多黏菌素B雾化治疗泛耐药鲍曼不动杆菌的临床案例分析  

Clinical case analysis of polymyxin B inhalation for Pan drug resistant Acinetobacter Baumannii

作　　者：陈婷 龚善初 李东 

机构地区：[1]深圳市罗湖区妇幼保健院,广东深圳518019 [2]暨南大学第二临床医学院,深圳市人民医院,广东深圳518020

出　　处：《中南药学》2017年第11期1629-1631,共3页Central South Pharmacy

摘　　要：目的评估多黏菌素B雾化治疗泛耐药鲍曼不动杆菌的有效性及意义。方法临床药师通过参与1例在替加环素治疗泛耐药鲍曼不动杆菌疗效不佳且治疗方案棘手的情况,通过查阅文献,收集资料,从药品品种,给药方案、使用疗程上为临床医师提供专业建议。结果通过更改多黏菌素B的用法,雾化治疗14 d后,患者临床症状基本稳定,体格检查无特殊,辅助检查感染指标正常,胸部CT提示病灶较前吸收,病情好转出院。结论为避免治疗的难度,提高患者生存率,可权衡使用多黏菌素B,考虑采用雾化治疗(超说明书用药),同时监测患者雾化吸入的不良反应。Objective To evaluate the effectiveness and significance of polymyxin B inhalation for Pan drug resistant Acinetobacter Baumannii. Methods Clinical pharmacists participated in the treatment of one patient who was given tigecycline for Pan drug resistant Acinetobacter Bauman but had poor effect. Doctors asked a pharmacist for help and the pharmacist provided professional advice, by searching literatures and collecting data on the varieties of drugs, and dosage project, the course of treatment. Results By changing the use of polymyxin B, 14 d after the spraying treatment, the clinical symptoms of the patient became stable, and physical examination was normal, and auxiliary examination and infection indicators were all normal, Chest CT showed the lesion was better absorbed than before, the illness improved and the patient was discharged. Conclusion Considering the difficulty and patient survival, We should adjust the use of polymyxin B, and try inhalation therapy （off-label use）, monitoring the adverse reactions during the inhalation.

关 键 词：多黏菌素B 雾化 鲍曼不动杆菌 临床药师 

分 类 号：R95[医药卫生—药学]