1例万古霉素致髋关节置换术患者术后药物热的临床分析与药学监护

Clinical Analysis of 1 Case of Drug Fever Induced by Vancomycin after Hip Arthroplasty and Its Pharmaceutical Care

目的:探究万古霉素致药物热的临床特点、鉴别诊断和处理措施,为临床合理用药提供参考。方法:临床药师参与1例髋关节置换术患者术后发热的诊疗过程,通过查阅文献资料,并结合患者病情及实验室检测结果,协助临床医生排查发热原因,并参与制定治疗方案和实施药学监护。结果:临床药师分析患者发热的原因与治疗用万古霉素有关,建议及时停用万古霉素,停用万古霉素改用亚胺培南-西司他丁钠的第3天,患者体温恢复正常。结论:临床药师积极参与临床诊疗实践,发挥在药物不良反应监测、药源性疾病诊断和预防等方面的专业优势,协助临床医生制定治疗方案,进一步提高了药物治疗的安全性和有效性。

Objective:To explore the clinical characteristics,differential diagnosis and treatment of drug fever induced by vancomycin,and to provide reference for rational drug use in clinic.Methods:The clinical pharmacist participated in the diagnosis and treatment process of a patient with fever after hip replacement,by searching literatures materials and combining with the patient’s condition and laboratory examination results,the clinical pharmacist assisted clinicians in screening the causes offever and formulating treatment plans and pharmaceutical care.Results:Clinical pharmacists analyzed that the cause of the patient’s fever was related to the therapeutic vancomycin,and suggested that vancomycin should be stopped on time.On the third day after vancomycin was stopped and imipenem-cilastatin sodium was used,the patient’s temperature returned to normal.Conclusion:Clinical pharmacists actively participate in clinical diagnosis and treatment practice,give full play to their professional advantages in the monitoring of adverse drug reactions,diagnosis and prevention of drug-derived diseases,and help clinicians to formulate treatment plans,and further prove the safety and effectiveness of drug therapy.