临床药师参与1例利奈唑胺个体化治疗的药学实践

目的 探讨利奈唑胺个体化给药治疗策略，为优化利奈唑胺给药方案积累经验。方法 介绍临床药师参与1例利奈唑胺治疗化脓性链球菌脓毒症合并骶髂关节感染患者的案例。临床药师通过血药浓度监测，结合利奈唑胺的药动学特点以及文献阅读结果，为临床提供超说明书增加利奈唑胺给药剂量的建议，并进行药学监护。结果 增加利奈唑胺给药剂量后，患者感染得到了有效控制，未出现药物不良反应，病情好转出院。结论 该案例为国内首例利奈唑胺超说明书剂量治疗化脓性链球菌脓毒症致多器官功能障碍合并骶髂关节感染对于部分特殊人群治疗，利奈唑胺的说明书剂量不足问题应受到关注。

A case of pharmaceutical care for linezolid individualized administration

Abstract Objective To discuss the treatment strategy of individualized administration of linezolid so as toaccumulate clinical experience for the optimization of the linezolid dosage regimen. Methods Clinical pharmacistparticipated in the linezolid treatment of a patient with Streptococcus pyogenes sepsis complicated with sacroiliacjoint infection. Combined with therapeutic blood concentration and pharmacokinetics characteristics of linezolid,reasonable suggestions were provided, and pharmaceutical care was carried out. Results After the treatment, the patient’sinfection was effectively controlled, no adverse drug reactions occurred, and the patient was discharged after improvement.Conclusion This case is the first report of linezolid with label-off use in China. For the treatment of some specialpopulation, pharmacists and physicians should pay attention to the problem of the insufficient dose of linezolid.