临床药师参与39例鲍曼不动杆菌感染患者会诊的实践与分析

发布时间：2018-03-25 03:35

  本文选题：临床药师　切入点：会诊　出处：《中国药房》2016年20期

【摘要】：目的:探讨临床药师参与临床鲍曼不动杆菌感染患者会诊的方法及切入点,以期提高临床合理用药水平。方法:回顾性分析我院2013-2014年神经内科临床药师参与的鲍曼不动杆菌感染患者会诊记录39例。对会诊患者一般资料、感染部位、细菌培养、药敏试验结果及会诊前后用药方案、病情、感染相关指标、营养状况进行统计分析。结果:所有患者均在痰培养中发现鲍曼不动杆菌,其中多重耐药鲍曼不动杆菌11例(28.2%),泛耐药鲍曼不动杆菌13例(33.3%),全耐药鲍曼不动杆菌8例(20.5%),非多重耐药菌7例(17.9%)。会诊意见中最常用的药物为米诺环素,平均剂量为0.2 g/d,其次为头孢哌酮钠舒巴坦钠,平均剂量为9g/d,头孢他啶平均剂量为6 g/d、依替米星平均剂量为0.27 g/d、阿米卡星平均剂量为0.4 g/d,日均剂量高于会诊前,3例患者会诊意见推荐使用磷霉素治疗。会诊前未使用抗菌药物患者2例(5.1%),单一用药13例(33.4%),二联用药22例(56.4%),三联用药2例(5.1%);会诊后未使用抗菌药物患者0例(0),单一用药7例(17.9%),两药联用26例(66.7%),三药联用6例(15.4%)。会诊后患者的症状、体温、感染相关指标均有好转,临床药师为12例(30.8%)患者调整了营养方案,为9例(23.1%)患者调整了化痰方案。11例(28.2%)患者白蛋白较会诊前升高,20例(51.3%)患者前白蛋白较会诊前升高。结论:临床药师在会诊中应当根据患者的感染情况和身体状况,制订合理用药方案,减少不合理用药,在提供抗感染治疗方案的同时,还应注意祛痰方案和营养支持方案的调整。
[Abstract]:Objective: To investigate the clinical pharmacists in clinical Bauman real methods infection patients consultation and the starting point, in order to improve the level of rational drug use. Methods: a retrospective analysis of 2013-2014 years of clinical pharmacists in Department of Neurology Bauman Acinetobacter infection patients consultation records of 39 cases in our hospital. The general data of patients, infection, bacteria before and after the training, the results of drug sensitivity test and medication consultation, disease, infection related indicators of nutritional status were analyzed. Results: all patients were found in the sputum of Bauman Acinetobacter, including multiple drug resistant Acinetobacter Bauman in 11 cases (28.2%), Bauman pan drug resistant Acinetobacter in 13 cases (33.3%) the real Bauman, drug resistance in 8 cases (20.5%), non coli multi drug resistant bacteria in 7 cases (17.9%). The most commonly used drug consultation for minocycline, an average dose of 0.2 g/d, followed by the head of cefoperazone sodium and sulbactam sodium, average agent 閲忎负9g/d,澶村��浠栧暥骞冲潎鍓傞噺涓，

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