1例哌拉西林他唑巴坦治疗肺脓肿患者致药物热及横纹肌溶解症药学监护

Pharmaceutical care of a patient with lung abscess with drug fever and rhabdomyolysis induced by piperacillin-tazobactam

目的探讨哌拉西林他唑巴坦治疗肺脓肿患者治疗发生药物热及横纹肌溶解症的原因,为临床合理用药提供参考。方法回顾1例临床药师监护肺脓肿患者治疗过程,检索相关文献,结合患者情况探讨哌拉西林他唑巴坦及莫西沙星发生不良反应的原因及临床应用的安全性。结果使用抗菌药物尤其是β-内酰胺类如哌拉西林他唑巴坦时,如体温突然上升要考虑药物热可能;莫西沙星致横纹肌溶解症可能与其化学结构特点有关,需注意控制药品输注速度,如发生不良反应,应及时停药。结论临床应重视抗感染治疗可能发生的药品不良反应,临床药师积极查阅文献等证据,可为临床用药治疗安全有效提供支持。

Objective To explore the causes of drug fever and rhabdomyolysis among patients with lung abscess during anti-infective treatment so as to provide reference for clinical rational use of drugs.Methods The process of monitoring one patient with lung abscess by a clinical pharmacist was retrospectively analyzed,related literature was retrieved,and the causes of adverse reactions of piperacillin-tazobactam and moxifloxacin as well as ways of safe clinical application with reference to the patient’s condition were discussed.Results When antibiotics were used,especiallyβ-lactams such as piperacillin and tazobactam,the likelihood of drug fever should be considered if the body temperature rose suddenly.Rhabdomyolysis caused by moxifloxacin might have been related to its chemical structure,so infusion speed had to be controlled and the drug withdrawn in time in case of adverse reactions.Conclusion Clinicians should be alert to the adverse drug reactions that may occur during anti-infective treatment.Clinical pharmacists are expected to consult literature to find evidence for the safety and effectiveness of clinical medication.