以静脉泵入的给药方式滴注万古霉素实现颅内感染有效治疗的药学监护

Pharmaceutical care of one patient with intracranial infection achieving the effective treatment by administering Vancomycin intravenously pumped with infusion pumps

目的为使用万古霉素日剂量不大(≤3 g)而血药浓度监测值却很高的患者的抗感染治疗和个体化药学服务提供参考。方法临床药师通过查阅相关资料和实施血药浓度监测,参与本院1例颅内感染患者的药学治疗实践,并对万古霉素的给药方案,尤其是给药方式提出建议,协助临床医师制定个体化给药方案。结果优化给药方案后,患者万古霉素血药谷浓度、峰浓度均在有效治疗范围内,且未见肾毒性等不良反应,经过治疗,感染较前明显控制,转至普通病房继续治疗。结论临床药师需加强知识储备,提高药学专业能力,可以运用血药浓度监测等相关技术,协助临床医师调整和制定个体化给药方案,在患者的抗感染治疗中发挥重要作用。

Objective To provide reference for anti-infection treatment and individualized pharmaceutical care in patients with low daily dose(≤3 g)of Vancomycin but high blood concentration.Methods Clinical pharmacists participated in the pharmaceutical treatment practice of one patient with intracranial infection in our hospital by consulting relevant data and implementing blood concentration monitoring,and made suggestions on the drug administration plan of Vancomycin,especially the way of drug administration,and assisted clinicians to develop personalized drug administration plan.Results After the drug administration plan optimized,the blood trough concentration and the peak concentration of Vancomycin of the patient reached the standard,without adverse reactions such as renal toxicity.After treatment,the infection was significantly controlled,and the patient was transferred to the general ward for further treatment.Conclusion Clinical pharmacists need to strengthen their knowledge reserve and improve pharmaceutical professional ability.They can use relevant technologies such as blood concentration monitoring to assist clinicians in adjusting and formulating personalized drug administration plan,so as to play an important role in anti-infection treatment of patients.