1例肾衰合并MRSA血流感染患者应用万古霉素的药学监护

Pharmaceutical Care of Vancomycin in the Treatment of a Patient with MRSA Bloodstream Infection

目的:提高耐甲氧西林金黄色葡萄球菌(MRSA)血流感染患者应用万古霉素抗菌治疗效果。方法:临床药师与医生配合对1例肾功能衰竭合并MRSA血流感染患者应用万古霉素抗感染治疗实施药学监护。在分析疾病和用药特点、评估患者肾功能及治疗方案,结合肾脏替代治疗方案,通过监护万古霉素的谷浓度及不良反应和相互作用等方面为临床提供药学服务。结果:药师与医生紧密配合,肾功能衰竭患者应用万古霉素抗感染治疗安全、有效。结论:临床药师在特殊病人的个体化药物治疗过程中起到了积极作用。

Objective： To increase the antibacterial effect of vancomycin in patients with methieillin resistant Staphylococcus aureus （MRSA） bloodstream infection. Methods：Pharmaceutical care was carried out under clinical pharmacist and doctor with the renal failure MRSA bloodstream infections patient used by vancomycin. The patient＇s disease and medication characteristics, evaluated patient＇ s renal function and the treatment of renal replacement therapy, and provided pharmaceutical service by monitored vancomycin concentrations, adverse reactions and drug interaction were analyzed. Results： The anti-infection treatment of vancomycin used in renal failure patient was safe and effective through closely cooperate with pharmacist and doctor. Conclusion： Clinical pharmacists played an active role in the process of individual drug therapy for special patients.