临床药师参与危重患者CRRT治疗时抗菌药物方案调整的药学实践

Pharmacy practice of designing anti-infection regime for serious patient with continuous renal replacement therapy

目的:评估临床药师参与危重患者连续肾脏替代治疗(CRRT)时抗菌药物方案调整的效果。方法:临床药师参与118例CRRT治疗患者的抗菌药物方案调整,以药物选择、给药剂量、给药途径等作为切入点,对比参与前后抗感染治疗的效果。结果:临床药师提出126条方案调整建议,其中73.02%被完全采纳,另有26.98%经商榷修改后予以采纳。参与调整抗菌药物方案后,患者感染得到有效控制。结论:临床药师可为CRRT危重患者提供合理化的抗菌药物方案调整建议,确保患者用药安全。

Objective: To evaluate the effect of clinical pharmacist intervention in the antibacterials treatment for critical patients with continuous renal replacement therapy (CRRT). Methods: The clinical pharmacist intervened in the antibacterials program of patients in the intensive care unit and nephrology with CRRT. The intervention points included choice of drug, dosage,route of administration and so on. The efficacy of anti-infection before and after intervention was statistically compared. Results:A total of 126 adjustment suggestions were propounded by clinical pharmacists. About 73.02% was fully adopted and 26.98% was adopted after discussion. Infection was effectively controlled after intervention of clinical pharmacist. Conclusion: The clinical pharmacist can provide reasonable anti-infection suggestions to patients with CRRT, which is a good starting point for clinical pharmacist to carry out pharmaceutical care.