万古霉素致白细胞及中性粒细胞减少症的药学监护

Pharmaceutical Monitoring of Vancomycin-Induced Leukopenia and Neutropenia

目的:报道并分析1例患者使用万古霉素后出现的白细胞及中性粒细胞减少不良反应,为临床合理安全使用提供参考。方法:对临床药师参与老年患者先天性左髋关节发育不良术后刀口感染应用万古霉素后导致白细胞及中性粒细胞减少的案例进行分析,根据Naranjo评估量表并结合文献资料,评估该不良反应与万古霉素间的关系及处理措施。结果:出现白细胞及中性粒细胞减少,临床药师建议停用万古霉素。患者停用4天后白细胞及中性粒细胞恢复至正常水平。根据Naranjo评估量表得分为5分,评价关系为“很可能”有关。结论:临床药师参与临床治疗用药的全过程,可帮助临床医生识别药物不良反应,警示临床医生关注患者使用万古霉素过程中引起的白细胞及中性粒细胞减少,保障患者用药安全性和有效性。

Objective:To report and analyze the adverse reactions of leukopenia and neutropenia in one patient after using vancomycin,and to provide reference for rational and safe clinical use.Methods:The clinical pharmacist's participation in the case of leukopenia and neutropenia induced by vancomycin which was administered to treat incision infection following the surgery for developmental dysplasia of the left hip in an elderly patients was analyzed.The Naranjo assessment scale and literature were used to assess the relationship between the adverse reactions and vancomycin as well as the treatment measures.Results:The clinical pharmacist advised to discontinue vancomycin upon the occurrence of leukopenia and neutropenia.The patient's leukocytes and neutrophils recovered to normal 4 days after vancomycin discontinuation.The score based on the Naranjo assessment scale was 5 points and the relationship was assessed as"probably"related.Conclusion:The participation of clinical pharmacists in the whole process of clinical medication can help clinicians to identify adverse drug reactions,warn to pay attention to the leukopenia and neutropenia caused by the use of vancomycin in patients,and guarantee the safety and efficacy of drug use in patients.