1例误诊为中间葡萄球菌肺部感染的药学监护  

Pharmaceutical care for a patient misdiagnosed as Staphylococcus intermedius pulmonary infection

作　　者：李楠[1] 黄海涛 雍小兰[1] LI Nan;HUANG Haitao;YONG Xiaolan(Department of Clinical Pharmacy, Chengdu Military General Hospital, Chengdu 610083, Sichuan, China;Department of Pharmacy, Chengdu Hospital of Chinese People Armed Police Forces, Chengdu 610041, Sichuan, China)

机构地区：[1]中国人民解放军成都军区总医院临床药学科 [2]中国人民武装警察部队四川总队成都医院药械科

出　　处：《中国临床药理学与治疗学》2017年第9期1067-1071,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:临床药师通过对1例误诊为甲氧西林耐药中间葡萄球菌肺部感染患者的药学监护,为临床合理用药提供参考。方法:通过判断是否存在感染及感染的程度、判断可能的病原体、评估可能病原体的耐药情况、经验治疗、目标治疗以及用药后不良反应监测和用药交代等6个方面进行分析,对痰培养及药敏结果为甲氧西林耐药中间葡萄球菌患者进行药学会诊和监护。结果:评估和再次培养均提示可能为多药耐药鲍曼不动杆菌,通过调整给药方案,患者症状和实验室指标得到改善,并且无药物不良反应发生。结论:临床药师参与患者药学监护不但要具备扎实的药学专业知识,同时还应掌握相关的临床诊断和检验分析能力,才能更好地为临床提供帮助和指导。AIM： To provide reference for clini- cal rational use of drugs, clinical pharmacists car- fled out pharmaceutical care for a patient misdiag nosed as methicillin-resistant Staphylococcus interme- dius pulmonary infection. METHODS： Pharmaceu- tical consultation and care on the patient with spu- tum culture and drug sensitivity test of methicillin- resistant Staphylococcus intermedius came into effects by analyzing and estimating the presence and degree of infection, the possible pathogens, the antimicro- bial resistance, the empirical therapy, the goal-di- rected therapy, the monitoring of adverse drug reac- tions and the guidance The results of multiple possible pathogen was to the patient. RESULTS： cultures suggested that the multi-drug-resistant Acinetobacter baumannii. The symptoms and laboratory pa- rameters of the patient were improved after dosage regimen of antimicrobial, and meanwhile no adverse drug reactions occurred. CONCLUSION： Clinical pharmacists participating in pharmaceutical care should not only have a solid knowledge of pharma- ceutical knowledge professionally, but also should grasp the methods of relevant clinical diagnosis and the analysis abilities of laboratory testing results. This can provide better guidance to the clinical treat- ments.

关 键 词：临床药师 中间葡萄球菌 鲍曼不动杆菌 痰培养 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]