Investigation on antimicrobial usage in 451 patients with complicated intra-abdominal infection / 中华急诊医学杂志

Objective To investigate the microbiological epidemiology and clinical use of antibiotics in patients complicated intra-abdominal infection (cIAI),therefore to optimize antibiotic use and to promote antimicrobial stewardship.Methods A total of 451 patients with cIAI from a Chinese tertiary hospital between January 2015 and December 2016 were retrospectively reviewed.The infection severity,timing of microbiological specimen sampling,culture results,initial antibiotic selection and later anti-infective regimen adjustment were analyzed.Results Three hundred and sixteen (70.1％,316/451) patients undergone microbiological investigation at infection sites within 3 days and 133 (42.1％) patients had a positive culture,of which 64.5％ were Enterobacteriaceae.Three hundred seventy-four patients (82.9％) initially received broad-spectrum antibiotics against gram-negative bacilli.Sixty-five patients (14.4％) initially received combined antibiotic therapy,of which 30.8％ were deemed as overuse.Among 308 patients who initially received broad-spectrum antibiotic therapy,268 patients (87.0％) clinically improved in five days,while de-escalation was only conducted in 72 cases (26.9％).On average,patients were treated with (2.29±1.30) antibiotics for a duration of (10.6±6.5) days,and 42.4％ received combined antibiotic therapy during hospitalization.Conclusions The major microbiological pathogens in cIAI patients in our hospital were Enterobacteriaceae.However,there are phenomena such as excessive usage with broad-spectrum antibiotics,insufficient awareness of de-escalation,and long course of anti-infective therapy,which needs to be further improved.

Pharmacological Care for One Case of Patient with Multiple Drug-resistant Pseudomonas Aeruginosa Spsis Treated with Amikacin / 中国药师

Clinical pharmacists performed pharmaceutical care for one case of patient with multiple drug-resistant pseudomonas aeruginosa sepsis, assisted doctors in formulating anti-infective drug treatment plans and adjusted the regimen according to the results of bacterial culture and drug susceptibility combined with renal function of the patient. The participation of clinical pharmacists in clinical treatment practice ensured the safety and effectiveness of the patient's medication, avoided the occurrence of adverse drug reactions, and finally controlled the infection and improved the condition.

Pharmaceutical Care for One Severe Pneumonia Patient with Pneumocystis Carinii and Aspergillosis Caused by Long-term Use of Glucocorticoids / 中国药师

Objective: To explore the breakthrough points of pharmaceutical care performed by clinical pharmacists for the patients with severe infection.Methods: One case of severe pneumonia patient with Pneumocystis carinii and aspergillosis was treated with pharmaceutical care and intervention, and the effect of anti infection treatment and adverse drug reactions were concerned and individualized dosing regimen were provided.Results: Through the pharmaceutical care for the patient with severe infection, the safety and effectiveness of drug use were ensured.Conclusion: Using the treatment contradictions and adverse drug reactions as the breakthrough points, clinical pharmacists participate in clinical practice to embody their own value.