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1例重症患者抗感染个体化给药策略分析
引用本文:石晓萍,吕迁洲,杨婉花,方洁.1例重症患者抗感染个体化给药策略分析[J].药学实践杂志,2017,35(6):554-558.
作者姓名:石晓萍  吕迁洲  杨婉花  方洁
作者单位:复旦大学附属中山医院药剂科, 上海 200032,复旦大学附属中山医院药剂科, 上海 200032,上海交通大学医学院附属瑞金医院药剂科, 上海 200025,上海交通大学医学院附属瑞金医院药剂科, 上海 200025
摘    要:目的 探讨对于重症感染的患者如何根据其特殊的病理生理状况制订个体化抗感染治疗方案。方法 临床药师参与1例急性泛发性发疹性脓疱病继发血流感染和肺部感染患者的抗感染治疗,通过分析其病理生理状况,运用治疗药物监测,协助临床医生制订个体化的给药方案。结果 患者初始抗感染治疗方案效果不佳,临床药师根据患者的个体情况和血药浓度监测结果调整给药方案,患者的感染得到控制,病情好转。结论 确保重症患者给药剂量达到药动学/药效学目标值是治疗成功的关键。

关 键 词:急性泛发性发疹性脓疱病  药物监测  万古霉素  阿米卡星
收稿时间:2017/1/19 0:00:00
修稿时间:2017/6/12 0:00:00

The individualized anti-infective treatment strategy for a critically ill patient
SHI Xiaoping,LYU Qianzhou,YANG Wanhua and FANG Jie.The individualized anti-infective treatment strategy for a critically ill patient[J].The Journal of Pharmaceutical Practice,2017,35(6):554-558.
Authors:SHI Xiaoping  LYU Qianzhou  YANG Wanhua and FANG Jie
Affiliation:Department of Pharmacy, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China,Department of Pharmacy, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China,Department of Pharmacy, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China and Department of Pharmacy, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
Abstract:Objective To design individualized anti-infective therapy for a critically ill patient.Methods Based on pathophysiological conditions and therapeutic drug levels,clinical pharmacists assisted physicians to optimize individual anti-infective medication regimens for a patient with acute generalized exanthematous pustulosis secondary to blood stream infection and pulmonary infection.Results The patient responded poorly to initial treatment. After the medication regimen adjustments byclinical pharmacists according to the individual situation and therapeutic drug monitoring results,patient''s condition was improved and the infection was under control. Conclusion The key to successful treatment is to ensure the dosage administered to the critically ill patients reach the target value of pharmacokinetics and pharmacodynamics.
Keywords:acute generalized exanthematous pustulosis  therapeutic drug monitoring  vancomycin  amikacin
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