摘要
本文报道临床药师参与的导管相关血流感染患者治疗过程,该患者诊断为导管相关性血流感染,但营养状况极差,需经深静脉通道输入营养物质,决定暂保留静脉导管。静脉血和导管培养均提示凝固酶阴性葡萄球菌,药敏试验提示对甲氧西林耐药,对万古霉素、利奈唑胺、达托霉素敏感。经与医生沟通后,选用万古霉素0.5 g,ivd,q6h联合万古霉素锁10 mg·ml^(-1)治疗。用药2 d后患者体温无明显改善,临床药师建议将给药方案调整为达托霉素0.5 g,ivd,qd,同时辅助使用达托霉素抗生素锁50 mg·ml^(-1)进行局部封闭治疗,建议被采纳,用药7 d后,患者病情逐渐改善。
This paper reported that clinical pharmacist was involved in the treatment of a patient with catheter-related bloodstream infection. The patient was diagnosed as catheter-related bloodstream infection, and the nutritional status was so poor that it was necessary to input nutrients through deep vein channel and the intravenous catheter was temporarily retained. Both venous blood culture and catheter culture indicated coagulase negative staphylococcus, drug susceptibility test indicated the resistance to methicillin, and the sensitivity to vancomycin, linazolamide and doxycycline. After the communication with doctors, the sensitive antibiotics vancomycin （0, 5 g, ivd, q6h） combined with vancomycin （10 mg·ml^-1） was used for the treatment. The body temperature of the patient was not significantly improved after two-day administration, and the clinical pharmacist suggested to adjust the administration scheme to the systemic administration of intravenous doxycycline （0.5 g, ivd, qd）, and at the same time, adjunctive use of doxycycline antibiotic lock （50 mg·ml^-1 was adopted for the local sealing treatment. The patient＇s condition was gradually improved after 7-day administration.
作者
郑俊敏
邓体瑛
Zheng Junmin;Deng Tiying(Department of Pharmacy,Wuhan Asian Heart Hospital,Wuhan 430022,China;Department of Pharmacy,Wuhan No.1 Hospital)
出处
《中国药师》
CAS
2018年第11期2007-2009,共3页
China Pharmacist
关键词
导管相关血流感染
凝固酶阴性葡萄球菌
达托霉素抗生素锁
临床药师
Catheter-related bloodstream infection
Coagulase negative staphylococcus
Doxycycline antibiotic locks
Clinical pharmacist
