| 摘要: |
| 目的:对临床药师参与1 例肝门空肠吻合术(Kasai 手术)后反复发作性胆管炎(RC)患儿的治疗过程进行分析,为RC 患
儿的治疗提供参考。方法:临床药师根据患儿胆道感染的情况、实验室检查并结合文献证据协助医师优化RC 的抗感染方案,
处理因长期使用抗菌药物导致的二重感染和细菌耐药,同时为患儿提供全面的药学监护。推荐美罗培南联合万古霉素及复方
磺胺甲唑治疗患儿胆管炎合并血流感染,并建议使用环丙沙星联合甲硝唑作为降阶梯治疗方案。结果:医师采纳临床药师建
议,使用复方磺胺甲唑、环丙沙星等药物,患儿胆管炎最终得到有效控制。结论:在RC 的长期管理中适时改变治疗策略能够
有效控制患儿的感染情况。 |
| 关键词: 胆道闭锁 胆管炎 临床药师 抗感染治疗 药学监护 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.04.006 |
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| 基金项目: |
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| Pharmaceutical Practice of Anti-Infective Treatment for a Child with Recurrent Cholangitis by ClinicalPharmacists |
| Wang Dongliang1, Ding Liyi2, You Yiwen3 |
| ((1. Huai’ an Women and Children’ s Health Care Hospital, Jiangsu Huai’ an
223001, China; 2. China Medical University, Shenyang 110122, China; 3. Third People’s Hospital of Huai’an, Jiangsu Huai’an
223001, China)) |
| Abstract: |
| Objective: To analyze the treatment process of a child with recurrent cholangitis (RC) after laparoscopic portojejunal
anastomosis (Kasai portoenterostomy), and to provide reference for the treatment of RC. Methods: According to the biliary tract
infection in children, laboratory tests, and literature evidence, clinical pharmacists assisted clinicians to optimize RC anti-infective
regimen, and to deal with the secondary infection and bacterial resistance induced by long-term use of antibiotics, and to provide
comprehensive pharmaceutical care for children. Meropenem combined with vancomycin and trimethoprim-sulfamethoxazole was
recommended for the treatment of cholangitis complicated with bloodstream infection. Moreover, the deescalation therapy involving
ciprofloxacin combined with metronidazole was suggested. Results: The clinicians accepted the clinical pharmacists’ advice and used
drugs such as compound trimethoprim-sulfamethoxazole and ciprofloxacin to control the cholangitis effectively. Conclusion: The longterm
management of RC requires timely adjustment of the therapeutic strategy to effectively control the infection. |
| Key words: biliary atresia recurrent cholangitis clinical pharmacists anti-infective treatment pharmaceutical care |
