对一例重症肺炎伴帕金森病病人的药学服务

Pharmaceutical care of a patient with severe pneumonia complicated with Parkinson's disease

目的:探讨临床药师在重症感染病人药物治疗中的作用。方法:临床药师通过参与1例重症肺炎伴帕金森病病例的救治,根据药物的抗菌谱、痰培养和药敏试验结果、药物化学结构分析等配合医师为病人提供个体化药物治疗方案。结果:病人痰培养和药敏试验报告为多药耐药的鲍曼不动杆菌和耐亚胺培南和庆大霉素的铜绿假单胞菌,给予大剂量联合用药;考虑到两种菌对阿米卡星均敏感,根据药物化学结构与耐药性的关系,选择既对致病菌敏感、不良反应又比阿米卡星小的依替米星替代,协助医师进行治疗方案的调整,进行药学监护,使感染及时得到控制。结论:临床药师参与抗感染治疗方案设计,可以协助医师进一步提高药物治疗的安全性和有效性。

Objective： To investigate the role of clinical pharmacists in the treatment of severe infected patients. Methods： Through participation in the treatment of one case of severe pneumonia complicated with Parkinson＇s disease, and in accordance with drug antibacterial spectrum, sputum culture, drug sensitivity test and drug chemical structure analysis, the clinical pharmacist could help physicians to present personalized treatment regimens. Results： Results of sputum culture and drug sensitivity test revealed that the pathogens were the multi drug resistant Acinetobacter baumannii and the imipenem and gentamicin resistant Pseudomonas aeruginosa, so combined high-dose drug therapy was applied. Considering that these two bacteria were all sensitive to amikacin, and in accordance with the structure resistance relationship of drugs, etimicin, which was more responsive to the pathogens but with less adverse reactions than amikaein, was finally chosen for treatment. The pharmacist success fully helped clinical physicians to adopt a better treatment regimen. As a result, severe infection was timely brought under control. Conclusion： Through participation in the design of drug treatment regimens, clinical pharmacists could help physicians to promote the safety and efficacy of clinical medication.