脓毒症休克患者抗感染治疗策略及用药分析

摘要

脓毒症休克的抗感染治疗策略包括控制感染源、早期有效的抗菌药物治疗、降阶梯治疗、目标性治疗及根据抗菌药物药代动力学、药效学特点优化抗菌药物给药方案。临床药师在重症患者治疗过程中应发挥专业特长。本文结合1例脓毒症休克合并急性肾功能不全患者的美罗培南给药方案的调整为例，佐证药师建议采用缩短给药间隔以及两步滴定法给药，使治疗取得良好效果，患者病情明显好转出院。%Antimicrobial therapy in patients with sepsis shock include infection source control, early and effective anti-infection therapy, de-escalation therapy, targeted therapy and optimizing dosing regimen of antibiotics based on the principle of PK/PD. Clinical pharmacists should help doctors formulate individual dosage regimens for severe patients with their specialized knowledge. Pharmacists assisted physicians to adjust the meropenem regimens for a patient with sepsis shock complicating with acute renal insufficiency through two-step infusion therapy and shorter dosing interval. Clinical physicians adopted the advice provided by pharmacists, and the patient experienced the treatment process smoothly and was improved greatly to leave hospital.