1例快速生长分枝杆菌血流感染的药学会诊实践

Pharmaceutical Consultation Practice for One Case of Rapidly by Growing Mycobacteria Bloodstream Infections

目的:探讨快速生长分枝杆菌血流感染的诊治方法。方法:通过1例骨折术后快速生长分枝杆菌血流感染的两次会诊实践,对治疗过程中不同阶段需要考虑的药物治疗问题进行总结分析。结果:第一次会诊,根据患者的血药浓度和肌酐清除率,优化了万古霉素给药剂量。第二次会诊,在患者症状和检验结果明显好转情况下,建议医生积极针对快速生长分枝杆菌进行抗感染治疗。建议停用抗结核药,改为克拉霉素联用阿米卡星后,患者病情好转出院。结论:对手术部位疑似、确诊快速生长分枝杆菌感染的病例,积极的干预和正确的诊治是成功的关键。

Objective： To investigate the diagnosis and treatment of rapidly growing mycobacteria bloodstream infections. Meth- ods： Based on the two pharmaceutical consultation practice for one case of rapidly growing mycobacteria bloodstream infections after fracture operation, the paper summarized and analyzed the problems in different stages of treatment. Results ： The first consultation op- timized the dosage of vancomycin according to the patient- serum concentration and creatinine clearance rate. The second consultation suggested doctors actively perform anti-infection treatment for rapidly growing mycobacteria after the patient＇ s clinical symptoms and ex- amination results were improved significantly. It is recommended to withdraw anti TB drugs, and the use of clarithromycin combined with amikacin was suitable. The patient was discharged with improved health conditions. Conclusion： Positive intervention and correct diagnosis are the keys for the successful treatment of suspected or definite mycobacteria infection in surgical sites.