临床药师参与1例内科ICU患者的药物治疗实践

目的：探讨临床药师参与危重感染患者药物治疗的实践方式。方法：回顾性分析临床药师参与1例因侵袭性播散性真菌病导致感染性休克的内科ICU患者的药物治疗过程。患者使用亚胺培南/西司他丁钠、万古霉素、伏立康唑抗感染治疗以及免疫、营养支持治疗纠正患者感染性休克状况,待患者病情稳定后给予降阶梯抗感染治疗以及静脉改口服序贯治疗。结果：最终患者病情好转出院。结论：在实施危重症感染患者的药物治疗时,临床药师能帮助医师权衡利弊、综合评估、选择治疗药物,促进患者的康复。

Practice of Clinical Pharmacists Participating in Drug Treatment for an ICU Patients in Internal Medicine Department

OBJECTIVE： To investigate the mode of clinical pharmacists participating in drug treatment for patients with severe infection. METHODS： The process of clinical pharmacists participated in drug treatment for a case of septic shock due to invasive disseminated fungal disease in ICU of internal medicine department was analyzed retrospectively. The patient received anti-infective treatment with imipenem/cilastatin sodium, vancomycin, voriconazole and immunity and nutritional support treatment to relieve septic shock. The patient was given de-escalation anti-infective treatment and sequential therapy of oral administration replacing intravenous administration after the disease condition became stable. RESULTS： At the last, the patient recovered and discharged from hospital. CONCLUSIONS： In drug treatment, clinical pharmacists can help doctors to weigh the merits and demerits and comprehensively evaluate the choice of therapeutic drugs. So, the recovery of patients can be promoted well.