摘要
目的:分析1例肺部感染伴脓毒症休克患者抗感染治疗过程,为临床脓毒症休克患者的救治提供参考。方法:该例脓毒症休克患者在ICU住院治疗期间,临床药师全程追踪,实时掌握患者的病情,通过查阅相关文献资料,协助医生制定个体化的抗感染治疗方案,并开展药学监护,在病情变化时及时进行调整。结果:在综合各种证据的情况下,考虑该例脓毒症休克患者的感染部位主要在肺部,为覆盖绝大多数可能病原菌初始经验性治疗药物选择了美罗培南,在多次痰培养结果报鲍曼不动杆菌(碳青霉烯类耐药),考虑其为主要致病菌,遂及时调整治疗方案,最终患者感染症得到有效控制。结论:面对脓毒症休克这类危重症患者,临床药师的参与可以充分发挥其在药学领域的专长,协助医生制定更有针对性的抗感染治疗方案,并开展药学监护,保证药物治疗的精准有效和安全性。
Objective:To investigate the anti-infection treatment process of one patient with pulmonary infection and septic shock,so as to provide reference for the treatment of patients with septic shock.Methods:During the hospitalization of the patient with septic shock in the ICU,clinical pharmacists traced the whole process and understood the patient’s conditions in real time.By searching relevant literatures and data,clinical pharmacists assisted the physicians in developing an individualized anti-infection treatment regimen,carried out pharmaceutical care,and made timely adjustments in case of any change in disease conditions.Results:According to various evidences,the infection site of this patient with septic shock was considered to be lungs.Meropenem was selected as the initial empiric drug to cover most possible pathogenic bacteria.The results of multiple sputum cultures reported Acinetobacter baumannii(carbapenemresistant),which was considered to be the main pathogenic bacteria.So the treatment regimen was adjusted in time,and finally the patient’s infection was effectively controlled.Conclusion:For critically ill patients with septic shock,the clinical pharmacists can give full play to their professional knowledge and skills in the pharmacy,assist physicians in developing more targeted anti-infection treatment regimen,and carry out pharmaceutical care to ensure the precise effectiveness and safety of drug therapy.
作者
孙丽
张爽
王金媛
王咏梅
SUN Li;ZHANG Shuang;WANG Jin-yuan;WANG Yong-mei(Department of Pharmacy,Jilin Provincial Hospital of Hepatobiliary Diseases,Changchun 130062,China)
出处
《抗感染药学》
2022年第8期1205-1209,共5页
Anti-infection Pharmacy
关键词
肺部感染
脓毒症休克
抗感染治疗
药学监护
pulmonary infection
septic shock
anti-infection therapy
pharmaceutical care
