1例妊娠期艰难梭菌感染伴尿路感染患者的药学监护

Pharmaceutical care of a patient with Clostridium difficile infection and urinary tract infection during pregnancy

目的分析1例妊娠期艰难梭菌感染(CDI)伴尿路感染患者的病例,探讨其抗感染方案的合理性,为该类患者的临床合理用药提供参考。方法临床药师全程参与1例妊娠期CDI伴尿路感染患者治疗的诊治过程,通过检索国内外相关文献,严格遵循循证医学证据并结合患者个体情况,协助医师制定抗感染治疗方案,采用口服甲硝唑治疗CDI,哌拉西林他唑巴坦治疗尿路感染。结果临床药师协助医师治愈了肠道CDI及泌尿道感染,保证了母胎安全。结论临床药师应遵循循证方法结合个体情况制定方案,针对并发感染用药应权衡利弊,在保证母胎安全的前提下解决感染问题,体现妇产科临床药师的职业价值。

Objective To analyze one case of pregnancy with Clostridium difficile infection and urinary tract infection,explore the rationality of the anti-infection treatment and provide reference for clinical rational drug use.Methods A clinical pharmacist participated in the treatment of a pregnant patient with Clostridium difficile infection and urinary tract infection.By retrieving related literature,strictly following the evidence-based medical practice and taking the patient’s conditions into consideration,the clinical pharmacist assisted the doctor in formulating the anti-infection treatment plan.Oral metronidazole and venous piperacillin tazobactam were used to treat Clostridium difficile infection and urinary tract infection,respectively.Results The clinical pharmacist helped doctors cure the infections and ensured the safety of the mother and fetus.Conclusion Clinical pharmacists should follow evidence-based methods and formulate a plan in combination with individual conditions.For the medication of concurrent infections,they should weigh the advantages and disadvantages and cure infections as long as the safety of the mother and fetus can be ensured,which can manifest the value of clinical pharmacists in obstetrics and gynecology.