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1例鹦鹉热衣原体重症肺炎患者的抗感染治疗及药学监护
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| 篇名： | 1例鹦鹉热衣原体重症肺炎患者的抗感染治疗及药学监护 |
| TITLE： | Anti-infection treatment and pharmaceutical care for a patient with severe pneumonia caused by Chlamydia psittaci |
| 摘要： | 目的 为鹦鹉热衣原体重症肺炎的抗感染药物治疗及药学监护提供思路和用药参考。方法临床药师参与1例鹦鹉热衣原体重症肺炎患者治疗的全过程，根据患者病史、临床症状、检验结果等情况，协助临床医师动态调整抗感染药物治疗方案：针对鹦鹉热衣原体感染，给予患者替加环素联合阿奇霉素治疗，并结合病原体检查结果对治疗其他感染的用药方案进行动态调整。在治疗过程中，患者出现了QTc间期延长和脂肪酶、淀粉酶升高的可疑药物不良反应，临床药师进行了药学监护并提出合理建议。结果临床医师采纳临床药师建议，患者经治疗后好转出院。结论治疗鹦鹉热衣原体重症肺炎，应兼顾患者、药物、病原体三者的特点个性化制定抗感染药物治疗方案。四环素类抗生素和大环内酯类抗生素对鹦鹉热衣原体感染有明确疗效，但是在临床应用中需关注药物可能引起的不良反应。 |
| ABSTRACT： | OBJECTIVE To provide ideas and reference for the anti-infection treatment and pharmaceutical care for severe pneumonia caused by Chlamydia psittaci. METHODS Clinical pharmacists participated in the whole process of the treatment for a patient with C. psittaci-induced severe pneumonia. According to the patient’s medical history， clinical symptoms and test results， clinical pharmacists assisted the physician to dynamically adjust the anti-infective scheme； for C. psittaci infection， the patient was treated with tigecycline combined with azithromycin successively， and other infection therapy plans were dynamically adjusted according to the results of pathogen examination. During the treatment， the patient suffered from suspicious adverse drug reactions such as prolonged QTc interval， elevated lipase and amylase； the clinical pharmacists conducted pharmaceutical care and put forward reasonable suggestions. RESULTS The physician adopted the pharmacists’ suggestion， and the patient was discharged after treatment. CONCLUSIONS For the treatment of severe pneumonia caused by C. psittaci， the characteristics of patients， drugs and pathogens should be taken into account to develop individualized anti-infective treatment. Tetracyclines and macrolides have a definite effect on C. psittaci infection， but attention should be paid to the possible ADR caused by drugs in clinical application. |
| 期刊： | 2024年第35卷第02期 |
| 作者： | 赖宗强；李俊；商永光 |
| AUTHORS： | LAI Zongqiang，LI Jun，SHANG Yongguang |
| 关键字： | 鹦鹉热衣原体；重症肺炎；替加环素；阿奇霉素；临床药师；药学监护 |
| KEYWORDS： | Chlamydia psittaci； severe pneumonia； tigecycline； azithromycin； clinical pharmacist； pharmaceutical care |
| 阅读数： | 91 次 |
| 本月下载数： | 6 次 |
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