1例肾功能不全合并耐碳青霉烯肺炎克雷伯菌感染患者的药学监护  

Pharmaceutical Care of a Patient With Renal Insufficiency Complicated With Carbapenem Resistant Klebsiella Pneumoniae Infection

作　　者：冯飞飞 刘伦[1] 周庆秋[1] 杜松 Feng Feifei;Liu Lun;Zhou Qingqiu;Du Song(Department of pharmacy,Shandong Tai'an Central Hospital(Tai'an Central Hospital Affiliated to Qingdao University,Taishan Medical Center),Tai'an,Shandong 271000,China)

机构地区：[1]山东省泰安市中心医院(青岛大学附属泰安市中心医院、泰山医养中心),山东泰安271000

出　　处：《首都食品与医药》2023年第7期76-78,共3页Capital Food Medicine

摘　　要：目的探索肾功能不全合并耐碳青霉烯肺炎克雷伯菌感染的治疗经验。方法总结1例肾功能不全合并耐碳青霉烯肺炎克雷伯菌肺部感染患者的治疗方案和药学监护。结果1例70岁男性患者,主因“车祸多处损伤1周”入院,诊断为多处损伤,颈髓损伤(C3-6水平),颈椎间盘突出,颈椎椎管狭窄,T9/10椎间盘突出,L4椎体滑脱,入院后因反复肺部感染和血流感染先后给予多种抗生素治疗,患者病情好转,后因痰培养为耐碳青霉烯肺炎克雷伯菌,感染加重,给予头孢他啶阿维巴坦联合氨曲南抗感染治疗,经治疗后患者体温降至正常,感染指标好转。结论头孢他啶阿维巴坦联合氨曲南是治疗产金属酶肺炎克雷伯菌感染治疗的有效方案;对于重症感染合并肾功能不全的患者,需要平衡重症感染和肾功能两者的关系优化药物治疗剂量。Objective To explore the treatment experience of renal insufficiency complicated with carbapenem resistant klebsiella pneumoniae infection.Methods The treatment plan and pharmaceutical care of a patient with renal insufficiency complicated with carbapenem resistant klebsiella pneumoniae pulmonary infection were summarized.Results A 70 year old male patient was admitted to the hospital mainly because of"multiple injuries in car accidents for one week".The diagnosis was multiple injuries,cervical spinal cord injury(C3-6 level),cervical disc herniation,cervical spinal canal stenosis,t9/10 disc herniation,L4 vertebral body spondylolisthesis.After admission,he was treated with a variety of antibiotics due to repeated lung infection and blood flow infection.The patient's condition improved,and then the infection was aggravated due to sputum culture for carbapenem resistant klebsiella pneumoniae,ceftazidimeavibatan and aztreonam were given to treat the infection.After treatment,the patient's body temperature fell to normal and the infection index improved.Conclusion Ceftazidime-avibatan and aztreonam are effective in the treatment of metalloenzyme producing klebsiella pneumoniae infection;for patients with severe infection complicated with renal insufficiency,it is necessary to balance the relationship between severe infection and renal function and determine the drug treatment plan.

关 键 词：头孢他啶阿维巴坦 氨曲南 耐碳青霉烯肺炎克雷伯菌 药学监护 

分 类 号：R969.3[医药卫生—药理学]