本文選題：臨床藥師　切入點：會診　出處：《中國藥房》2016年20期

【摘要】：目的:探討臨床藥師參與臨床鮑曼不動桿菌感染患者會診的方法及切入點,以期提高臨床合理用藥水平。方法:回顧性分析我院2013-2014年神經(jīng)內(nèi)科臨床藥師參與的鮑曼不動桿菌感染患者會診記錄39例。對會診患者一般資料、感染部位、細(xì)菌培養(yǎng)、藥敏試驗結(jié)果及會診前后用藥方案、病情、感染相關(guān)指標(biāo)、營養(yǎng)狀況進(jìn)行統(tǒng)計分析。結(jié)果:所有患者均在痰培養(yǎng)中發(fā)現(xiàn)鮑曼不動桿菌,其中多重耐藥鮑曼不動桿菌11例(28.2%),泛耐藥鮑曼不動桿菌13例(33.3%),全耐藥鮑曼不動桿菌8例(20.5%),非多重耐藥菌7例(17.9%)。會診意見中最常用的藥物為米諾環(huán)素,平均劑量為0.2 g/d,其次為頭孢哌酮鈉舒巴坦鈉,平均劑量為9g/d,頭孢他啶平均劑量為6 g/d、依替米星平均劑量為0.27 g/d、阿米卡星平均劑量為0.4 g/d,日均劑量高于會診前,3例患者會診意見推薦使用磷霉素治療。會診前未使用抗菌藥物患者2例(5.1%),單一用藥13例(33.4%),二聯(lián)用藥22例(56.4%),三聯(lián)用藥2例(5.1%);會診后未使用抗菌藥物患者0例(0),單一用藥7例(17.9%),兩藥聯(lián)用26例(66.7%),三藥聯(lián)用6例(15.4%)。會診后患者的癥狀、體溫、感染相關(guān)指標(biāo)均有好轉(zhuǎn),臨床藥師為12例(30.8%)患者調(diào)整了營養(yǎng)方案,為9例(23.1%)患者調(diào)整了化痰方案。11例(28.2%)患者白蛋白較會診前升高,20例(51.3%)患者前白蛋白較會診前升高。結(jié)論:臨床藥師在會診中應(yīng)當(dāng)根據(jù)患者的感染情況和身體狀況,制訂合理用藥方案,減少不合理用藥,在提供抗感染治療方案的同時,還應(yīng)注意祛痰方案和營養(yǎng)支持方案的調(diào)整。
[Abstract]:Objective: To investigate the clinical pharmacists in clinical Bauman real methods infection patients consultation and the starting point, in order to improve the level of rational drug use. Methods: a retrospective analysis of 2013-2014 years of clinical pharmacists in Department of Neurology Bauman Acinetobacter infection patients consultation records of 39 cases in our hospital. The general data of patients, infection, bacteria before and after the training, the results of drug sensitivity test and medication consultation, disease, infection related indicators of nutritional status were analyzed. Results: all patients were found in the sputum of Bauman Acinetobacter, including multiple drug resistant Acinetobacter Bauman in 11 cases (28.2%), Bauman pan drug resistant Acinetobacter in 13 cases (33.3%) the real Bauman, drug resistance in 8 cases (20.5%), non coli multi drug resistant bacteria in 7 cases (17.9%). The most commonly used drug consultation for minocycline, an average dose of 0.2 g/d, followed by the head of cefoperazone sodium and sulbactam sodium, average agent 閲忎負(fù)9g/d,澶村浠栧暥騫沖潎鍓傞噺涓，

本文編號：1661395