摘要
目的对1例侵袭性肺毛霉菌肺炎的抗感染治疗进行病例分析,探讨其治疗过程中抗感染治疗药物的选择,以期为临床针对侵袭性肺毛霉菌抗感染治疗提供参考。方法临床药师通过查阅相关文献,结合此例患者的病史、临床表现、实验室检查等情况探讨临床对侵袭性肺毛霉菌感染的治疗过程,并对其抗感染治疗药物选择进行分析,用药学思维提出合理用药建议。结果患者使用注射用两性霉素B联合泊沙康唑口服液3 d后出现胃部不适、恶心,心前区不适,逐渐不能耐受,临床药师考虑可能为泊沙康唑不良反应,建议单用注射用两性霉素B。患者上述症状逐渐缓解,相关感染指标较前下降,提示抗感染有效,使用9 d后患者一般状态明显好转给予转诊当地医院继续治疗。结论在侵袭性肺毛霉肺炎治疗过程中,临床药师可运用药学知识协助医师制定合理的抗感染治疗方案,并进行动态调整,共同提高抗感染诊疗水平,促进药物的合理使用,确保患者用药安全。
Objective To analyze the anti-infective treatment of a case of invasive pulmonary mucormycosis and discuss the choice of anti-infective drugs in the course of treatment in order to provide reference for clinical anti-infective treatment of invasive pulmonary mucormycosis.Methods Clinical pharmacists discussed the treatment process of invasive pulmonary mucormycosis by consulting relevant literature,combining with the medical history,clinical manifestations,laboratory examination and so on,and analyzed the selection of anti-infection drugs,and put forward rational drug use suggestions based on pharmacological thinking.Results After 3 days of using amphotericin B for injection combined with posaconazole oral liquid,patients developed stomach discomfort,nausea and cardiac discomfort,which gradually became intolerable.Clinical pharmacists considered that it might be an adverse reaction of posaconazole.It is suggested that the above symptoms of patients with amphotericin B for injection alone gradually eased,and the related infection indicators decreased compared with before,suggesting that anti-infection was effective.After 9 days of use,the general state of patients improved significantly and were referred to local hospitals for further treatment.Conclusion In the treatment of invasive pulmonary mucor pneumonia,clinical pharmacists can use pharmaceutical knowledge to assist physicians to formulate a reasonable anti-infection treatment plan and make dynamic adjustments to jointly improve the level of anti-infection diagnosis and treatment,promote the rational use of drugs and ensure the safety of patients'medication.
作者
杜萌萌
刘巾玮
DU Meng-meng;LIU Jin-wei(Department of Pharmacy of Chifeng Hospital,Chifeng 024000,China)
出处
《中国处方药》
2023年第12期80-82,共3页
Journal of China Prescription Drug
