药师参与1例重症肺部感染患者用药方案的调整

摘要

本文报告临床药师参与的1例入住呼吸内科重症监护病房治疗的感染性休克合并急性肾功能不全的慢性阻塞性肺疾病急性加重患者的抗感染治疗及药学监护过程，探讨严重肾功能不全情况下抗菌药物的选择及其用法用量的调整以及嗜麦芽窄食单胞菌的合理治疗方案，体现了临床药师能在促进合理用药、降低药物不良反应，保证临床安全、有效地用药方面发挥积极作用。%The anti-infection treatment and pharmaceutical care of a patient with septic shock, acute renal insufifciency and acute exacerbation of chronic obstructive pulmonary diseases involved by clinical pharmacists in a respiratory intensive care unit was reported. How to rationally treat Stenotrophomonas maltophilia infection and how to choose the right species and doses of antibiotic agents were discussed under the condition of severe renal insufifciency. This case showed that clinical pharmacists could play a positive role in promoting rational medication, reducing the adverse drug reactions and ensuring the safe and effective medication in clinic.