1例支气管扩张合并肺部铜绿假单胞菌感染患者的抗菌药物选择分析  

Analysis on anti-infection treatment of a bronchiectasis patient with pulmonary infection by Pseudomonas aeruginosa

作　　者：林高通 陈旭[2] 徐珊珊[2] 王戟锋 莫菊彩 马玲敏 陶俊宏 

机构地区：[1]台州市肿瘤医院药剂科,浙江温岭317502 [2]台州市中心医院临床药学室,浙江椒江317700

出　　处：《中国药物应用与监测》2016年第3期188-190,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：1例83岁女性患者,因反复咳嗽咳痰60年,加重10 d,诊断为"支气管扩张"。入院后给予头孢他啶(2 g,bid,ivgtt)联合左氧氟沙星(0.5 g,qd,ivgtt)抗感染治疗,5 d后症状无改善反而加重,咳嗽咳痰加重,药敏结果示铜绿假单胞菌,遂将耐药的头孢他啶更换为敏感的美罗培南(1 g,q 8 h,ivgtt)。治疗期间,临床药师根据抗菌药物PK/PD理论对优化抗菌药物给药方案提出建议,包括对美罗培南的剂量调整、药品不良反应的监测及其他药学监护。经抗感染等对症治疗后,患者整体症状得到有效控制,病情好转出院。One 83-year-old female patient was admitted mainly because of repetitive cough and expectoration for 60 years which was aggravated for 10 days. The patient was treated with ceftazidime(2 g, bid, ivgtt) combined with levofloxacin(0.5 g, qd, ivgtt) after admission. On the fifth day after admission, the patient had no improvement. Meanwhile, Pseudomonas aeruginosa was detected by the bacterial culture of sputum. Then we changed ceftazidime to meropenem. During the treatment, clinical pharmacists gave advice on adjusting the dose of antibacterials according to PK/PD and clinical treatment guidelines, especially for the dosage adjustment of meropenem. After anti-infection and symptomatic treatment, the patient recovered and discharged from hospital.

关 键 词：支气管扩张 铜绿假单胞菌 美罗培南 药学监护 

分 类 号：R562.22[医药卫生—呼吸系统] R563.1[医药卫生—内科学]