1例左氧氟沙星治疗耐碳青霉烯类肺炎克雷伯菌新生儿肺炎的病例分析及文献回顾

A Case Report and Literature Review of Levofloxacin in the Treatment of Neonatal Pneumonia with Carbapenem-resistant Klebsiella Pneumoniae

关键词:  左氧氟沙星  耐碳青霉烯类肺炎克雷伯菌  肺炎  新生儿

Key words:  levofloxacin  carbapenem-resistant Klebsiella pneumoniae  pneumonia  neonate

摘要:

目的 探讨临床药师在耐碳青霉烯类肺炎克雷伯菌新生儿肺炎抗感染治疗中的作用。方法 回顾性分析临床药师参与1例左氧氟沙星治疗耐碳青霉烯类肺炎克雷伯菌新生儿肺炎抗感染治疗的案例。结果 临床药师通过对喹诺酮类药物用于新生儿感染的风险和益处进行评估，参与抗感染方案的调整，并对患儿的治疗过程进行药学监护。结论 在无安全有效的抗感染替代方案时，儿科患者使用氟喹诺酮类也是安全合理的，可根据氟喹诺酮类药物在儿科患者体内的药动学和药效学特征，确定合理的药物治疗方案，降低儿科患者耐碳青霉烯类革兰阴性菌重症感染的致死率。

Abstract:

OBJECTIVE To investigate the role of clinical pharmacists in anti-infective treatment of neonatal pneumonia with carbapenem-resistant Klebsiella pneumoniae. METHODS A retrospective analysis of clinical pharmacists participated in a case of levofloxacin treatment of neonatal pneumonia with carbapenem-resistant Klebsiella pneumonia was studied. RESULTS Clinical pharmacists evaluated the risks and benefits of quinolones for neonatal infection, participated in the adjustment of anti-infective regimens, and carried out pharmaceutical care for the treatment of the neonate. CONCLUSION In the absence of safe and effective alternative anti-infective regimens, pediatric patients treated with fluoroquinolones may be safe and reasonable. According to pharmacokinetics and pharmacodynamics characteristics of fluoroquinolones in pediatric patients, physician and clinical pharmacists shall determine a reasonable drug therapeutic schedule to reduce the mortality rate of carbapenem-resistant gram-negative bacteria in pediatric patients.