一例基于万古霉素血药浓度监测治疗肾功能亢进患者颅内感染的药学实践

A case of pharmaceutical practice based on vancomycin blood concentration monitoring in the treatment of intracranial infection in patients with augmented renal clearance

目的探讨肾功能亢进(ARC)患者基于血药浓度监测的万古霉素给药剂量优化,及临床药师在抗感染治疗中发挥的作用。方法对一例颅内感染伴ARC患者实施药学会诊,应用万古霉素血药浓度监测为患者制订个体化给药方案。结果基于万古霉素血药浓度监测,临床药师积极开展药学会诊,协助临床医师及时调整治疗方案,保证了治疗效果。结论临床药师利用血药浓度监测技术实施药学监护,可以保障ARC患者抗感染治疗的有效性和安全性,在临床感染性疾病的治疗中起到了重要作用,充分体现了临床药师的专业价值。

Objective To explore the optimization of vancomycin dosage based on blood concentration monitoring and the role of clinical pharmacists in anti-infection treatment for patients with augmented renal clearance(ARC).Methods A patient with intracranial infection and ARC was given pharmaceutical consultation.Vancomycin blood concentration monitoring was used to formulate individualized drug administration scheme for the patient.Results Based on the monitoring of vancomycin blood concentration,clinical pharmacists actively carried out pharmaceutical consultation and assisted clinicians to adjust the treatment plan in time to ensure the therapeutic effect.Conclusion The practice of clinical pharmacists using blood drug concentration monitoring technology to implement pharmaceutical care can ensure the effectiveness and safety of anti-infection treatment for ARC patients,which plays an important role in the treatment of clinical infectious diseases,and fully reflects the professional value of clinical pharmacists.