1例疑似美罗培南过敏安全使用亚胺培南西司他丁钠患者的药学监护  

Pharmaceutical Care of a Patient Suspected to Be Allergic to Meropenem and Treated with Imipenem/Cisstatine Sodium

作　　者：马雪[1] 漆婷婷 余文韬[1] MA Xue;QI Tingting;YU Wentao(Department of Pharmacy,School of Medicine,University of Electronic Science and Technology,Sichuan Cancer Center,Chengdu Sichuan 610041,China;Cancer Hospital&Institute,Chengdu Sichuan 610041,China)

机构地区：[1]四川省肿瘤医院研究所,四川省癌症防治中心,四川成都610041 [2]电子科技大学医学院药学部,四川成都610041

出　　处：《中国药物警戒》2021年第9期887-889,共3页Chinese Journal of Pharmacovigilance

基　　金：四川省重点研发计划(2018SZ0268)。

摘　　要：目的探讨使用一种碳青霉烯类药物发生过敏时患者的药学监护,以及不同β-内酰胺类、不同碳青霉烯类药物之间交叉过敏反应的发生情况与发生机制。方法对1例结肠癌术后继发严重腹腔感染的老年男性患者使用美罗培南后出现全身散在皮疹的用药情况进行分析,并积极抗过敏,换用亚胺培南西司他丁钠继续抗感染治疗,给予全程药学监护。结果患者经过积极治疗,皮疹消退,未再出现其他过敏反应,治疗20 d后好转出院。结论碳青霉烯类药物发生过敏主要与其各自的侧链有关,如无法避免使用,在已知一种碳青霉烯类过敏的情况下,建议谨慎选择另一种碳青霉烯药物。Objective To investigate the pharmaceutical care of one patient allergic to carbapenems and analyze the occurrence and mechanism of cross-reactivity betweenβ-lactams and carbapenems.Methods The medication of an elderly male patient who had been treated with meropenem following severe abdominal infection after colon cancer surgery and developed skin rash was analyzed.The patient was then treated with imipenem acetaminophen sodium in conjunction with anti-allergy drugs and pharmaceutical care.Results After twenty days of anti-infection treatment,the patient’s rash subsided and there were no other allergic reactions before he was discharged after improvement.Conclusion Limited studies have shown that the occurrence of allergies is mainly related to the side chain.If carbapenem has to be used,cautious administration of an alternative carbapenem should be considered for patients with previous allergy to another carbapenem.

关 键 词：美罗培南 亚胺培南西司他丁钠 过敏 

分 类 号：R969.3[医药卫生—药理学]