张小飞;张莉翎;郭晓红;朱永红;

• 1:贵州省六盘水市第三人民医院药剂科
• 2:南通大学附属医院药学部
• 3:贵州省六盘水市第三人民医院感染科

摘要(Abstract)：

目的探讨金黄色葡萄球菌(金葡菌)脓毒症伴肾功能亢进患者抗感染治疗的药学监护模式。方法患者因反复发热6 d入院,被诊断为脓毒症后给予抗感染及对症支持治疗。临床药师根据临床表现及相关实验室检查对患者进行药学监护,重点分析万古霉素血药浓度低及抗感染治疗效果不佳的可能原因,同时提出治疗建议。结果经万古霉素抗感染治疗2周后,患者仍反复发热、血培养金葡菌阳性。之后采用达托霉素日剂量8 mg·kg-1抗感染治疗19 d后,患者病情好转出院。治疗期间,未出现药物相关不良反应。经有效抗感染后,患者肌酐清除率由204.89 m L·min-1逐步降至161.22 m L·min~(-1)。结论肾功能亢进能显著影响万古霉素血药浓度,即使使用高剂量万古霉素抗感染治疗也可能出现无效;达托霉素可用于金葡菌脓毒症伴肾功能亢进患者抗感染治疗;治疗期间,患者肌酐清除率呈动态变化趋势。

关键词(KeyWords)： 肾功能亢进;脓毒症;血药浓度;药学监护

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张小飞;张莉翎;郭晓红;朱永红;

Email:

DOI: 10.19577/j.1007-4406.2021.01.015

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