Pharmaceutical care of complicated drug treatment for one patient with severe infection caused by rhizopus spp after kidney transplantation / 中国药学杂志

ABSTRACT

OBJECTIVE: To introduce the pharmaceutical care for one patient with severe infection caused by Rhizopus spp after kidney transplantation which achieved a better therapeutic effect. METHODS: According to the activity of zygomycetous, clinical pharmacists recommended the patient using posaconazole to treat Rhizopus spp infection which has less kidney injury. Clinical pharmacists optimized the treatment schemes with considering the pathophysiological conditions of the patient, the pharmacokinetic characteristics of the drug and metabolic drug interactions. RESULTS: The Rhizopus spp infection was controlled using posaconazole oral suspension 200mg qid mixed with enteral nutrition. According to adjust the amount of tacrolimus by the plasma concentration and CYP3A5 genotype test result, the tacrolimus concentration was most time maintained 4.8-6.7 μg·L-1 during the treatment, which ensure the safety of the transplanted kidney. The diarrhea was reduced by adjusting the methods of taking posaconazole, reducing the dose of mycophenolate and adding microecologics. CONCLUSIONS: Drug treatment is generally complex for the patient with severe infection after renal transplantation. So, clinical pharmacists can carry out pharmaceutical care for such special patients for safety and effectiveness, through therapeutic drug monitoring and knowledge of pharmacokinetics to promote such patients to get the optimal drug treatment.