某慢性肾炎并发腹膜炎患者抗菌药物应用分析  

Analysis of Application of Antibiotics in Chronic Nephritis Patients with Peritonitis

作　　者：桂万弟 马若浩 

机构地区：[1]武汉市江夏区第一人民医院,武汉430200

出　　处：《中国药房》2014年第22期2055-2058,共4页China Pharmacy

摘　　要：目的:为慢性肾炎并发腹膜炎患者的抗菌药物合理应用提供参考。方法:对某慢性肾炎并发腹膜炎患者的抗菌药物应用情况,从该患者特殊的肾功能状况、腹膜炎常见致病菌分析初始抗菌药物的合理性;从腹水病原微生物培养结果及抗感染相关指标分析后续抗菌药物的合理性,并以此建议用药方案。结果:患者腹膜炎初始抗菌药物选择哌拉西林/他唑巴坦和庆大霉素基本合理,但哌拉西林/他唑巴坦用量可能偏大;同时基于理论后续抗菌药物选择亚胺培南可能比头孢哌酮/舒巴坦效果更优。结论:慢性肾炎患者感染时抗菌药物的合理应用需考虑其特殊的肾功能状况以及致病菌种类,并依据病原微生物培养结果及抗感染相关指标制订和优化用药方案,提高经验用药和后续用药的准确性。OBJECTIVE： To provide reference for the rational application of antibacterial in chronic nephritis patients with peritonitis. METHODS ： The use of antibacterial of a chronic nephritis patient with peritonitis was analyzed on the rationality of initial antibacterial agents in respects of particular renal function and common pathogens of peritonitis. The rationality of subsequent antibacterial agents was analyzed from the culture of pathogenic microorganisms and anti-infection related indicators. The drug regimen was proposed. RESULTS： Piperacillin/tazobactam and gentamicin as the initial antibacterial agents was reasonable basically for the patient with peritonitis; but the dosage of piperacillin/tazobactam may be too large; based on the theory, the effects of imipenem as the subsequent antibacterial drugs were better than that of cefoperazone/sulbactam. CONCLUSIONS： Rational use of antibacterial drugs should consider about the special renal function and the type of pathogens in the chronic nephritis patients. Based on the culture results of pathogenic microorganisms and anti-infection related indicators, the drug program is drawn up and optimized, which improves the accuracy of the experiential and subsequent treatment.

关 键 词：慢性肾炎 腹膜炎 哌拉西林 他唑巴坦 庆大霉素 亚胺培南 合理分析 

分 类 号：R656.41[医药卫生—外科学] R969.3[医药卫生—临床医学]