疾病监测与控制2023，Vol.17Issue(3)：175-179,5.DOI:10.19891/j.issn1673-9388.(2023)03-0175-05
临床药师参与中毒性表皮松解症合并血流感染的药学实践
CLINICAL PHARMACISTS'PARTICIPATION IN THE PHARMACEUTICAL CARE PRACTICE OF TOXIC EPIDERMAL NECROLYSIS COMVINED WITH BLOODSTREAM INFECTION
摘要
Abstract
Objective By participating in the pharmaceutical care practice of a patient with drug-induced toxic epider-molysis,the value of clinical pharmacists in the identification and management of drug-induced diseases and in the treatment of co-infections was reflected.Methods A patient with severe pulmonary infection after cerebral hemorrhage was admitted to Or-dos Central Hospital on September 8,2019.The patient successively developed toxic epidermolysis(TEN)followed by Acineto-bacter baumannii and Staphylococcus aureus bacteremia 1 month after anti-infective treatment with cefoperazone sodium and sulbactam sodium,tigecycline,imipenem and cilastatin,ornidazole,and amikacin.Clinical pharmacists timely iden-tify and deal with the adverse reactions in combination with the patient's condition and relevant literature literature,and put forward individualized treatment recommendations for patient infection.Results Clinical pharmacists used specific ALDEN methods(different from routine adverse reaction evaluation methods)to assess individual evalua-tion of drug causality causing toxic epidermolysis(TEN),assisted physicians in timely discontinuation of the drug and recommended methylprednisolone and gamma globulin treatment.The patient developed TEN with elevated body temperature,and blood cultures at three different periods within 1 week revealed Acinetobacter baumannii and Staphylococcus aureus.The clinical pharmacist assisted the physician in judging the value of blood cultures and ad-vised the physician to give linezolid 600 mg q 12h and monitor the patient's condition throughout.After two weeks of anti-infective treatment,the patient's skin was significantly improved.Conclusion Clinical pharmacists help phy-sicians to identify drug-induced diseases,and assist physicians to develop individualized treatment plan and moni-tor the whole process,avoiding the occurrence of drug-induced diseases in patients again,fully reflecting the value of clinical pharmacists in the treatment team.关键词
中毒性表皮松解症/替加环素/头孢哌酮舒巴坦/临床药师Key words
Toxic epidermolysis/Tigecycline/Cefoperazone sulbactam/Clinical pharmacist分类
医药卫生引用本文复制引用
解沛涛,苏云,张利宏,董利森,刘俊保,王星,苏长海..临床药师参与中毒性表皮松解症合并血流感染的药学实践[J].疾病监测与控制,2023,17(3):175-179,5.基金项目
鄂尔多斯市医学重点学科建设项目 （）
