中国临床药学杂志2025，Vol.34Issue(3)：192-199,8.DOI:10.19577/j.1007-4406.2025.03.006
儿童感染性心内膜炎的药物治疗及药学监护特征分析
Analysis of drug therapy and pharmaceutical care of infective endocarditis in children
摘要
Abstract
AIM To analyze the characteristics of drug treatment for infective endocarditis in children,summarize the characteristics of pharmaceutical care for such cases from the perspective of clinical pharmacists,thereby improving the diagnosis and treatment level of infective endocarditis.METHODS From May 2016 to May 2023,12 children with infective endocarditis were recruited into the analysis.Their clinical characteristics,treatment plans,and pharmaceutical care regimes were then analyzed and summarized.RESULTS A total of 12 children with infective endocarditis were collected.There were 4 males and 8 females,and the mean age of onset was(6.93±4.95)years.Operative intervention was applied to 10 patients,and retention therapy was implemented in 2 patients.The average length of hospitalization was(41.85±18.19)days.There were 10 patients with congenital heart disease or cardiovascular malformation,and 2 patients with no underlying heart disease.Of the patients,6 were cured and discharged,5 improved,and 1 died.Among the 12 cases,bacteria or fungi were detected in 10 cases(83.33％),with 9 of these showing positive cultures from sterile site specimens.Among the 12 cases,bacteria or fungi were detected in 10 cases(83.33％),with 9 of these showing positive cultures from sterile site specimens.The 29 strains were detected in sterile parts such as blood/cerebrospinal fluid/intraoperative neoplasms.The 28 strains were gram-positive(96.55％);1 gram-negative strain(3.45％);13 strains of Staphylococcus aureus(all methicillin-resistant Staphylococcus aureus(MRSA),44.83％);6 strains of deficient anaerobic bacteria(20.69％);5 strains of Streptococcus bradycosus(17.24％);2 strains of blood streptococcus(6.9％);1 strain of Streptococcus viridans(3.45％);1 strain of Klebsiella oxytoca(3.45％);1 strain of Bacillus cereus(3.45％).The utilization rate of antibiotics is 100％.The main drugs used were linezolid,vancomycin,norvancomycin,teicoplanin,meropenem,and cephalosporin/enzyme inhibitors.All of the children were treated with myocardial energy metabolism activators,83.33％(10/12)were treated with positive inotropic drugs.A total of 4 times of valid vancomycin blood trough concentration monitoring and 6 times of digoxin blood trough concentration monitoring were conducted.CONCLUSION Most of the children diagnosed with infective endocarditis had secondary infection and Gram-positive bacteria are the main pathogens.All the staphylococcus aureus detected are MRSA.Streptococcus resistance varies greatly.Antimicrobial therapy is primarily based on linezolid and glycopeptides.It is necessary to strengthen the monitoring of the blood drug concentration of antibacterial drugs.关键词
儿童/感染性心内膜炎/抗菌药物/药学监护Key words
children/infective endocarditis/antibacterial drug/pharmaceutical care分类
药学引用本文复制引用
李三妮,秦亚彬,张楠,孟艳,张古英..儿童感染性心内膜炎的药物治疗及药学监护特征分析[J].中国临床药学杂志,2025,34(3):192-199,8.基金项目
河北省药学会"晴冀药学"医院药学专项科研面上课题(编号2022-Hbsyxhqjyxms13) （编号2022-Hbsyxhqjyxms13）
河北省医学科学研究课题计划(编号20150568) （编号20150568）
