临床药师参与抗生素相关性腹泻患者治疗的药学实践

Pharmaceutical Care on Patients with Antibiotics-Associated Diarrhea by Clinical Pharmacists

目的:探讨抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)发生的原因和处理方法。方法:回顾性分析临床药师参与1例疑似AAD患者治疗的药学实践。结果:临床药师对该病例进行了分析和讨论,包括患者病情和腹泻原因,如抗菌药物的使用、联合应用的药物及患者自身疾病等。该患者的腹泻高度疑似AAD,但也不排除联合用药导致的腹泻。临床药师参与了腹泻的处理,根据患者病情建议适当停用可疑药物及针对性抗菌治疗,并加用微生态制剂治疗。临床医师采纳了上述建议,后患者腹泻症状好转。结论:患者使用抗菌药物后,出现了腹泻,要考虑AAD的可能。临床药师应注意药品不良反应,结合患者病情和用药情况,分析腹泻原因,协助医师及时调整用药方案,为患者的用药安全保驾护航。

OBJECTIVE： To probe into the causes and countermeasures of antibiotic-associated diarrhea（ AAD）.METHODS： To retrospectively analyze the pharmaceutical care of 1 case of suspected AAD by clinical pharmacists.RESULTS： Clinical pharmacists had analyzed and discussed about the case,including patient＇s illness state and the causes of diarrhea,such as the application of antibiotics,drug combination and patient＇s other diseases. The patient was highly suspected with AAD,which also could be induced by drug combination. Clinical pharmacists participated in dealing with diarrhea, withdrew suspicious drugs and conducted targeted antibiotic therapy, added in microecologics. Patient went better after clinicians accepted these advices. CONCLUSIONS： AAD should be considered when patients with diarrhea have applied with antibiotics. Clinical pharmacists should pay attention on adverse drug reactions,explore the causes of diarrhea in consideration of patients＇ illness state and drug application,give assistance to clinicians in adjusting therapeutic regimen,so as to ensure patients＇ medication safety.