临床药师参与1例颅内感染患者的药学监护

目的:探讨临床药师对颅内感染患者安全、合理用药的重要性。方法:针对1例开颅术后颅内感染患者,为患者制订个体化治疗方案。患者因颅内压高而应用甘露醇、呋塞米等,本身肾脏负担大,且应用万古霉素治疗过程中出现肾脏损害,为减轻肾损害而减少万古霉素剂量患者感染出现反复。临床药师根据患者细菌培养及药敏结果,建议使用利奈唑胺,并进行药学监护。结果:患者感染最终得以控制,肾功能也逐渐恢复。结论:临床药师参与疾病治疗工作可提高药物疗效,避免不良反应,对患者的治疗起到了积极作用。

Pharmaceutical Care for a Patient with lntracranial Infection by Clinical Pharmacists

OBJECTIVE： To explore the importance of clinical pharmacists in safe and rational drug use in patient with intracranial infection. METHODS： For a patient with intracranial infection after craniotomy, clinical pharmacists developed individual treatment plan. The patient with high intracranial pressure and big kidney burden because mannitol, furosemide and other drugs were used; the patient suffered from kidney damage during vancomycin treatment. To relieve kidney damage so as to decrease the infection relapse of patients treated with vancomycin, clinical pharmacists suggested that linezolid could be used and pharmaceutical care should be provided according to bacterial cultivation and drug sensitivity test. RESULTS： The infection had been controlled finally, and renal function of the patient had been recovered gradually. CONCLUSIONS： The participation of clinical pharmacists in clinical treatment can improve therapeutic efficacy, avoid ADR and play active role on treatment.