1例复方磺胺甲唑过敏患者脱敏治疗的实践与分析

Practice and analysis of desensitization treatment for a patient with compound sulfamethoxazole allergy

1例65岁中年女性患者,因“后腰背痛2年余,反复发热、听力下降加重3个月”入院,入院后完善相关检验检查,诊断为肉芽肿血管炎、肺部感染,给予糖皮质激素、生物制剂控制血管炎症状以及美罗培南、伏立康唑、万古霉素抗感染治疗,后根据细菌培养和药敏结果,将美罗培南、万古霉素调整为复方磺胺甲唑,治疗过程中患者发生皮肤过敏反应。临床药师查阅相关文献指南,发现本次不良反应的发生很可能与复方磺胺甲唑有关。结合患者病情,临床药师协助医师制定复方磺胺甲唑脱敏治疗方案,最终患者脱敏治疗成功,病情稳定后出院。

One 65-year-old female patient was admitted to the hospital due to lumbago and backache for more than 2 years,recurrent fever and hearing loss aggravated for 3 months.After admission,relevant examinations were completed and she was diagnosed as granulomatous vasculitis and pulmonary infection.And glucocorticoids and biological agents were given to control the symptoms of vasculitis,anti-infection treatment of meropenem,voriconazole and vancomycin were given to her.And then meropenem and vancomycin were replaced by compound sulfamethoxazole according to the results of bacterial culture and drug sensitivity.The patient developed skin allergy during the treatment,which was considered to be probably associated with compound sulfamethoxazole by clinical pharmacist based on the literature and relevant guidelines.Desensitization therapy of compound sulfamethoxazole were given to her with the help of clinical pharmacist and relevant pharmaceutical care were preformed during the course of treatment.Eventually the desensitization therapy were successfully completed and the patient was discharged with a stable condition.