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OBJECTIVE：To optimize the ant i-infective treatment plan for the super-premature infants and provide reference for the clinical treatment of the super-premature infants and the whole pharmaceutical care. METHODS ：A super-premature infant with gestational age of 25+5 weeks and weight of 400 g was delivered in the second department of neonatology in Hunan Maternal and Child Health Hospital. This child suffered from complex complications. Clinical pharmacists ，relevant medical staff and hospital infection department personnel formed a multidisciplinary treatment team. According to Neonatal Sepsis Treatment Scheme ， Antimicrobial Treatment Guide ，Premature Medicine ，combining with the analysis of infection indicators ，biochemical indicators ， vital signs and other indicators ，a individualized anti-infective diagnosis and treatment plan was developed for the child. After entering the NICU ，this child was given Piperacillin sodium and sulbactam sodium for injection （100 mg/kg，ivgtt，q12 h）for anti-infective treatment ；considering the possibility of sepsis ，clinical pharmacists suggested that Piperacillin sodium and sulbactam sodium for injection should be stopped and Meropenem for injection （40 mg/kg，ivgtt，q12 h）should be used instead. After 7 day of meropenem treatment ，clinical pharmacists suggested adding antifungal Fluconazole injection （5.0 mg/kg，ivgtt，qod）. After 11 days of meropenem treatment ，in order to avoid the aggravation of infection ，according to the drug sensitivity results （sensitive to Ticarcillin sodium and clavulanate potassium for injection ），clinical pharmacists suggested adding Ticarcillin sodium and clavulanate potassium for injection （75 mg/kg，ivgtt，q8 h）for combined anti-infective treatment ，and hospital infection treatment was carried out at the same time. After the infection index was stable ，all antibiotics were stopped. When E. coli infection occurred later，clinical pharmacists suggested that Piperacillin tazobactam sodium for injection （75 mg/kg，ivgtt，q8 h）should be used. After the infection aggravated ，Piperacillin tazobactam sodium for injection was stopped and Imipenem cilastatin sodium forinjection（20 mg/kg，ivgtt，q8 h）was used instead. The child received ladder treatment after the decline of infection index ，and Ceftazidime for injection （50 mg/kg，ivgtt，q12 h）was used. RESULTS ：The doctors adopted the above suggestions. After treatment ，the prognosis of the child was good ，the vital signs were stable ，and the body weight reached 3 000 g at discharge. CONCLUSIONS ：For preterm infants as special group ，before using antibiotics ，clinical pharmacists should focus on the vital signs ，infection indicators and laboratory test results of the child ，so as to help doctors improve the treatment plan and ensure the effectiveness and safety of their medication.
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Taking full advantage of professional knowledge,clinical pharmacist involved in the whole treatment process of one case of mycobacterium infection by assisting doctors in determining and optimizing the anti-infective treatment plan, and performing pharmaceutical care. After the active, rational and effective anti-infective treatment, the patient's infection was controlled effectively. The active participation of clinical pharmacist gains clinical experience for the treatment of rare bacterial infections.
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OBJECTIVE: To explore the role of clinical pharmacists in anti-infective treatment for the patient with septic shock induced by intrauterine infection. METHODS: Clinical pharmacists participated in anti-infective treatment for a patient with septic shock induced by intrauterine infection, and assisted physicians to formulate empirical anti-infective treatment, determine that Escherichia coli was pathogenic bacteria and analyze the causes of fluctuations in body temperature. According to the patient's disease condition and results of assistant examination, clinical pharmacists suggested using Imipenem and cilastatin sodium for injection 1. 0 g, ivgtt, q6 h, stopping Teicoplanin for injection, de-escalation using Cefoxitin sodium for injection 2. 0 g, ivgtt, q8 h for anti-infective treatment, with oral sequential therapy. RESULTS: Physicians adopted most advice of pharmacists. After 30 d anti-infective and symptomatic treatment, the patients symptoms were better than before, and discharged from the hospital. CONCLUSIONS: Clinical pharmacists participate in formulating individual anti-infective treatment regimen, so as to promote the rational use of antibiotics and improve the response rate and success rate of treatment.
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Objective:To investigate the role of clinical pharmacists in the anti-infective treatment of one patient with complexity urinary tract infection with septic shock induced by cellulitis. Methods:Clinical pharmacists participated in one case of complexity uri-nary tract infection with septic shock induced by cellulitis, and according to the clinical curative effect and the patient' s condition change, clinical pharmacists adjusted the medication nine times and provided individualized pharmaceutical care and service in the whole process. Results:Physician accepted the suggestions of clinical pharmacists, the infection was controlled after the 38-day treat-ment, and then the patient was discharged from the hospital. Conclusion:Clinical pharmacists should participate in the clinical treat-ment, provide whole process of pharmaceutical care for severe patients and assist physician in drug treatment decisions to promote safe, effective and economical drug use.
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OBJECTIVE:To provide reference for rational use of antibiotics in community-acquired pneumonia (CAP) pa-tients. METHODS:Medical records of 342 CAP inpatients in our hospital during Jan.-Dec. in 2014 were analyzed retrospectively by DDDs and SPSS 19.0 statistical software. According to the age,the patients were divided into youth group,the young group, middle age group and elderly group,and clinical information and the use of antibiotics were analyzed statistically. RESULTS:Mi-crobiological examination of 320 of 342 CAP inpatients were performed with detection rate of 93.57%;sputum culture,blood cul-ture and PCT were conducted in 67 case to find out pathogenic bacteria with negative rate of 20.18%. 338 patients had used antibi-otics (98.83%),and other 4 patients refused anti-infective treatment. Selected empirical antibiotics of our hospital were mainlyβ-lactam (50.07%),quinolones (35.70%) and macrolides (9.80%). CAP inpatients were mainly given two-drug therapy,of which cephalosporin combined with quinolone were most common,including 178 cases in total (53.61%). During treatment,17 patients suffered from ADR,with incidence of 5.03%. CONCLUSIONS:The detection rate from patients with CAP in our hospital is high in microbiological examination,but culture results should be analyzed dialectically according to clinical signs. Empirical an-ti-infective therapy mainly include β-lactams,quinolones and macrolides antibiotics alone or in combination with,basically meet the guideline for CAP Diagnosis and Therapy Guideline.
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OBJECTIVE:To investigate the role of clinical pharmacists in anti-infective treatment for the patient with septic shock. METHODS:Clinical pharmacists participated in anti-infective treatment for a patient with septic shock,assisted physicians to formulate individual regimen based on empirical anti-infective treatment,ESBLs producing Escherichia coli and anti-fungal treat-ment. Clinical pharmacists suggested using Itraconazole injection 200 mg,ivgtt,qd,for anti-fungal treatment;Itraconazole cap-sules 200 mg,po,bid,instead of fusidinic for anti-fungal treatment;meropenem 0.5 g,ivgtt,q6 h,for anti-infective treatment. RESULTS:Physicians adopted the suggestion of clinical pharmacists;the infection had been controlled after 16 d treatment and then the patient discharged from the hospital. CONCLUSIONS:Clinical pharmacists participate in clinical treatment,and assist phy-sicians to make a decision and formulate individual regimen,so as to promote rational drug use.
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Objective: To discuss the importance of pharmaceutical care in anti-infective treatment for one patient with severe pneumonia and renal insufficiency performed by clinical pharmacists. Methods: Clinical pharmacist participated in evaluating and changing the anti-infective treatment regimen, adjusted the drug dosage according to the renal function reasonably to avoid adverse drug reactions and completed the medication education and health education for the patient. Results:The infection was controlled effective-ly, gasp was controlled effectively and blood pressure was steady. Conclusion:Clinical pharmacists should monitor the whole treatment process,evaluate the drug regimen comprehensively and reduce adverse drug reaction to the maximum limit during the pharmaceutical care.