摘要
目的分析脓肿分枝杆菌复合群(MABC)引起人工关节置换术后假体周围感染(PJI)的文献,探讨MABC致PJI的治疗现状及药学监护。方法检索中国知网、万方、中国生物医学文献服务系统、PubMed、ScienceDirect、Springer Link、Wiley Online Library等数据库,自建库以来至2020年9月30日期间符合纳入标准的病例资料。统计MABC致PJI的患者基线信息、外科治疗、抗感染药物治疗等情况,分析MABC致PJI的治疗方案及药学监护。结果各大数据库中共检索出14篇关于MABC致PJI的个案报道,有效病例15例;外科治疗方法主要包括关节穿刺术、开放清创术、二期翻修术;抗感染治疗强调根据药物敏感性结果长期联合用药,常见药品不良反应为阿米卡星的耳、肾毒性及替加环素的胃肠道反应。结论MABC是PJI罕见且难治的病原菌,需要外科手术联合抗感染药物治疗。患者在接受长期治疗的过程中易发生不良反应,临床药师应积极开展药学监护工作。
Objective To investigate the therapeutic regimens and pharmaceutical care of periprosthetic joint infection(PJI)caused by Mycobacterium abscessus complex(MABC)after arthroplasty.Methods CNKI,Wanfang,SinoMed,PubMed,ScienceDirect,Springer Link,Wiley Online Library databases were retrieved from establishment to September 30,2020.To discuss the therapeutic regimens and pharmaceutical care of MABC PJI,data were analyzed on patient baseline information,surgical treatment and antimicrobial treatment.Results A total of 14 articles and 15 valid cases were included.Surgical treatment mainly consists of arthrocentesis,open debridement and two-stage revision.It was vital to conduct a prolonged and multidrug antimicrobial regimen according to in vitro drug susceptibility tests.The most common adverse drug effects were ototoxicity and nephrotoxicity of Amikacin followed by gastrointestinal reactions induced by Tigecycline.Conclusion MABC is a rare and intractable pathogen of PJI.Surgical procedures combined with antimicrobial drug therapy are needed.Patients are prone to encounter adverse drug reactions during prolonged therapy.Clinical pharmacists should actively provide pharmaceutical care.
作者
陈玥
戴书玥
刘磊
CHEN Yue;DAI Shu-yue;LIU Lei(Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100129,China;Clinical Pharmacy,School of Pharmacy,Tianjin Medical University,Tianjin 300070,China;Department of Neurosurgery,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)
出处
《临床药物治疗杂志》
2022年第2期67-75,共9页
Clinical Medication Journal
关键词
脓肿分枝杆菌复合群
非结核分枝杆菌
假体周围关节感染
抗感染治疗
药学监护
Mycobacterium abscessus complex
non-tuberculous mycobacteria
periprosthetic joint infection
antimicrobial treatment
pharmaceutical care
