1例挤压综合征术后感染患者的药学监护

1例26岁男性患者,因一氧化碳中毒后导致双下肢挤压伤入院。入院后行挤压综合征减张术后发生感染,肌肉持续坏死、筋膜感染,曾使用多种抗菌药物,感染控制不佳,多次分泌物培养为志贺氏菌属。临床药师会诊后,制订了个体化给药方案,第一疗程10 d:亚胺培南西司他丁联合克林霉素;第二疗程14 d:克林霉素联合哌拉西林他唑巴坦;第三疗程5 d:头孢呋辛。3 d后,体温正常,白细胞和粒细胞降低,21 d后无肌肉持续坏死现象,23 d后,体温、血常规均正常,感染得到控制。

Pharmaceutical care on one patient with postoperative infection after crush syndrome

One 26-year-old male patient with crush injuries to both lower extremities after being involved in carbon monoxide poisoning was admitted to hospital.After the operation for treatment of crush syndrome,he developed postoperative infection,sustained muscle necrosis and fascial infections.The patient used some antimicrobial agents,while the efficacy of infection control was poor,and Shigella was found from secretions.After consultation with clinical pharmacists,the individualized dosing regimen was made.In th...