摘要
目的探讨临床药师参与肠杆菌科细菌感染治疗的策略和关注点。方法回顾性分析首都医科大学宣武医院2015年11月30日至2019年11月30日期间临床药师参与的肠杆菌科细菌感染患者会诊记录,包括患者一般情况、感染部位、细菌耐药性、会诊前后用药方案、感染相关指标、营养状况及会诊意见采纳情况等。结果本研究共纳入79例患者,平均年龄为67岁,以肺部和泌尿系统感染为主,主要为肺炎克雷伯菌和大肠埃希菌感染。抗感染方案以β-内酰胺类、碳青霉烯类和氨基糖苷类的双联抗感染方案为主,替加环素等药物的加用利于感染的控制。临床药师根据患者情况提供个性化的抗菌方案、营养方案及水电解质调节方案后,患者感染指标有所改善,显效率、有效率分别为67.09%和21.52%。会诊前后患者的肝肾功能、血糖及蛋白等指标差异均无统计学意义。会诊意见采纳率为89.87%。结论肠杆菌科细菌是神经内科患者感染重要的病原菌。应用β-内酰胺类、碳青霉烯类与氨基糖苷类的双联抗感染方案控制感染效果良好。临床药师参与会诊有利于患者用药的有效性和安全性。
Objective To explore the strategies and concerns of clinical pharmacists in the treatment of Enterobacteriaceae bacterial infection.Methods The consultation records of patients with bacterial infection of Enterobacteriaceae attended by clinical pharmacists in Xuanwu Hospital Capital Medical University from November 30,2015 to November 30,2019 were ret⁃rospectively analyzed.The information was collected including patients'general information,infected site,bacterial resis⁃tance,medication regimen before and after consultation,infection-related indicators,nutritional status and the adoption of consultation advice.Results A total of 79 patients with an average age of 67 years were included in this study.Most of the pa⁃tients were diagnosed with lung and urinary tract infections,mainly caused by Klebsiella pneumoniae and Escherichia coli.The main anti-infection regimens wereβ-lactams,carbapenems and aminoglycosides,and the addition of Tigecycline and other drugs was beneficial to the control of infection.Based on the patents'conditions,clinical pharmacist provided personalized antimicrobial programs,nutrition programs and water and electrolyte regulation programs the infection indexes of patients were improved after pharmacist consultation,the significant efficiency and effective rate were 67.09%and 21.52%,respectively.There were no significant differences in liver and kidney function,blood glucose and protein before and after consultation.The adoption rate of consultation advice was 89.87%.Conclusion Enterobacteriaceae bacterial is an important pathogen of infec⁃tion in neurology department of the hospital.The combined anti-infection regimens ofβ-lactam antibiotics,carbapenems and aminoglycosides were applied to control the infection and obtained good clinical effects.The efficacy and safety of patients'drug use can benefit from the participation of clinical pharmacists in the consultation.
作者
张瑞雪
闫素英
齐晓涟
ZHANG Rui-xue;YAN Su-ying;QI Xiao-lian(Department of Pharmacy,Xuanwu Hospital Capital Medical University,Beijing 100053,China;School of Pharmaceutical Sciences,Capital Medical University,Beijing 100069,China)
出处
《临床药物治疗杂志》
2021年第9期65-69,共5页
Clinical Medication Journal
关键词
临床药师
神经内科
肠杆菌科细菌
肺炎克雷伯菌
大肠埃希菌
抗感染治疗
clinical pharmacist
department of neurology
Enterobacteriaceae infections
Klebsiella pneumoniae
Esche⁃richia coli
anti-infective regimen
