利奈唑胺与头孢哌酮-舒巴坦钠联用致患者血小板减少的案例分析  

Case Analysis of Thrombocytopenia in Patients Caused by Linezolid Combined with Cefoperazone-Sulbactam Sodium

作　　者：牟景丽 李茜 牟景秀 MOU Jing-li;LI Qian;MOU Jing-xiu(The People's Hospital of Liupanshui City,Liupanshui Guizhou 553000,China)

机构地区：[1]六盘水市人民医院,贵州六盘水553000

出　　处：《抗感染药学》2023年第3期242-247,共6页Anti-infection Pharmacy

基　　金：六盘水市社会攻关计划项目(52020-2014-0-05-01)。

摘　　要：目的:分析利奈唑胺联合头孢哌酮-舒巴坦钠抗感染治疗与患者发生血小板减少的关联情况及其相关机制,为保障临床利奈唑胺和头孢哌酮-舒巴坦钠的用药安全提供参考。方法:患者因“突发胸闷、气促伴呼吸困难3 h余”被收入医院ICU,诊断发现其存在肺部感染,且后续痰涂片检出革兰阴性菌和革兰阳性菌,遂予头孢哌酮-舒巴坦钠和利奈唑胺抗感染治疗。结果:患者使用头孢哌酮-舒巴坦钠和利奈唑胺后,出现血小板计数进行性下降的情况,最低达78×10^(9)/L,考虑头孢哌酮-舒巴坦钠和利奈唑胺均有引起血小板减少的情况,且该案例中用药时间与不良反应的发生存在强关联性,遂立即停用头孢哌酮-舒巴坦钠和利奈唑胺,改用美罗培南和万古霉素治疗;不久,患者的血小板指标恢复正常。结论:血小板减少是头孢哌酮-舒巴坦钠和利奈唑胺共同的药物不良反应,临床药师在开展药学监护时对于此种情况应格外重视,重点监测药物不良反应的发生情况,以确保患者的用药安全。Objective:To analyze the correlation between the anti-infective therapy with linezolid combined with cefoperazone-sulbactam sodium and the occurrence of thrombocytopenia in patients and its related preparations,so as to provide reference for the clinical safety of linezolid and cefoperazone-sulbactam sodium.Methods:The patient was admitted to ICU of the hospital because of"sudden chest tightness,shortness of breath and dyspnea for more than 3 hours".It was diagnosed that the patient had pulmonary infection,and Gram-negative and Gram-positive bacteria were found on the subsequent sputum smear,then the patient received anti-infective therapy with cefoperazone-sulbactam sodium and linezolid.Results:After taking cefoperazone-sulbactam sodium and linezolid,the patient had a progressive decrease in platelet count,with a minimum of 78×10^(9)/L.Considering that both cefoperazone-sulbactam sodium and linezolid could cause thrombocytopenia and the time of medication was strongly correlated with the occurrence of adverse reaction in this case,cefoperazone-sulbactam sodium and linezolid were discontinued immediately,and meropenem and vancomycin were used for treatment.Soon,the patient's platelet index returned to normal.Conclusion:Thrombocytopenia is a common adverse drug reaction of cefoperazone-sulbactam sodium and linezolid.Clinical pharmacists should pay special attention to this situation during the pharmaceutical care,and focus on monitoring the occurrence of adverse drug reactions to ensure the medication safety of patients.

关 键 词：血小板减少症 药物不良反应 利奈唑胺 头孢哌酮-舒巴坦钠 

分 类 号：R969.3[医药卫生—药理学]