多黏菌素E和头孢他啶-阿维巴坦序贯治疗老年痴呆患者并发卒中相关性难治肺炎的思路分析

Analysis of the thought in the sequential treatment of a senile dementia patient complicated with stroke-associated refractory pneumonia with polymyxin E and ceftazidime-avibactam

目的:介绍临床药师参与治疗1例老年痴呆患者并发卒中相关性难治肺炎的策略与思路,为抗感染药学服务提供参考。方法:在此例难治性肺炎患者的治疗过程中,临床药师多次会诊,根据患者的临床表现、医院细菌流行病学特点、临床指南以及药物药动学(PK)/药效学(PD)特点,先后以多黏菌素E和头孢他啶-阿维巴坦为基础制定不同抗感染方案,并实施药学监护。结果:医师和护士采纳临床药师的抗感染方案,患者感染指标明显好转,生命体征(包括脉搏、呼吸、体温、血压等)趋于平稳,顺利出院,转至康复医院进行康复训练。结论:临床药师跟踪药学前沿知识,积极将先进药物引入临床难治肺炎,实施个体化治疗,有助于患者康复。

Objective:To introduce the strategies and ideas of clinical pharmacists participating in the treatment of a case of senile dementia complicated with stroke-associated refractory pneumonia to provide further reference for anti-infection pharmaceutical care.Methods:During his hospitalization of the patient with refractory pneumonia,the clinical pharmacists participated in many consultations,formulated different anti-infection regimens and implemented clinical pharmaceutical care based on new drugs including polymyxin E and ceftazidime-avibactam according to the patient’s clinical manifestations,the hospital bacterial epidemiological characteristics,the latest clinical guidelines,and the characteristics of pharmacokinetics/pharmacodynamics.Results:The anti-infection regimens were adopted by the doctors and nurses.And then,the patient’s infection index improved significantly,and his vital signs returned to be stable,including pulse rate,respiration rate,body temperature,and blood pressure.Finally,the patient was transferred to rehabilitation hospital to receive rehabilitation training.Conclusion:Clinical pharmacists following the forefront of pharmaceutical knowledge,actively introducing advanced drugs into refractory pneumonia treatment and implementing individualized treatment can help patients recover.