目的评估本院住院患者应用达托霉素的病例特点和用药情况,为临床优化应用达托霉素给药方案提供参考。方法基于"医疗机构药品不良事件主动监测与智能评估警示系统",对本院2014年1月1日至2017年12月31日期间使用达托霉素的住院...目的评估本院住院患者应用达托霉素的病例特点和用药情况,为临床优化应用达托霉素给药方案提供参考。方法基于"医疗机构药品不良事件主动监测与智能评估警示系统",对本院2014年1月1日至2017年12月31日期间使用达托霉素的住院患者进行回顾性分析,收集患者的年龄、性别、身高、体重、科室分布等基本资料,评估达托霉素抗感染疗效及药品不良反应等病例特点以及用药适应证、给药剂量、途径、溶媒、疗程等用药行为。结果共164例住院患者应用达托霉素抗感染治疗,平均年龄(48.61±18.43)岁。抗感染用药原因中仅64例次(35.96%)符合说明书批准的适应证;164例住院患者中149例(90.85%)给予达托霉素常规剂量0.5 g qd,另外15例(9.15%)基于肾功能和体重进行了个体化剂量调整。达托霉素给药前的微生物送检率为59.15%,抗感染治疗有效率66.46%,病历记载的ADR共2例;通过系统主动监测的人工关联性评价阳性的药源性肝损伤2例,达托霉素相关的肌酸激酸升高4例(2.44%),未发现药源性肾损伤阳性病例。结论达托霉素为特殊使用级抗菌药物,本院在使用中仍存在微生物送检率未达标、超适应证用药等问题,提示临床应进一步规范微生物标本送检并优化达托霉素给药方案。展开更多
Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophi...Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.展开更多
文摘目的评估本院住院患者应用达托霉素的病例特点和用药情况,为临床优化应用达托霉素给药方案提供参考。方法基于"医疗机构药品不良事件主动监测与智能评估警示系统",对本院2014年1月1日至2017年12月31日期间使用达托霉素的住院患者进行回顾性分析,收集患者的年龄、性别、身高、体重、科室分布等基本资料,评估达托霉素抗感染疗效及药品不良反应等病例特点以及用药适应证、给药剂量、途径、溶媒、疗程等用药行为。结果共164例住院患者应用达托霉素抗感染治疗,平均年龄(48.61±18.43)岁。抗感染用药原因中仅64例次(35.96%)符合说明书批准的适应证;164例住院患者中149例(90.85%)给予达托霉素常规剂量0.5 g qd,另外15例(9.15%)基于肾功能和体重进行了个体化剂量调整。达托霉素给药前的微生物送检率为59.15%,抗感染治疗有效率66.46%,病历记载的ADR共2例;通过系统主动监测的人工关联性评价阳性的药源性肝损伤2例,达托霉素相关的肌酸激酸升高4例(2.44%),未发现药源性肾损伤阳性病例。结论达托霉素为特殊使用级抗菌药物,本院在使用中仍存在微生物送检率未达标、超适应证用药等问题,提示临床应进一步规范微生物标本送检并优化达托霉素给药方案。
文摘Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.
