临床药师参与输卵管癌患者化疗后中性粒细胞缺乏症伴发热合并感染的治疗实践

Pharmaceutical Practice for Treatment of Neutropenic Fever with Infection After Chemotherapy in Patients with Fallopian Tube Cancer by Clinical Pharmacists

目的:探讨临床药师参与输卵管癌患者化疗后中性粒细胞缺乏症伴发热合并感染的治疗实践。方法:针对1例输卵管癌化疗后发生中性粒细胞缺乏症伴发热合并感染的患者,临床药师全程参与其抗感染治疗,协助医师分析危险因素后预防选药,评估患者风险及耐药情况后进行降阶梯联合用药,根据初始经验性抗菌药物治疗情况、经验治疗后根据微生物检查结果及病情变化,多次调整抗菌药物应用方案。结果:患者获得了有效及优质的治疗,预后得到了改善。结论:临床药师在药学监护过程中,应利用自身专业优势,充分认识粒细胞缺乏症患者的特殊性,了解疾病的病原学特点,综合分析药物的药动学/药效学特点、患者病理生理状况和药物相互作用等,协助医师制订个体化治疗方案,保障患者用药安全、有效。

OBJECTIVE: To investigate the pharmaceutical practice for treatment of neutropenic fever with infection after chemotherapy in patients with fallopian tube cancer by clinical pharmacists. METHODS: For a patient with neutropenic fever and infection after chemotherapy for fallopian tube cancer, the clinical pharmacists participated into the anti-infective treatment, assisted the clinicians in analyzing the risk factors, preventing the selection of drugs, and assessing the risk and drug resistance of the patient. According to the initial experience of antibiotic treatment, after the experience and treatment, according to the results of microbiological examination and changes in the condition, the application of antibacterial drugs was adjusted with several times. RESULTS: The patient received effective and quality treatment and the prognosis was improved. CONCLUSIONS: In the process of pharmaceutical care, clinical pharmacists should make full use of their own professional advantages, fully understand the particularity of patients with agranulocytosis, investigate the pathogenic characteristics of the disease, comprehensively analyze the pharmacokinetic/pharmacodynamic characteristics of the drugs, the pathophysiological status of the patient and drug interactions, so as to assist the clinicians in the development of individualized treatment programs to ensure the safe and effective medication in patients.