摘要
1例患有系统性红斑狼疮、高血压及2型糖尿病基础疾病的老年女性患者合并诺卡菌感染,使用多种抗感染药物联合治疗有效,但出现了肾功能损害、骨髓抑制以及胃肠道功能紊乱导致无法进食等严重不良反应。及时调整和减少可能引起不良反应的药物(如利奈唑胺、复方磺胺甲噁唑等)并积极对症支持治疗,患者整体状态逐渐好转,脏器功能逐渐恢复。后复查发现头颅感染病灶增加,重新使用利奈唑胺但减量至0.6 g,qd,po。治疗过程中未出现明显不良反应,且头颅及肺部感染病灶有所吸收。本例反映药物治疗中疗效和不良反应的矛盾。
An elderly female patient with systemic lupus erythematosus(SLE),hypertension,type 2 diabetes mellitus(T2DM)and being complicated with Nocardia infection was effectively treated by a combination therapy of anti-infective drugs.However,serious adverse drug reactions such as renal function damage,bone marrow suppression and gastrointestinal dysfunction occurred.So we adjusted the medication plan and discontinued some drugs such as linezolid,compound sulfamethoxazole and so on.The overall condition and organ function of the patient were gradually improved after an active symptomatic support treatment was given.We found after reexamination that the infection focus in head were increased.Therefore,the linezolid was reused but reduced to 0.6 g,qd,po.No obvious adverse reactions occurred during the treatment,and the infection focus in head and lung were absorbed.This case reflected the contradiction between the curative effect and the adverse reactions in drug treatment.
作者
叶晓芬
张捷青
金美玲
YE Xiaofen;ZHANG Jieqing;Jin Meiling(Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of PCCM,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《上海医药》
CAS
2020年第21期71-75,共5页
Shanghai Medical & Pharmaceutical Journal
关键词
诺卡菌感染
联合抗感染
不良反应
疗效
Nocardia infection
combination therapy of anti-infection
adverse reactions
efficacy
