1例头孢他啶/阿维巴坦个体化给药案例报道

A case report of ceftazidime-avibactam individualized administration

目的:探讨肾功能不全的重症患者头孢他啶/阿维巴坦个体化给药治疗策略,为优化头孢他啶/阿维巴坦给药方案积累经验。方法:临床药师参与1例由碳青霉烯类耐药肺炎克雷伯菌所致重症感染的急性肾功能不全患者的治疗,运用治疗药物监测(TDM)协助临床医师优化抗感染治疗方案,对患者初始给药方案选择、后续方案调整、疗效观察和不良反应监测等方面提出建议或进行药学监护。结果:TDM结果表明头孢他啶/阿维巴坦达到了理想的PK/PD靶值。患者感染得到了迅速有效的控制,且未出现不良反应。结论:临床药师可运用药学知识特长,协助临床制定合理的治疗方案,评估药物疗效,监测不良反应,保证药物治疗安全、有效、经济。

Objective:To explore the treatment strategy of individualized administration of ceftazidime-avibactam in critically ill patients with renal impairment so as to accumulate clinical experience for the optimization of the ceftazidimeavibactam dosage regimen.Methods:The clinical pharmacists participated in the treatment of infections caused by carbapenemresistant Klebsiella pneumoniae in a patient with acute renal insufficiency and assisted clinicians in optimizing anti-infective treatment plans using therapeutic drug monitoring(TDM)and perform pharmaceutical care in the selection of patients’initial dosing plan,subsequent plan adjustments,efficacy observations and adverse reaction monitoring.Results:TDM showed that the PK/PD target rate of ceftazidime-avibactam was 100%and the patient experienced rapid clearance of his carbapenem-resistant Klebsiella pneumoniae without adverse reactions.Conclusion:The clinical pharmacists can use their expertise in pharmaceutical knowledge to assist clinicians in formulating reasonable treatment plans,assess drug efficacy,monitor adverse reactions and ensure the safety,economy,effectiveness and rationality of drug treatment.