儿科临床药师参与1例白血病化疗后骨髓抑制合并感染患儿的治疗实践

Paediatric Clinical Pharmacists Participating in the Treatment for a Patient with Bone Marrow Depression Complicating with Infection after Leukemia Chemotherapy

目的:探讨儿科临床药师参与临床药物治疗工作的模式。方法:临床药师通过参与1例白血病化疗后骨髓抑制合并感染患儿的会诊,参与临床药物使用遴选,提出药物治疗方案:美罗培南,每次15mg/kg,q8h,ivgtt;万古霉素,每天40mg/kg,tid,ivgtt,每次滴注持续60min以上;伏立康唑7mg/kg,q12h,ivgtt。并对万古霉素的血药浓度进行监测。结果:治疗3d后,患儿无发热,咳嗽明显减少,咽充血减轻,血常规示:白细胞5.03×109L-1、中性粒细胞计数2.69×109L-1、超敏C反应蛋白(hs-CRP)69.38mg/L,提示感染得到控制。治疗6d后,患儿无发热,咳嗽明显减轻,hs-CRP9.04mg/L,感染控制好,准予出院。结论:临床药师可参与临床药物治疗工作,为患者提供有效、安全的药物治疗方案。

OBJECTIVE： To explore the pattern of paediatric clinical pharmacists participating in clinical drug treatment. METHODS： Clinical pharmacists participated in the consultation for a patient with bone marrow depression complicating with infec- tion after leukemia chemotherapy, participated in the selection of clinical drug use and suggested the clinical protocols： meropenem 15 mg/kg, q8h, ivgtt; vancomycin 40 mg/kg, tid, ivgtt, for 60 min every time; voriconazole 7 mg/kg, ql 2h, ivgtt. The blood concen- tration monitoring of vancomycin was carried out. RESULTS： After 3 d of treatment, absence of fever, significant reduction of cough, pharyngeal congestion relief, blood rountine ： leukocyte 5.03×10^9L^-1, neutrophil count 2.69×10^9L^-1, CRP 69.38 rag/L, indi- cated infection had been controlled. After 6 d of treatment, absence of fever, significant reduction of cough, CRP 9.04 mg/L, indi- cated infection control; the patient discharged from hospital. CONCLUSIONS： Clinical pharmacists could participate in clinical drug treatment and offer the effective and safe drug treatment regimen for patients.