临床药师参与耐药诺卡菌及尖端赛多孢菌肺部感染的药学实践  

Clinical pharmacists participating in drug treatment of drug-resistant nocardia and Scedosporium apiospermum infection

作　　者：邓体瑛[1] 胡志敏[2] 徐清[3] 张韶辉[1] 郭珩[1] 胡磊[1] 陈凡[1] DENG Ti-ying;HU Zhi-min;XU Qing;ZHANG Shao-hui;GUO Heng;HU Lei;CHEN Fan(Department of Pharmacy,the First Hospital of Wuhan,Wuhan 430022;Microbiology Section,the First Hospital of Wuhan,Wuhan 430022;Department of Respiratory Medicine,the First Hospital of Wuhan,Wuhan 430022)

机构地区：[1]武汉市第一医院药学部临床药学室,武汉430022 [2]武汉市第一医院检验科微生物室,武汉430022 [3]武汉市第一医院呼吸内科,武汉430022

出　　处：《中南药学》2019年第6期912-916,共5页Central South Pharmacy

摘　　要：临床药师参与了1例耐药诺卡菌及罕见尖端赛多孢菌肺部感染病例的药物治疗过程,通过查阅多方循证证据提出首选大剂量磺胺联合亚胺培南覆盖耐药诺卡菌,并进行药学监护及用药教育。其后患者再发肺部尖端赛多孢菌感染,临床药师再次会诊并予以用药建议并药学监护。其后患者病情好转出院。临床药师在临床发挥了主观能动性,在临床耐药菌、罕见真菌感染的个体化治疗及合理用药中体现其作用,协助医师制订和优化药物治疗方案,保证了用药的安全、有效。Clinical pharmacists participated in the drug treatment process for drug-resistant nocardia combined with rare Scedosporium apiospermum lung infection. By reviewing literature, clinical pharmacists advised the use of high-dose sulfonamides in combination with imipenem to kill nocardia, at the same time, conducting pharmaceutical care and ADR monitoring. The lungs of the patient re-infected with Scedosporium apiospermum, and the clinical pharmacists were consulted again and recommended medication and pharmacological monitoring. Physicians adopted clinical pharmacists’ suggestions. The patient’s condition was improved and was discharged. Clinical pharmacists demonstrated their useful roles in individualized treatment of clinical drug-resistant bacteria and rare fungal infections, and rational drug use to assist physicians in formulating and optimizing drug treatment programs to ensure the safety and effectiveness of drug use.

关 键 词：临床药师 诺卡菌 尖端赛多孢菌 复方磺胺甲噁唑 伏立康唑 

分 类 号：R963.3[医药卫生—微生物与生化药学]