临床药师对1例肺孢子菌肺炎治疗方案的评价和药学监护

Evaluation of the Treatment Plan and Pharmaceutical Care for One Patient with Pneumocystis Pneumonia by Clinical Pharmacists

目的:探讨临床药师对肺孢子菌肺炎患者实施药学监护的重要性和在临床中应具备的临床思维。方法:通过呼吸内科临床药师对参与的1例肺孢子菌肺炎患者的治疗过程进行分析,分析初始抗菌药物方案并调整治疗方案为复方磺胺甲唑片3片、po、q12h(其中复方磺胺甲唑片每片含磺胺甲唑400mg、甲氧苄啶80mg),同时对患者进行个体化的药学监护,从而保证疗效、避免不良反应发生。结果:患者的体温逐渐下降至正常,咳嗽、咳痰症状有所改善后出院。结论:临床药师可以药物的选择、相互作用、不良反应、用药注意事项、治疗药物建议及出院宣教等方面作为药学服务工作的切入点,充分发挥自身的专业优势,促进抗菌药物的合理应用。

OBJECTIVE： To investigate the importance of pharmaceutical care for pneumocystis pneumonia by clinical pharmacists, and clinical thinking which clinical pharmacists should possess in the clinic. METHODS： By analyzing clinical pharmacists participating in the treatment for a case of pneumocystis pneumonia in respiratory medicine department, initial treatment plan was analyzed and adjusted as 3 pieces of Compound sulphamethoxazole tablet, p.o., q12h （Compound sulphamethoxazole tablet con- rained sulphamethoxazole 400 mg and trimethoprim 80 mg per tablet） ; at the same time, clinical pharmacists provided individual pharmaceutical care for the patient so as to ensure the curative effect and avoid the occurrence of ADR. RESULTS： The patient was discharged from the hospital after body temperature returned to normal, and the symptoms of cough and expectoration had been improved. CONCLUSIONS ： Clinical pharmacists can provide pharmaceutical care from the perspective of drug selection, drug interaction, ADR, matters need attention, drug suggestions, discharged education, and give full play to their advantages in order to promote the rational use of antimicrobial agents.