendations of the reduction of the glucocorticoid.
出处
《中国药物应用与监测》
CAS
2011年第6期358-360,共3页
Chinese Journal of Drug Application and Monitoring
关键词
临床药师
药学监护
复杂葡萄糖非发酵菌
曲霉菌
Clinical pharmacist
Pharmaceutical care
Complex glucose non-zymogenic bacteria
Aspergillus
