摘要
降阶梯治疗是抗菌药物管理中有明确循证医学证据,且行之有效的重要干预措施之一。本文报道了1例化脓性肌炎患者的抗菌药物降阶梯决策治疗过程。患者入院后明确感染病原体为甲氧西林敏感的金黄色葡萄球菌。临床药师在抗感染多学科诊疗团队中,结合患者病情、病原学结果以及循证医学证据,为患者制定抗菌药物降阶梯治疗决策。降阶梯治疗后患者体温仍有波动,多学科团队在加强引流同时仍坚持降阶梯治疗决策,最终患者痊愈出院。本文通过1例临床药师参与化脓性肌炎抗菌药物降阶梯治疗决策病例分析,检索最新循证医学证据,深入探讨抗菌药物降阶梯治疗的有效性和安全性;以期为抗菌药物安全合理使用提供依据。
Antimicrobial de-escalation is one of the important and effective interventions with clear evidence in antimicrobial stewardship. This article reports a case of a patient with pyomyositis who underwent a antimicrobial de-escalation decision-making process. After the patient was admitted to the hospital, it was confirmed that the infectious pathogen was methicillin-sensitive Staphylococcus aureus. Clinical pharmacist in the anti-infective multi-disciplinary team, combined with the patient’s condition, etiological results and evidence-based medicine, formulated antibacterial de-escalation treatment decisions for the patient. After de-escalation treatment, the patient’s body temperature still fluctuated. The multi-disciplinary team insisted on de-escalating treatment decision while strengthening drainage, and eventually the patient recovered and was discharged from the hospital. This article analyzes a case of clinical pharmacist participating in the decision-making of antimicrobial de-escalation therapy for pyomyositis, retrieves the latest evidence, and deeply discusses the effectiveness and safety of antimicrobial de-escalation therapy, in order to provide evidence for the safe and rational use of antibiotics.
作者
应颖秋
孔旭东
郑佳佳
张哲浩
路明
翟所迪
YING Ying-qiu;KONG Xu-dong;ZHENG Jia-jia;ZHANG Zhe-hao;LU Ming;ZHAI Suo-di(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Department of Laboratory Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Respiratory and Critical Care Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pharmacy,Beijing Municipal bureau of prisons Qinghe Branch hospital,Beijing 100032,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2023年第3期430-433,共4页
The Chinese Journal of Clinical Pharmacology
基金
国家科技重大专项子课题(NO.2017ZX09101001-007-001)。
