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目的探讨药师参与鲍曼不动杆菌感染患者用药方案调整及其对合理用药的影响。方法选取临沂市精神卫生中心2013—2015年收治的鲍曼不动杆菌感染患者28例,统计分析药师参与会诊前后的用药方案、体温、血常规及症状。结果 8例为多重耐药鲍曼不动杆菌感染,9例为反耐药鲍曼不动杆菌,6例为全耐药鲍曼不动杆菌,5例为非多重耐药菌。会诊后,米诺环素、头孢他啶、头孢哌通纳舒巴坦钠、丁胺卡那霉素、依替米星日平均剂量均比会诊前高;1例因合并基础疾病给予糖皮质激素,2例经会诊商定给予磷霉素治疗;2例患者保持用药方案不变,25例用药方案调整,1例重新设计用药方案;会诊后,19例采用二联抗感染方案,5例单一用药,4例三联用药;6例会诊前后体征无明显变化,21例体征明显减轻,1例强行出院;血常规好转率为85.71%;体温改善率为96.43%。结论药师参与会诊后,可结合患者的实际情况给予合理的用药方案,从而达到提高治疗效果和控制不合理用药的目的。
Objective To explore pharmacokinetics in patients with Acinetobacter baumannii infection medication program to adjust and its effect on the rational use of drugs. Methods 28 cases of Acinetobacter baumannii infection in Linyi Mental Health Center from 2013 to 2015 were selected, and the medication regimen, body temperature, blood routine and symptoms of the pharmacists participating in the consultation were statistically analyzed. Results Eight cases were multidrug-resistant Acinetobacter baumannii, 9 were anti-drug-resistant Acinetobacter baumannii, 6 were all drug-resistant Acinetobacter baumannii, and 5 were non-multi-drug resistant. Minocycline, ceftazidime, ceftazidime, sulbactam sodium, amikacin, and etimicin daily averaged higher than those before the consultation; one case was given glucocorticoid due to the combination of basic diseases, Two patients were treated with fosfomycin after consultation. Two patients remained unchanged medication regimen, 25 patients received medication regimen, and 1 patient redesigned medication regimen. After the consultation, 19 patients were treated with dual anti-infectives regimen and 5 were single- 4 cases of triple therapy; 6 cases before and after the consultation no significant changes in signs, signs of 21 patients significantly reduced, 1 case forced discharge; blood routine improvement rate was 85.71%; body temperature improvement rate was 96.43%. Conclusion After participating in the consultation, the pharmacist can give a reasonable dosage regimen according to the actual situation of the patients so as to achieve the goal of improving the therapeutic effect and controlling the irrational use of drugs.