临床药师在抗菌药物剂量调整中的作用  

Role of Clinical Pharmacists in Dose Adjustment of Antimicrobial Drug

作　　者：孙浩[1] 徐英宏[1] 肇丽梅[1] 王大南[2] 菅凌燕[1] 

机构地区：[1]中国医科大学附属盛京医院药学部,沈阳110004 [2]中国医科大学附属盛京医院党委,沈阳110004

出　　处：《中国药房》2013年第26期2483-2485,共3页China Pharmacy

基　　金：中华医学基金会课题(No.CMB09-977)

摘　　要：目的:探讨临床药师在抗菌药物剂量调整中的作用。方法:通过参与1例细菌性脑膜炎抗感染治疗,临床药师借助药动学/药效学(PK/PD)原理和药物浓度监测手段,将抗菌药物进行个体化调整为:万古霉素1.0g,q8h;美罗培南1.0g,q6h,为医师提供抗菌药物剂量调整方案建议。结果:医师采纳临床药师用药建议,抗感染治疗效果显著,患者颅内感染治愈。结论:临床药师加入抗感染治疗团队后,发挥自身专业特长,使抗感染治疗更为个体化。OBJECTIVE：To discuss the role of clinical pharmacists in dose adjustment of antimicrobial drug. METHODS：Clini-cal pharmacist participated in anti-infection treatment of bacterial meningitis and provided dose adjustment proposal of antimicrobial drug for doctors by means of the principle of PK/PD and drug concentration monitoring to adjust the dose of vancomycin as 1.0 g, q8h and meropenem as 1.0 g, q6h. RESULTS： Doctors adopted the advice of clinical pharmacist and cured bacterial meningitis sue- cessfully. Anti-infective treatment showed significant effect. CONCLUSIONS： Clinical pharmacists give full play to their own pro-fessional skills and provide more individual anti-infection treatment after joining in the treatment team of anti-infection.

关 键 词：神经系统感染 抗菌药物 药动学 药效学 药物浓度监测 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]