临床药师参与肾功能亢进儿童骨感染治疗的病例分析

Analysis of clinical pharmacists participated in the anti-infective treatment of bone infection in children with augmented renal clearance

目的为临床肾功能亢进儿童骨感染诊治提供参考。方法临床药师参与某院收治肾功能亢进葡萄球菌引起的骨感染患儿抗感染治疗。病例1,年龄13岁,男,骨感染疾病类型为右胫骨近端骨髓炎,感染病原菌为猫葡萄球菌,临床药师参与会诊,协助医师制定治疗方案,先后给予注射用头孢唑林钠(1 g,bid)、注射用万古霉素(0.4 g,q6 h)、注射用万古霉素(0.5 g,q6 h)、注射用美罗培南(0.5 g,q8 h)、利奈唑胺葡萄糖注射液(0.6 g,q12 h)、米诺环素胶囊(米诺环素胶囊)+利奈唑胺葡萄糖注射液(0.6 g,q12 h,每次泵入8 h)、利奈唑胺葡萄糖注射液(0.6 g,q12 h,每次泵入8 h)对症治疗。病例2,12岁,男,髋关节滑膜炎,给予注射用阿莫西林克拉维酸钾(1.2 g,q8 h),血培养为耐甲氧西林金黄色葡萄球菌(MRSA感染),给予利奈唑胺葡萄糖注射液(0.6 g,q12 h,每次泵入8 h)对症治疗,并密切监测患儿治疗过程中相关指标的变化和不良反应。结果医师采纳临床药师建议,患儿治疗后好转,且住院期间无不良反应发生;出院后随访,患儿无疾病复发症状。结论临床一旦发现类似感染应结合病原菌种类及耐药特征及时给予针对性治疗,以有效控制病情。本文可为类似肾功能亢进葡萄球菌骨感染患儿提供治疗参考。

Objective To provide reference for the diagnosis and treatment of bone infection in children with augmented renal clearance(ARC).Methods The clinical pharmacist participated in the anti-infective treatment of children with bone infection caused by Staphylococcus hyperfunction aureus with ARC were treated in our hospital.Case 1 was a 13-year-old male.The type of bone infection was osteomyelitis of the proximal right tibia.The pathogen was Staphylococcus feline.Clinical pharmacists participated in the diagnosis and treatment and assisted physicians in formulating treatment plans,intravenous drip cefazolin(1 g,bid),vancomycin(0.4 g,q6 h),vancomycin(0.5 g,q6 h),meropenem(0.5 g,q8 h),linezolid glucose(0.6 g,q12 h),minocycline capsule+linezolid(0.6 g,q12 h,each pump into 8 h),linezolid(0.6 g,q12 h,each pump into 8 h)were given successively.Case 2,12 years old,male,hip synovitis,was given amoxicillin and clavulanate potassium(1.2 g,q8 h)for intravenous drip.The blood culture was methicillin resistant Staphylococcus aureus(MRSA),and linezolid glucose injection(0.6 g,q12 h,each pump into 8 h)was given for symptomatic treatment.The changes of related indicators and the occurrence of adverse reactions during treatment were closely monitored.Results Physicians adopted the suggestions of clinical pharmacists,the cases were improved after treatment,and no adverse reactions occurred during hospitalization;and after discharge follow-up,the patient had no symptoms of disease recurrence.Conclusion Once similar infections are found in clinic,targeted treatment should be given in time in combination with the types of pathogenic bacteria and drug resistance characteristics to effectively control the disease.This article can provide a treatment reference for children with Staphylococcus bone infection similar to ARC.