1例既往万古霉素假性过敏患者骨髓炎术后复发的药学监护  

Pharmaceutical care of postoperative recurrence of osteomyelitis in a patient with previous vancomycin pseudoallergy

作　　者：罗伟伟 金建峰[1] 杨琼[1] 郑盼盼[1] 周靓昉 钟丹妮 LUO Weiwei;JIN Jianfeng;YANG Qiong;ZHENG Panpan;ZHOU Liangfang;ZHONG Danni(Department of Pharmacy,Ningbo No.6 Hospital,Ningbo 315100,Zhejiang Province,China)

机构地区：[1]宁波市第六医院药学部,浙江宁波315100

出　　处：《药物流行病学杂志》2024年第8期944-948,共5页Chinese Journal of Pharmacoepidemiology

基　　金：宁波市鄞州区卫生健康科技计划项目(2023Y20)。

摘　　要：1例既往使用万古霉素治疗后出现皮疹的骨髓炎患者复发入院,拟行“硫酸钙-万古霉素植入术”。该患者既往皮疹,经临床药师鉴别为红人综合征(RMS)而非真性药物过敏反应。同时针对既往发生RMS的患者能否行“硫酸钙-万古霉素植入术”,临床药师进行文献分析,建议可在密切监护下继续进行手术。患者术后未出现RMS及过敏反应,且病情好转。本文临床药师从RMS、速发型过敏反应的鉴别入手,同时对万古霉素局部使用与RMS的发生风险进行文献复习,对后续治疗方案提出建议,为临床安全用药及类似疾病的治疗提供参考。A patient with osteomyelitis who developed a rash after previous treatment with vancomycin was admitted to the hospital due to a recurrence of osteomyelitis.After admission,the orthopedic doctor intended to perform a"calcium sulfate vancomycin implantation surgery"on him.Clinical pharmacist identified the patient's previous rash reaction as red man syndrome(RMS)rather than genuine drug allergy.At the same time,in response to the clinical doubt of whether patients with previous RMS can undergo"calcium sulfate vancomycin implantation surgery",clinical pharmacists reviewed and analyzed the literature,and suggested that the surgery can continue under close monitoring.The patient did not experience RMS or allergic reactions after surgery,and the condition improved.In this paper,the clinical pharmacists started with the identification of RMS and rapid allergic reactions,reviewed the literature on the local use of vancomycin and the risk of RMS,and provide suggestions for subsequent treatment,and also provide references for clinical safe drug use and treatment of similar diseases.

关 键 词：万古霉素 假性过敏 红人综合征 临床药师 骨髓炎 

分 类 号：R969.3[医药卫生—药理学]