临床药师对泛耐药鲍氏不动杆菌重症肺炎药学监护探讨

Clinical pharmacists participation to pharmaceutical care of severe pneumonia caused by pandrug-resistant Acinetobacter baumannii

目的探讨临床药师参与重症肺炎患者药学监护的方法和作用,促进医院抗菌药物的合理应用。方法以2014年1月1例泛耐药鲍氏不动杆菌重症肺炎患者治疗为例,临床药师从制定个体化用药方案、提供用药依据、监测药物不良反应等,提供全程的药学监护,应用超常规剂量的替加环素治疗,并进行临床效果评价。结果临床药师积极参与药物治疗过程,对患者实施合理的药学监护,患者体温、血常规、C-反应蛋白等显著好转,两下肺病灶较前显著吸收,痰培养鲍氏不动杆菌为阴性,取得了满意的治疗效果。结论对重症肺炎患者开展药学监护非常必要,保证了患者治疗的安全性和有效性,有利于临床合理用药及医院整体用药水平的提高。

OBJECTIVE To discuss the measures and effectiveness of the clinical pharmacists participation to the pharmaceutical care of the patients with severe pneumonia so as to promote the reasonable use of antibiotics . METHODS In Jan ,2014 ,1 patient with severe pneumonia caused by pandrug‐resistant Acinetobacter baumannii was recruited as the study object ,then the clinical pharmacists offered the whole process pharmaceutical care by formulating the individual mediation program ,providing medication basis ,and monitoring the adverse events of drugs ,the patient was treated with super‐normal dose of tigecycline , and the clinical effect was evaluated . RESULTS The clinical pharmacist took an active part in the drug therapy ,the reasonable pharmaceutical care was carried out for the patient ;the body temperature ,blood routine ,and C‐reactive protein were significantly im‐proved ,two lung lesions were remarkably absorbed ,the sputum was cultured negative for A .baumannii ,and the therapeutic effect was satisfactory .CONCLUSION It is very necessary to carry out the pharmaceutical care for the patients with severe pneumonia ,the safety and effectiveness of the treatment have been ensured ,which is condu‐cive to the reasonable use of antibiotics and the improvement of overall level of medication .