儿童心脏移植术后耐碳青霉烯类肺炎克雷伯菌血流感染的治疗药物分析

Analysis of therapeutic drugs for bloodstream infection by carbapenem-resistant Klebsiella pneumoniae after heart transplantation in children

目的:通过对1例临床儿童心脏移植术后耐碳青霉烯类肺炎克雷伯菌(CRKP)血流感染的病例分析,为临床CRKP抗感染治疗提供用药依据。方法:临床药师全程参与儿童心脏移植术后患者的抗感染治疗,分析了联合用药方案以及治疗药物和剂量的选择,帮助医生制定个体化给药方案。结果:该患者采用联合治疗方案头孢他啶阿维巴坦、多黏菌素B联合替加环素,此外结合手术清创引流,彻底清除坏死感染组织后,治疗效果明显。结论:临床药师通过参与临床治疗过程,为患者提供全程化药学服务,保障抗感染用药的安全、有效。

Objective:A case of bloodstream infection by carbapenem-resistant Klebsiella pneumoniae(CRKP)after heart transplantation in a child was analyzed to provide evidence for clinical anti-infection treatment of CRKP.Methods:Clinical pharmacists participated in the whole course of anti-infection treatment of this patient after heart transplantation,analyzed the combination drug regimen and the choice of therapeutic drugs and dosage and assisted doctors in formulating individual drug administration regimen.Results:The treatment effect was obvious after the patient was treated with ceftazidime avibactam,polymyxin B combined with tigecycline,in addition,combining with surgical debridement and drainage and complete removal of the necrotic infected tissue.Conclusion:The safety and effectiveness of anti-infective drugs can be ensured by clinical pharmacists participating in clinical treatment and providing whole-process pharmaceutical care for patients.