1例经直肠前列腺穿刺活检术后感染性休克患者抗感染治疗用药分析  

Rationality of anti-infection treatment of a transrectal prostate biopsy patient with septic shock

作　　者：高利臣[1,2] 赵莹凡 文丹丹 

机构地区：[1]长沙市中心医院药学部,长沙410004 [2]长沙市肿瘤研究所,长沙410004 [3]长沙市精神病医院药剂科,长沙410004

出　　处：《中南药学》2017年第12期1788-1791,共4页Central South Pharmacy

基　　金：湖南省科技计划项目(No.2016SK2066);湖南省卫生计生科研计划课题(No.B2016214);湖南省药学会研究基金(No.hn2017009)

摘　　要：目的探讨经直肠前列腺穿刺活检(TPB)术后感染性休克患者抗感染治疗的合理性,为临床合理用药提供参考。方法对1例TPB术后感染性休克患者抗感染治疗方案的制定、用药进行分析,探讨其诊治合理性。结果该患者初始经验性感染治疗方案基本合理,但细菌学检查明确为大肠埃希菌感染后,碳青霉烯类抗生素联合使用头孢哌酮舒巴坦和万古霉素抗感染循证药学证据不足。结论 TPB术后感染性休克患者抗感染治疗,应初始经验性选用碳青霉烯类抗生素及早治疗,但药敏结果明确后建议针对性的选择抗生素抗感染治疗,并利用循证医学证据合理选择抗感染治疗方案。Objective To explore the rationality of anti-infection treatment of a transrectal prostate biopsy patient with septic shock, and provide reference for the rational use of drugs in clinical practice. Methods We analyzed the empirical and subsequent anti-infection therapeutic regimens for a transrectal prostate biopsy patient with septic shock, and evaluated the rationality of drug use. Results The empirical anti-infection treatment for this patient was basically reasonable. However, if Escherichia coli were confirmed by bacteriological examination, there was inadequate ecidence to support the combination use of carbapenems, vancomycin and cefoperazone sulbactam. Conclusion The empirical anti-infection treatment for patients with septic shock after transrectal prostate biopsy should begin with carbapenems in the early treatment. When the drug susceptibility test of infected bacteria was confirmed, the empirical anti-infection treatment with carbapenems is necessary, and the drug choice should be evidence-based.

关 键 词：直肠前列腺穿刺活检术 感染性休克 抗感染治疗 用药分析 

分 类 号：R96[医药卫生—药理学]