临床药师参与2例难治性泌尿系统耐碳青霉烯类肺炎克雷伯菌感染的药物治疗实践

Participation of clinical pharmacists in drug treatment for 2 cases of refractory carbapenem-resistant Klebsiella pneumoniae infection in urinary system

目的探讨临床药师在难治性泌尿系统耐碳青霉烯类肺炎克雷伯菌感染药物治疗过程中的作用。方法临床药师参与2例多黏菌素B局部灌注治疗难治性泌尿系统耐碳青霉烯类肺炎克雷伯菌感染患者的治疗过程,协助医师共同探索并解决现行抗感染方案无法攻克的顽固耐药菌问题;同时进行体温检测,血常规等感染指标检查以及不良反应监测等药学监护。结果2例患者通过静脉滴注多黏菌素B及局部膀胱灌注治疗,感染得到控制,细菌学清除,临床症状改善,且治疗期间耐受良好,未发生药物相关不良反应。结论临床药师加入临床治疗团队,从药学思维和角度提供药学服务及治疗策略,帮助患者提高临床药物治疗效果。

Objective To explore the role of clinical pharmacists in the treatment of refractory carbapenem-resistant Klebsiella pneumoniae infection in the urinary system.Methods Clinical pharmacists participated in the treatment of 2 cases of local irrigation of polymyxin B in the treatment of refractory carbapenem-resistant Klebsiella pneumoniae infection in urinary system,and assisted physicians to explore and solve the problem of stubborn drug-resistant bacteria that could not be overcome by current anti-infective regimen.At the same time,they carried out body temperature detection,blood routine examination and detection of other infection indicators,as well as adverse reaction monitoring and other pharmaceutical care.Results In both cases,after venous infusion of polymyxin B and local bladder irrigation,the infection was controlled,the bacteriology was cleared,and the clinical symptoms were improved.There was good tolerance during the treatment and no drug-related adverse reactions were observed.Conclusion Clinical pharmacists join the clinical treatment team to provide pharmaceutical services and treatment strategies from a pharmaceutical thinking and perspective to help patients improve clinical drug treatment effects.