1例化脓性血栓静脉炎继发肺部感染患者的药物治疗分析

Analysis of drug therapy in a patient with pulmonary infection secondary to suppurative thrombophlebitis

目的探讨在治疗化脓性血栓静脉炎继发转移性肺部感染患者过程中药学监护的作用。方法回顾性分析1例确诊为化脓性血栓静脉炎,并继发肺部转移性感染患者的治疗及临床药师参与监护的全过程,评价抗菌药物的使用,并探索化脓性血栓性静脉炎治疗中抗凝管理的经验。结果临床药师基于感染部位、脓毒性血栓特点、万古霉素血药浓度监测、抗菌药物代谢动力学/药效学特性等,在抗感染方案调整、万古霉素个体化治疗优化、抗凝时机等方面为临床医师及患者提供全面药学服务,患者全身感染及脓毒性血栓得到有效控制,促进了化脓性血栓静脉炎患者的治疗。结论临床药师能在重症患者治疗团队中发挥重要作用,提高抗菌药物的合理使用。

Objective To explore the role of pharmaceutical care in the treatment of patients with pulmonary infection secondary to suppurative thrombophlebitis.Methods The treatment of a patient diagnosed with pulmonary metastatic infection secondary to suppurative thrombophlebitis and the whole process of clinical pharmacists participating in the monitoring were analyzed retrospectively.The use of antibiotics was evaluated,and the experience of coagulation management in suppurative thrombophlebitis was explored.Results Based on the infection site,characteristics of septic thrombus,monitoring of vancomycin blood concentration,pharmacokinetics and pharmacodynamics characteristics of antibiotics,clinical pharmacists provided comprehensive pharmaceutical services for clinicians and patients in terms of anti-infection scheme adjustment,optimization of vancomycin individualized treatment,anticoagulant timing.Patient’s systemic infection and septic thrombus can be effectively controlled and which promotes the treatment of patients with suppurative thrombophlebitis.Conclusion Clinical pharmacists can play an important role in the treatment team of severe patients to improve the rational use of antibiotics.