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目的:探讨临床药师在重症感染患者救治中的作用。方法:临床药师参与1例重型脑外伤后合并肺部和真菌性血流感染患者的联合治疗,对抗感染药物治疗方案的制订提出了具体意见,采取先用亚胺培南/西司他汀然后降阶梯使用哌拉西林/他唑巴坦抗细菌感染,采用氟康唑抗真菌的联合抗感染的治疗方案,治疗的同时加强对必要的血常规、肾功能、肝功能,凝血功能药学监护。结果:临床药师提供的合理治疗方案取得了良好的治疗效果,患者体温、血常规、肾功能恢复正常,神志意识恢复,治愈出院。结论:临床药师通过实施药学监护,协助医师优化治疗方案,减少不必要的抗生素换用,提高了治疗效果,减少了细菌耐药和药品不良反应的发生。
Objective: To investigate the role of clinical pharmacists in the treatment of patients with severe infections. Methods: The clinical pharmacists participated in the combination therapy of one case of severe traumatic brain injury with pulmonary and fungal bloodstream infection and put forward specific suggestions on the preparation of the treatment plan of anti-infective drugs. The first use of imipenem / cilastatin and then Step-by-step piperacillin / tazobactam antibacterial infection, the use of fluconazole anti-fungal combination of anti-infective treatment options, while strengthening the necessary blood routine, renal function, liver function, blood coagulation pharmacy care. Results: The rational pharmacotherapy provided by clinical pharmacists achieved a good therapeutic effect. Patients’ body temperature, blood routine, renal function returned to normal, consciousness recovery, and cured. Conclusion: Through the implementation of pharmacy care, clinical pharmacists can help physicians optimize treatment programs, reduce unnecessary use of antibiotics, improve the therapeutic effect, and reduce the incidence of bacterial resistance and adverse drug reactions.