临床药师参与1例前交通动脉瘤术后颅内多重耐药菌感染诊疗的实践体会

Pharmaceutical Practice of Clinical Pharmacist Participating in Diagnosis and Treatment for One Case of Intracranial Infection after Operation of Traffic Tumor with the Extra Ventficular Drainage

关键词:  颅内感染  鞘内给药  超说明书用药  药学实践

Key words:  intracranial infection  intrathecal injection  exceeding the specification of drugs  pharmaceutical practice

摘要:

目的 通过参与对1例前交通瘤和双侧脑室引流术后颅内感染患者的治疗，探讨多重耐药菌颅内感染病例的药学监护点，分享抗菌药物应用得失体会。方法 临床药师在患者治疗中给予抗感染治疗方案建议，分析患者病情和感染因素，调整抗菌药物，联合脑室内和鞘内阿米卡星给药，并进行全程药学监护。结果 临床医师采纳药师建议，患者颅内感染得到控制，并且没有出现器官功能的损伤和药物不良反应，患者康复出院。结论 术后颅内感染治疗应注重去除感染因素，依据药敏监测结果及时调整抗菌药物，药学监护下适时启用和停用局部用抗菌药物。

Abstract:

OBJECTIVE To discuss the pharmaceutical care points in intracranial infection of multidrug-resistant organism and share the experience in anti-bacterial drug usage by the participation in therapy of a patient with intracranial infection after the operation of traffic tumor. METHODS Clinical pharmacist monitored the whole process of anti-infective treatment. Providing suggestion to the administration of drugs, analyzing the condition of the patient and factors related to infection. Giving the proposal of amikacin administrated via intraventricular and intrathecal injection according to various literature. RESULTS The proposal was adopted by the doctor and the intracranial infection was controlled. The patient was discharged from hospital without any injury of organ function and adverse reaction. CONCLUSION Removing the infected factors and adjusting anti-bacerial drugs according to drug sensitivity tests in time is important. Local use of antibiotics can be enabled and disabled under the care of clinical pharmacists.