临床药师参与1例诺卡菌感染导致肝脓肿患者治疗的药学实践

Pharmaceutical practice in the treatment of a patient with liver abscess induced by Nocardia infection

1例53岁女性患者,因“纳差乏力2周,发现肝脓肿3 d”于2021年11月12日入院。入院后完善相关检查,积极给予抗感染治疗3 d,效果欠佳,行肝穿刺活检,细菌培养显示为诺卡菌,医师请临床药师会诊,临床药师通过查阅国内外相关指南及文献等资料建议调整抗菌药物,给予复方磺胺甲唑(磺胺甲唑0.8 g,甲氧苄啶0.16 g)联合头孢曲松(2 g,qd,ivgtt),临床采纳建议,调整抗感染方案,联合经皮肝穿刺引流。药师对患者进行药学监护,患者病情好转,无特殊不适,顺利出院。出院1个月后随访,预后良好。

A 53-year-old female patient was admitted to the hospital on 12^(th) November 2021 due to anorexia and fatigue for 2 weeks,being found liver abscess 3 days ago.After admission,the relevant examinations were completed and active anti-infective therapy was given to her.3 days later,liver biopsy and bacerial culture were performed due to the poor curative effect.And Nocardia was found.Clinical pharmacists suggested giving compound sulfamethoxazole(sulfamethoxazole 0.8 g,trimethoprim 0.16 g)combined with ceftriaxone(2 g,qd,ivgtt)after reviewing relevant guidelines and literature at home and abroad.The physician adopted the advice and gave percutaneous liver puncture drainage at the same time.The pharmacists carried out pharmaceutical care for the patient.After that,the condition of the patient improved and she was discharged without any particular discomfort.After 1 month follow-up,the prognosis was good.