肺泡灌洗液培养出马尔尼菲青霉菌治疗方案分析

Analysis of treatment scheme for penicillium marneffei cultured by alveolar lavage fluid

回顾分析临床药师参与1例肺泡灌洗液培养出马尔尼菲青霉菌(PM)患者的治疗工作,从其病原学特点、传播途径、微生物学及组织培养结果解释多方面考虑患者是否为马尔尼菲青霉菌感染,并从感染后患者的病情评估、治疗方案、药品不良反应多方面分析,建议临床选择两性霉素B静脉滴注,因该患者治疗期间出现持续性的肌酐升高,临床药师建议减量,病情稳定改为口服序贯治疗,全程进行药学监护。经治疗后患者病情明显好转,临床症状逐渐消失,影像学检查提示病灶吸收。患者感染的确立、感染后病情评估、治疗方案的评价及药学监护是临床药师考虑的重点。临床药师提供药学服务,及时进行药学监护,可提高患者用药的安全性及有效性。

A retrospective analysis was made on clinical pharmacists-involved treatment for1case withpenicillium marneffei cultured by alveolar lavage fluid.Consideration of penicillium marneffei infection was madein accordance with pathogenic characteristics,route of transmission,microbiology and tissue culture outcomes.Further analysis was made on the basis of disease assessment,treatment scheme and adverse drug reactions,and itsuggested clinical implement of amphotericin B through intravenous drip.Due to continuous creatinine increase inthe patient during treatment,clinical pharmacists suggested dosage decrement,followed by oral sequential therapyafter stabilized condition,along with whole course of pharmaceutical monitoring.After treatment,this patientshowed obviously improved condition and gradually relieved clinical symptoms,with lesions absorption shown byimageological examination.Key points in consideration by clinical pharmacists included infection confirmation,post-infection disease assessment,evaluation of treatment scheme and pharmaceutical monitoring.Pharmaceuticalservice and timely pharmaceutical monitoring provided by clinical pharmacists improved safety and effectivenessof medication.