临床药师参与术后感染病例的药学会诊实践与体会

目的:总结本院药师在术后感染会诊方面的实践经验和体会,供临床药学工作者参考。方法:结合本院临床药师参与会诊的典型术后感染病例,分析术后感染的及时诊断、个体化的抗菌药物应用和疾病的转归,总结术后感染药师会诊的经验。结果:判断术后发热是否是感染性发热,是药学会诊的关键点和难点;早期准确的判断感染部位,是药学会诊经验性用药的重要依据;及时评价术后感染程度、调整治疗方案,是降低死亡率的重要措施;临床药师应结合患者的具体情况,制订个体化抗感染治疗方案;掌握药品的特点,监测患者相关指标的动态变化,关注患者的用药安全,制订个体化药学监护计划。结论:复杂的术后感染要及时地控制,不仅需要对致病菌正确的判断和合理的应用抗菌药物,还需要对患者术中及术后病情变化正确的分析、判断和评估,在个体化的药学监护下应用安全、有效、合理的抗菌方案。

Practice and Experience of Pharmacists Participating in Consultation for Postoperative Infections

OBJECTIVE： To summarize the practice and experience of pharmacists participating in consultation for postopera- tive infection in our hospital, and to provide reference to clinical pharmacist. METHODS： Combined with pharmacists participating in consultation for typical cases of postoperative infection, timely diagnosis, individual application of antibiotics and outcome of postoperative infection were analyzed, and pharmacist＇s experience was summarized. RESULTS： The key point and difficult point of pharmacy consultation were whether postoperative fever was fever caused by infection or not; early accurate judgment of infec- tion site is importance evidence for pharmacy consultation of empirical medication; prompt evaluation of postoperative infection and the adjustment of therapeutic scheme were important measures for the reduction of mortality; clinical pharmacists should formu- late individual anti-infective scheme on the basis of the condition of patients; they also mastered the characteristics of drugs, moni- tored the dynamic change of related index, pay attention to the safety of medication and formulated individual pharmaceutical care. CONCLUSIONS： The prompt control of comprehensive postoperative infection not only need correct judgment of pathogenic bacte- ria and rational use of antibiotics, but also need correct analysis, judgment and evaluation of perioperative and postoperative dis- ease condition with individual pharmaceutical care and safe, effective and reasonable antibiotic scheme.