临床药师参与治疗人工髋关节置换术后迟发性感染1例
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摘要
为探索临床药师在人工髋关节置换术后迟发性感染患者的抗感染治疗中的价值,临床药师通过日常查房,对1例人工髋关节置换术3年后发生人工关节周围感染的患者进行监护,结合相关文献报道,从外科干预、药物选择和剂量调整方面向医师提出用药建议,参与制定患者药物治疗方案。医师采纳临床药师的部分建议,通过治疗,患者的症状、影像学检查好转,为患者后续治疗提供保障。临床药师参与临床用药方案的制定,对于提高临床抗感染合理用药具有重要意义。
In order to explore the value of clinical pharmacist in the anti-infective treatment of the patients with late-onset infection after artificial hip joints replacement,clinical pharmacists performed ward round and pharmaceutical care for one patient with infection around the artificial joints after artificial hip joints replacement three years ago. According to the relevant literatures,clinical pharmacist provided medical advice for physician from the following aspects: surgical interventions,drug choice and dosage adjustment,and participated in the medicine therapeutic scheme for the patient. Physicians partly accepted the suggestions of clinical pharmacists,and the symptoms and imaging examination results of the patient improved after the treatment,which provided guarantee for the followup treatment. It is of great significance for clinical pharmacists to participate in the formulation of clinical medication plan to improve the rational drug use in clinical anti-infection treatment.
In order to explore the value of clinical pharmacist in the anti-infective treatment of the patients with late-onset infection after artificial hip joints replacement,clinical pharmacists performed ward round and pharmaceutical care for one patient with infection around the artificial joints after artificial hip joints replacement three years ago. According to the relevant literatures,clinical pharmacist provided medical advice for physician from the following aspects: surgical interventions,drug choice and dosage adjustment,and participated in the medicine therapeutic scheme for the patient. Physicians partly accepted the suggestions of clinical pharmacists,and the symptoms and imaging examination results of the patient improved after the treatment,which provided guarantee for the followup treatment. It is of great significance for clinical pharmacists to participate in the formulation of clinical medication plan to improve the rational drug use in clinical anti-infection treatment.
引文
1 Jose L,Del P,Robin P.Infection associated with prosthetic joints[J].N Engl J Med,2009,361:787-794
2 陈涛,尚希福,贺瑞,等.关节假体周围感染研究进展[J].国际骨科学杂志,2010,31(4):224-226
3 Osmon DR,Berbari EF,Berendt AR,et al.Diagnosis and management of prosthetic joint Infection:clinical practice guidelines by the Infectious Diseases Society of America[J].Clin Infect Dis,2013,56(1):e1-e25
4 Dale WB,Dellinger EP,Keith MO,et al.Clinical practice guidelines for antimicrobial prophylaxis in surgery[J].Am J Health-Syst Pharm,2013,70:195-283
5 Werner Z,Andreas FW.Role of rifampin for treatment of orthopedic implant-related staphylococcal infections[J].JAMA,1998,279:1587-1541
6 John S,Jeffrey AN.Prolonged suppressive antibiotic therapy for infected orth-opedic prostheses[J].Clin Infect Dis,1998,27:711-713
7 Jeremy G,Terence JG.Can this prosthesis be saved?implant salvage attempts in infected primary TKA[J].Clin Orthop Relat Res,2011,469:970-976
8 Sendi P,Zimmerli W.Antimicrobial treatment concepts for orthopaedic device-related infection[J].Clin Microbiol Infect,2012,18:1176-1184
2 陈涛,尚希福,贺瑞,等.关节假体周围感染研究进展[J].国际骨科学杂志,2010,31(4):224-226
3 Osmon DR,Berbari EF,Berendt AR,et al.Diagnosis and management of prosthetic joint Infection:clinical practice guidelines by the Infectious Diseases Society of America[J].Clin Infect Dis,2013,56(1):e1-e25
4 Dale WB,Dellinger EP,Keith MO,et al.Clinical practice guidelines for antimicrobial prophylaxis in surgery[J].Am J Health-Syst Pharm,2013,70:195-283
5 Werner Z,Andreas FW.Role of rifampin for treatment of orthopedic implant-related staphylococcal infections[J].JAMA,1998,279:1587-1541
6 John S,Jeffrey AN.Prolonged suppressive antibiotic therapy for infected orth-opedic prostheses[J].Clin Infect Dis,1998,27:711-713
7 Jeremy G,Terence JG.Can this prosthesis be saved?implant salvage attempts in infected primary TKA[J].Clin Orthop Relat Res,2011,469:970-976
8 Sendi P,Zimmerli W.Antimicrobial treatment concepts for orthopaedic device-related infection[J].Clin Microbiol Infect,2012,18:1176-1184