基于临床实践探讨抗PD-1受体治疗患者联用抗菌药物的选择思路  

Choice of antibiotics in combination with anti-PD-1 receptor therapy based on clinical practice

作　　者：潘姝[1] 励萍 陈慧瑾[1] PAN Shu;LI Ping;CHEN Hui-jin(Department of Pharmacy,Shanghai Ninth People’s Hospital,School of Medicine of Shanghai Jiao Tong University,Shanghai 200011;Department of Pharmacy,Mental Health Center of Shanghai Pudong New Area,Shanghai 200124)

机构地区：[1]上海交通大学医学院附属第九人民医院药剂科,上海200011 [2]上海市浦东新区精神卫生中心药剂科,上海200124

出　　处：《中南药学》2021年第4期772-775,共4页Central South Pharmacy

摘　　要：临床药师通过参与临床使用PD-1抑制剂治疗的糖尿病口腔颌面间隙感染患者诊疗过程,协助医师及时发现抗PD-1受体治疗的疗效与肠道菌群紧密联系,发现广谱抗菌药物会改变肠道菌群微生物的组成,从而影响PD-1抑制剂发挥作用,遂与医师一起进行了抗菌治疗方案的调整,为如何根据患者病情制订更合理、有效、有针对性的用药方案提供了思路。患者经过治疗,情况好转。抗PD-1受体治疗患者联用抗菌药物时,方案选择不当可能对免疫治疗产生负面影响,甚至导致严重感染危及生命。临床药师与医师紧密合作制订了能够平衡抗感染和保护肠道特定菌群的个体化抗菌药物治疗方案,使得患者有更好的获益。Clinical pharmacist participated in antibiotic therapy for patients with diabetes mellitus and deep neck infections treated by PD-1 inhibitors,and helped physicians to find out that the efficacy of anti-PD-1 receptors was closely related to gut microbiome,and broad-spectrum antibiotics would change their compositions so as to influence the effect of PD-1 immunotherapy.Clinical pharmacists adjusted the antibiotic choices together with physicians,and provided more rational,effective and targeted drug treatments for patients.Improper antibiotic choices in combination with anti-PD-1 receptor therapy would have negative impact on the immunotherapy,and cause life-threatening infections.Clinical pharmacists working together with physicians in making individualized antibiotic treatment plan help balance the anti-infection and protect specific gut microbiome in patients.

关 键 词：抗PD-1受体治疗 PD-1抑制剂 抗菌药物 临床实践 

分 类 号：R95[医药卫生—药学]