临床药师参与1例嵌合抗原受体T细胞治疗后继发肺毛霉菌病的抗感染治疗  

Anti-Infective Treatment for a Case of Pulmonary Mucormycosis Secondary to Chimeric Antigen Receptor T Cell Therapy by Clinical Pharmacists

作　　者：何丹[1] 曹清 周媛婕 王静[1] 李志玲 He Dan;Cao Qing;Zhou Yuanjie;Wang Jing;Li Zhiling(Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心,上海200127

出　　处：《儿科药学杂志》2024年第7期18-22,共5页Journal of Pediatric Pharmacy

摘　　要：目的:探讨儿科临床药师在肺毛霉菌感染治疗中的作用。方法:临床药师通过参与1例儿童嵌合抗原受体T细胞治疗后继发肺部毛霉菌感染药物治疗,结合抗真菌药物的药动学/药效学(PK/PD)特点、血药浓度监测结果,实施个体化给药治疗。结果:患儿在两性霉素B胆固醇硫酸酯复合物联合泊沙康唑治疗6周后临床症状好转,影像学改善,泊沙康唑血药浓度达标,两性霉素B胆固醇硫酸酯复合物治疗过程中未出现严重不良反应。结论:对于少见的儿童肺毛霉菌感染,两性霉素B联合泊沙康唑治疗可能有效。Objective:To explore the role of pediatric clinical pharmacists in the treatment of pulmonary Mucormycosis infection.Methods:Clinical pharmacists participated into the drug treatment of a child with pulmonary Mucormycosis infection secondary to chimeric antigen receptor T cell therapy.Combined with the pharmacokinetic/pharmacodynamic(PK/PD)characteristics and blood concentration monitoring results of antifungal drugs,individualized drug administration was implemented.Results:After 6 weeks of treatment with amphotericin B cholesteryl sulfate complex combined with posaconazole,improvement was observed in clinical symptoms and imaging,posaconazole blood levels were up to standard level,and there were no severe adverse drug reactions during treatment with amphotericin B cholesteryl sulfate complex.Conclusion:Amphotericin B combined with posaconazole may be effective in the treatment of rare pulmonary Mucormycosis infection in children.

关 键 词：毛霉菌 儿童 两性霉素B 泊沙康唑 血药浓度监测 

分 类 号：R725.6[医药卫生—儿科]