临床药师参与1例宫内感染致脓毒性休克患者的抗感染治疗病例分析

摘要

OBJECTIVE: To explore the role of clinical pharmacists in anti-infective treatment for the patient with septic shock induced by intrauterine infection. METHODS: Clinical pharmacists participated in anti-infective treatment for a patient with septic shock induced by intrauterine infection, and assisted physicians to formulate empirical anti-infective treatment, determine that Escherichia coli was pathogenic bacteria and analyze the causes of fluctuations in body temperature. According to the patient's disease condition and results of assistant examination, clinical pharmacists suggested using Imipenem and cilastatin sodium for injection 1. 0 g, ivgtt, q6 h, stopping Teicoplanin for injection, de-escalation using Cefoxitin sodium for injection 2. 0 g, ivgtt, q8 h for anti-infective treatment, with oral sequential therapy. RESULTS: Physicians adopted most advice of pharmacists. After 30 d anti-infective and symptomatic treatment, the patients symptoms were better than before, and discharged from the hospital. CONCLUSIONS: Clinical pharmacists participate in formulating individual anti-infective treatment regimen, so as to promote the rational use of antibiotics and improve the response rate and success rate of treatment.%目的:探讨临床药师在宫内感染致脓毒性休克患者抗感染治疗中的作用.方法:临床药师参与1例宫内感染致脓毒性休克患者的抗感染治疗,协助医师制订早期经验性抗感染方案、判定大肠埃希菌为致病菌、分析体温波动原因.根据患者病情变化及辅助检查结果,临床药师先后建议给予注射用亚胺培南西司他丁钠1. 0 g,ivgtt,q6 h;停用注射用替考拉宁;降阶给予注射用头孢西丁钠2. 0 g,ivgtt,q8h抗感染,可序贯为口服.结果:医师部分采纳临床药师建议,经30 d的抗感染及对症治疗后,患者症状好转出院.结论:临床药师参与制订个体化的抗感染治疗方案,有利于促进抗菌药物的合理使用,提高治疗的有效率和成功率.