ABSTRACT
Objective To describe clinical characteristics and anti-infective treatment of Listeria monocytogenes(L.monocytogenes)meningitis.Methods Clinical manifestations and cerebrospinal fluid(CSF)examination results of 6 patients with L.monocytogenes meningitis in a hospital were analyzed retrospectively.Evaluation methods were developed according to relevant guidelines and literatures,anti-infective treatment and prognosis of patients with L.monocytogenes meningitis were evaluated.Results Two of 4 adults with L.monocytogenes meningitis had triad of fever,stiff neck,and altered mental status,the mean white blood cell count(WBC)of the initial CSF detection was 997×106/L,CSF/blood glucose ratio was 0.32,CSF protein was 1.43g/L;the other 2 neonates had fever,epilepsy,and hyponatremia,WBC were both>1 000×106/L,CSF protein were both>1 g/L,CSF/blood glucose ratio was<0.5.Of 6 patients,none were treated with appropriate initial empiric anti-infection therapy,confirmed by CSF or blood culture,5 cases were treated with ampicillin anti-infective therapy,1 used compound sulfamethoxazole due to penicillin allergy;1 neonate died,1 elderly patient was with moderate disability,the remaining 4 cases were all recovered and discharged from hospital.Conclusion Clinical manifestations and CSF findings of L.monocytogenes meningitis are not different from other purulent meningitis,commonly used antimicrobial agents for the treatment of purulent meningitis are not sensitive to L.monocytogenes,which should be paid attention in clinic.
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Objective:To analyze the anti-infection therapy for one lung cancer patient with agranulocytosis and fever after chemo-therapy to provide pharmaceutical care and support for the rational anti-infection drug use in the patient. Methods: Clinical pharma-cists analyzed the drugs used in the patient and provided pharmaceutical care for doctors according to the examination results and diag-nosis of the patient. Results:By participating in the treatment plan, clinical pharmacists ensured the treatment for the patient was safe and effective. Conclusion:Clinical pharmacists should assist doctors in making out the treatment plan according to patients’ situation in order to promote rational drug use in clinics and reflect the value of pharmaceutical care.
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Objective:To analyze the pharmaceutical care performed by clinical pharmacist for one patient with biliary tract infec -tion to investigate the role of clinical pharmacists in clinical treatment .Methods:The clinical pharmacist supervised the whole process of treatment for the patient and optimized the treatment regimen together with the clinical doctors to achieve good efficacy .Results:With the cooperation of clinical pharmacist , the clinical doctors changed the treatment drugs to avoid the potential adverse drug reac -tions until the patient was cured .Conclusion:The participation of clinical pharmacist in the pharmaceutical care for the patients with biliary tract infection can provide a new thought of working mode .
ABSTRACT
Objective:To analyze the characteristics of infectious diseases from neurology ward and provide reference for the treat-ment. Methods:The consultation record of the neurological patients who suffered infection diseases were retrospectively summarized from January 2011 to December 2013. All the consultation were performed by clinical pharmacists. SPSS 19. 0 software was used to an-alyze the adoption and prognosis of the outcomes. Results:In 439 consultation cases,256 patients(58. 31%)were older than 65 years. Most of the cases were respiratory infection(294 cases,65. 33%),urinary tract infection(40 cases,8. 89%)and intracranial infection(37 cases,8. 22%). There were 510 strains of bacteria isolated by culturing,in which 362 strains were gram-negative bacte-ria(70. 98%),127 strains were gram-positive bacteria(24. 90%)and 21 strains were fungi(4. 12%). The top five of pathogenic bac-teria were Pseudomonas aeruginosa(125 stains,24. 51%),Acinetobacter baumannii(93 stains,18. 24%),Staphylococcus aureus(88 stains,17. 25%),Staphylococcus aureus(68 stains,13. 33%)and Escherichia coli. (32 stains,6. 27%). The detection rates of ESBLs of K. pneumonia and E. coli were 61. 36% and 75. 00%,respectively. Among 125 strains of P. aeruginosa,the sensitive rate to meropenem and inipenem was 65. 8% and 70. 6%,respectively. A. baumannii was highly multidrug resistant,and 21 strains (22. 58%)with pan-drug resistance were isolated. Gram-positive bacteria were highly sensitive to vancomycin and teicoplanin. Totally 35 strains(52. 24%)of MRSA were isolated. The complete adoption rate of consultation opinion was 84. 74%(372 cases),the partial adoption rate was 7. 28%(32 cases),and 35 cases(7. 97%)were declined. In all the adopted cases(319 cases,78. 96%)showed effectiveness. In the linear correlation analysis,the consultation adoption and therapy outcomes had significant correlation(P<0. 01). Conclusion:Clinical pharmacists can improve the efficiency in anti-infection therapy and play important roles in the treatment of infec-tious diseases in neurology ward,especially in the treatment of drug-resistant bacterial infections.