1例肝移植术后耶氏肺孢子虫肺炎患者的药学监护

Participation of Clinical Pharmacist in the Therapy for One Case of Pneumocystis Jiroveci Pneumonia after Liver Transplantation

关键词:  感染  耶氏肺孢子虫肺炎  复方新诺明  卡泊芬净

Key words:  infection  pneumocystis jiroveci pneumonia  sulfamethoxazole compound  caspofungin

摘要:

目的 探讨肺部感染耶氏肺孢子虫患者的治疗方案及临床药师在感染治疗中的作用。方法 临床药师参与1例肝移植术后肾功能不全患者感染耶氏肺孢子虫肺炎的治疗经过，同时查阅国内外文献，对耶氏肺孢子虫感染的临床表现、治疗方法进行分析。结果 医师采纳临床药师建议，患者感染得到控制，病情好转出院。结论 对于移植患者应早期识别耶氏肺孢子虫感染，轻度肾功能不全的患者可以考虑使用低剂量复方新诺明联合卡泊芬净治疗耶氏肺孢子虫肺炎。

Abstract:

OBJECTIVE To investigate the therapeutic regimen of pneumocystis jiroveci infection and the role of clinical pharmacists in the treatment of pneumocystis jiroveci infection. METHODS Clinical pharmacists participated in the treatment of pneumocystis jiroveci pneumonia in a patient with renal insufficiency after liver transplantation. Meanwhile, the clinical manifestations and treatment of pneumocystis jiroveci pneumonia infection were analyzed by reference to literature at home and abroad. RESULTS The doctor adopted the suggestion of clinical pharmacist, and the patient's infection was controlled with the condition improved, and the patient was discharged. CONCLUSION Pneumocystis jiroveci infection shall be recognized early in transplant recipients. Patients with mild renal insufficiency may consider the use of low-dose combination of compound sulfamethoxazole and caspofungin in the treatment of pneumocystis jiroveci infection.