| 摘要: |
| 目的：探讨1例感染性心内膜炎伴骨髓炎儿童患者的治疗药物应用决策及基于血药浓度监测的万古霉素剂量调整，分析临床药师在抗感染治疗中的作用。方法：对1例罹患感染性心内膜炎伴骨髓炎患儿实施药学监护和药学会诊，同时根据万古霉素血药浓度监测结果进行个体化给药调整。结果：在治疗过程中，患儿出现药物相关性超敏反应、病情反复和血药浓度异常等情况，在临床药师多次参与会诊和全程监护下，抗感染治疗好转出院。结论：临床药师在抗感染治疗优化方案、药物不良反应评估处理、血药浓度监测和个体化给药调整等方面具有专业优势，在儿童严重感染的治疗中发挥着重要作用，充分体现了临床药师的职业价值。 |
| 关键词: 儿童 感染性心内膜炎 万古霉素 血药浓度监测 药学监护 |
| DOI：doi:10.13407/ j.cnki.jpp.1672-108X.2022.02.006 |
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| 基金项目: |
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| Individualized Pharmaceutical Care for a Child with Infective Endocarditis and Osteomyelitis |
| Wang Siyun1, Liang Dandan2, Ma Jiulong1, Zhai Lijie1, Chai Jin1, Fu Xiujuan1, Li Xin1 |
| (1. The Second Hospital of Jilin University, Changchun 130041, China; 2. Jilin University Hospital, Changchun 130012, China) |
| Abstract: |
| Objective: To explore the decision-making of therapeutic drug application and the dose adjustment of vancomycin based on blood concentration monitoring in a child with infective endocarditis and osteomyelitis, so as to analyze the role of clinical pharmacists in anti-infective treatment. Methods: Omnidirectional pharmaceutical care and pharmaceutical consultation were performed on a child with infective endocarditis and osteomyelitis. Individualized drug administration regimen was adjusted according to the results of vancomycin blood concentration. Results: During the treatment, situations such as the drug-related hypersensitivity reaction, recrudescent symptoms and abnormal blood concentration were observed. With the participation of clinical pharmacists for many consultations and the whole process of monitoring, the child was discharged from the hospital after improved anti-infective treatment. Conclusion: Clinical pharmacists have professional advantages in anti-infective treatment optimization, adverse drug reaction assessment and management, blood concentration monitoring and individualized drug administration adjustment, and play an important role in the treatment of severe infection in children, fully reflecting the professional value of clinical pharmacists. |
| Key words: children infective endocarditis vancomycin therapeutic drug monitoring pharmaceutical care |
