临床药师参与1例气性坏疽患儿抗感染治疗的实践与分析

发布时间：2018-02-28 04:44

本文关键词： 气性坏疽抗感染治疗用药分析临床药师　出处：《中国药房》2017年29期 　论文类型：期刊论文

【摘要】：目的:探讨临床药师在气性坏疽患儿抗感染治疗中的作用。方法:临床药师参与1例气性坏疽患儿的抗感染治疗过程,根据患儿临床症状及各科室会诊意见,建议使用注射用哌拉西林钠他唑巴坦钠初始抗感染治疗;患儿经左下肢清创引流、坏死组织清除术后,临床药师根据气性坏疽的病原学特点及相关指南,建议停用注射用哌拉西林钠他唑巴坦钠,改用注射用青霉素钠+注射用亚胺培南西司他丁钠联合抗感染;根据患儿伤口分泌物细菌培养及药敏试验结果,建议加用盐酸克林霉素氯化钠注射液0.6g,q8 h,ivgtt抑制产气荚膜梭菌生长;根据患儿体征及病原学结果的改变,先后提出停用盐酸克林霉素氯化钠注射液、改用注射用盐酸万古霉素等建议。结果:医师采纳临床药师建议。患儿经外科手术及抗感染治疗后,病情好转,生命体征平稳,转入骨科普通病房继续治疗。结论:临床药师参与气性坏疽患儿的治疗过程,结合相关指南以及患儿的临床症状、病原学检查结果、各科室会诊意见,协助医师制订和调整抗感染治疗方案,保证了患儿用药的安全、有效。
[Abstract]:Objective: to explore the role of clinical pharmacists in anti-infective treatment of children with gas gangrene. Methods: clinical pharmacists participated in the process of anti-infective treatment of one case of gas gangrene, according to the clinical symptoms of children and the consultation opinions of various departments. It was suggested that piperacillin sodium and tazobactam sodium for injection should be used as initial antiinfective therapy, and that the children should be treated with debridement and drainage of the left lower extremity, after the removal of necrotic tissue, according to the etiological characteristics and related guidelines of gas gangrene. It is suggested that piperacillin sodium and tazobactam sodium for injection should be stopped and imipenem cilastatin sodium for injection should be used instead of imipenem sodium for injection. It is suggested to add clindamycin hydrochloride sodium chloride injection 0.6 g / g Q 8 h iv GTT to inhibit the growth of Clostridium perfringens, according to the changes of children's physical signs and etiological results, the discontinuation of clindamycin hydrochloride sodium chloride injection was put forward successively. Results: doctors accepted the advice of clinical pharmacists. After surgery and anti-infection treatment, the child's condition improved and the vital signs were stable. Conclusion: clinical pharmacists are involved in the treatment of children with gas gangrene, combined with the relevant guidelines and clinical symptoms, etiological examination results, consultation opinions of each department, Assist doctors to formulate and adjust anti-infection treatment program to ensure the safety and effectiveness of drug use in children.
【作者单位】：重庆医科大学附属永川医院药学部;
【基金】：重庆医科大学附属永川医院院内科研课题资助项目(No.YJQN201431)
【分类号】：R725.1

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