1例药源性伪膜性肠炎患者的临床药学监护

Pharmaceutical Care of a Patient with Drug-induced Pseudomembranous Enteritis

关键词:  抗菌药物  质子泵抑制剂  伪膜性肠炎  艰难梭菌感染

Key words:  antibiotic  proton pump inhibitors  pseudomembranous enteritis  Clostridium difficile infection

摘要:

目的 报告1例腹痛不伴有腹泻症状的伪膜性肠炎患者的临床治疗与药学监护，以提示临床提高警惕。方法 临床药师通过参与诊疗，获知患者的疾病史与药物治疗史，结合肠镜寻找病因，提出建议，与医师协同合作，提高医疗质量。结果 经过调查分析其药物治疗经过，最可能的病因是广谱抗菌药物、质子泵抑制剂的联合使用导致艰难梭菌感染，为药品不良反应。结论 抗菌药物及质子泵抑制剂的不合理使用造成严重艰难梭菌感染，值得引起重视。对于长时间、多品种使用抗菌药物且无腹泻症状的伪膜性肠炎更应予以关注。

Abstract:

OBJECTIVE To report a case of clinical treatment and pharmaceutical care of a patient with pseudomembranous enteritis and abdominal pain but no diarrhea to warn clinical safety.METHODS The clinical pharmacists investigated the patient’s disease history and drug treatment history, meanwhile, combined the results of colonoscopy to analyze the condition and drug characteristics, and provided treatment suggestions.RESULTS After comprehensive analysis, it was considered that the combination of broad-spectrum antibiotics and proton pump inhibitors led to Clostridium difficile infection, which was an adverse drug reaction.CONCLUSION It should pay attention to inappropriate use of antibiotics and proton pump inhibitors can cause severe Clostridium difficile infection. More attention should be paid to pseudomembrane enteritis, which has been treated with multiple antibiotics for a long time without diarrhea symptoms.