1例正常免疫功能宿主的肺诺卡菌病患者临床抗感染治疗的药学监护

Pharmaceutical Care for Clinical Medication in a Patient with Pulmonary Nocardiosis of Normal Immune Function Host

目的:探究临床药师在正常免疫功能宿主的肺诺卡菌病患者药物治疗中的作用。方法:临床药师参与会诊,分析正常免疫宿主的肺诺卡菌感染的临床特点及诊疗过程,并结合患者病情及药敏试验结果,建议停用环丙沙星、亚胺培南-西司他丁治疗;将此治疗方案调整为莫西沙星与复方磺胺甲噁唑联用治疗(1周后改为单用复方磺胺甲噁唑),并全程参与抗感染治疗的药学监护过程及患者出院后的随访,并实时药学监护。结果:医师采纳临床药师建议,及时调整用药方案,患者病情好转,出院后随访其复诊结果,CT检查显示好转。结论:临床药师参与病程长、易复发的感染性疾病患者的药学服务全过程,促进了合理用药,确保了患者治疗的有效性和安全性。

Objective:To explore the role of clinical pharmacists in clinical medication for patients with pulmonary Nocardiosis of normal immune function.Methods:Clinical pharmacists participated in the consultation to analyze the clinical characteristics and diagnosis and treatment process of pulmonary Nocardia infection in normal immune hosts.Combined with the patient’s condition and drug sensitivity test results,it was suggested to stop the treatment of ciprofloxacin and imipenem-cilastatin.The treatment regimen was adjusted to moxifloxacin combined with cotrimoxazole(changed to cotrimoxazole alone after 1 week),and the whole process of pharmaceutical care of anti-infection treatment and followup of patients after discharge,and real-time pharmaceutical care.Results:The physician took the advice of the clinical pharmacist and adjusted the medication regimen in a timely manner.The patient’s condition was improved.After discharge,the patient was followed up and the CT examination showed improvement.Conclusion:Clinical pharmacists participated in the whole process of pharmaceutical care for patients with infectious diseases with long course of disease and prone to relapse,which promoted rational drug use and ensured the effectiveness and safety of patients’treatment.