1例糖尿病足抗感染治疗诱发全身重症药疹患者药学监护实践

Pharmaceutical Care of Severe Systemic Drug Eruption Induced by Anti-Infection Treatment of Diabetes Foot:A Case Report

目的探讨药师在糖尿病足抗感染方案的制订及药物诱发重症药疹诊治过程中的作用。方法回顾性分析医院收治的1例使用万古霉素后出现全身重症药疹糖尿病足患者的治疗过程,给予地塞米松等常规抗过敏药物治疗效果欠佳,且皮疹呈进行性加重。临床药师查阅相关文献和指南,分析地塞米松导致全身皮疹加重可能性大,建议调整激素为甲泼尼龙抗过敏治疗。结果医师采纳药师建议,调整治疗方案,患者皮疹逐渐好转,糖尿病足感染好转。结论临床药师参与糖尿病足患者抗感染及重症药疹的诊治,可体现自身专业价值,提高用药安全性与合理性。

Objective To investigate the role of pharmacists in the formulation of anti-infection therapeutic scheme for diabetes foot and the diagnosis and treatment of drug-induced severe drug eruption.Methods The treatment process of a patient with diabetes foot admitted to the hospital experiencing severe systemic drug eruption after using vancomycin was retrospectively analyzed.The conventional anti-allergic drugs such as dexamethasone were not very effective and the rash was progressively aggravated.Based on the relevant literature and guidelines,clinical pharmacists considered that this adverse reaction might be induced by dexamethasone,and suggested that this hormone should be replaced by methylprednisolone for anti-allergic treatment.Results Physicians adopted the pharmacist′s suggestions and adjusted the therapeutic scheme,then the patient′s rash and diabetes foot gradually improved.Conclusion The participation of clinical pharmacists in the anti-infection of diabetes foot,diagnosis and treatment of severe drug eruption can reflect their professional value and promote the safe and rational drug use.