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1 例生痰二氧化碳嗜纤维菌脑膜炎合并肾功能亢进患儿的抗感染治疗实践
何翠瑶,李听松,罗媛媛,廖双
0
(重庆医科大学附属儿童医院,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点试验室,儿科学重庆市重点实验室,重庆 400014)
摘要:
目的:探讨临床药师在儿童细菌性脑膜炎抗感染治疗中的作用。 方法:临床药师通过参与 1 例由生痰二氧化碳嗜纤维菌引起的儿童细菌性脑膜炎患者的多次药学会诊,与医师通力合作,对患儿治疗效果欠佳的原因进行分析,结合患儿存在肾功能亢进这一特殊生理病理特点及抗菌药物药动学/ 药效学(PK/ PD)理论,优化抗感染治疗方案并实施药学监护。 结果:临床药师提出的治疗方案被医师采纳,患儿临床症状改善、脑脊液恢复正常并顺利出院。 结论:临床药师对临床上罕见致病菌引起的特殊部位感染,应充分发挥药学专业特长,进一步提高抗感染药物的临床疗效。
关键词:  生痰二氧化碳嗜纤维菌  细菌性脑膜炎  肾功能亢进  临床药师
DOI:10.13407/j.cnki.jpp.1672-108X.2024.06.001
基金项目:重庆市科卫联合面上项目,编号 2023MSXM068
Practice of Anti-Infective Treatment in a Child with Capnocytophaga Sputigena Bacteremia MeningitisComplicated with Augmented Renal Clearance
He Cuiyao, Li Tingsong, Luo Yuanyuan, Liao Shuang
(Children’s Hospital of Chongqing Medical University, National ClinicalResearch Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing KeyLaboratory of Pediatrics, Chongqing 400014, China)
Abstract:
Objective: To probe into the role of clinical pharmacists in anti-infective treatment of bacterial meningitis in children.Methods: Clinical pharmacists participated into multiple pharmaceutical consultations for a child with Capnocytophaga sputigenabacteremia meningitis complicated with augmented renal clearance. Clinical pharmacists cooperated with clinicians to analyze the causesof poor therapeutic effects, and optimized the anti-infective treatment regimen and implemented pharmacological care in combination withthe special physiopathological characteristics of augmented renal clearance and pharmacokinetics/ pharmacodynamics (PK/ PD) theory ofantibiotics. Results: The treatment regimen proposed by clinical pharmacists was adopted by clinicians. The child was clinically stablewith normal cerebrospinal fluid and was discharged successfully. Conclusion: Clinical pharmacists should give full play to theprofessional expertise in pharmacy to further improve the clinical efficacy of anti-infective drugs for special site infections induced by rarepathogenic bacteria in the clinic
Key words:  Capnocytophaga sputigena bacteremia  bacterial meningitis  augmented renal clearance  clinical pharmacists

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