临床药师进行伏立康唑血药浓度监测在假阳性真菌感染患者治疗中的作用

Role of voriconazole TDM in the treatment of false-positive fungal infection

目的探讨临床药师进行伏立康唑血药浓度监测在假阳性真菌感染患者治疗中的作用。方法临床药师参与1例左下肺肺炎老年男性患者的治疗。患者2次痰培养白假丝酵母菌阳性,应用伏立康唑治疗。临床药师对其进行药学监护,监测伏立康唑的血药浓度,排查浓度过高的原因,判断痰培养结果为假阳性,协助医师为患者更改治疗方案。结果医师采纳临床药师建议,停用伏立康唑,改变治疗方案,感染好转,不良反应症状缓解,避免了伏立康唑的蓄积中毒,减轻了患者的经济负担。结论临床药师参与的伏立康唑血药浓度监测帮助判断痰培养结果的准确性,有效提高了用药的合理性、安全性和经济性。

Objective To investigate the effect of TDM of voriconazole in the treatment of false-positive fungal infection.Methods Clinical pharmacists participated in the treatment of an elderly male patient with left lower lung pneumonia.The sputum culture results were candida albicans positive for twice.Therefore,the voriconazole was used for treatment.Clinical pharmacists carried out pharmaceailcal care for patients,monitored the plasma concentration of voriconazole,and analyzed the reason of high plasma concentration of voriconazole.Clinical pharmacists found the fact that sputum culture results were false-positive.This finding helped physicians to adjust the dosing regimen timely.Results Physicians accepted the advices of the pharmacist and stopped using voriconazole,and changed the treatment program.The infection was improved,and adverse reactions was reduced,which avoided the accumulation poisoning of voriconazole,and reduced the economic burden of patients.Conclusion The TDM of voriconazole,involving clinical pharmacists,can help determine the accuracy of sputum culture results and improve the rationality,safety and economy of drug application.