OBJECTIVE: To investigate the methods and breakthrough point of clinical pharmacist participating in the consultation for Acinetobacter baumannii infection cases, in order to improve the level of clinical rational drug use. METHODS: The consultation records of 39 A. baumannii infection cases in neurology department of our hospital during 2013-2014 were analyzed retrospectively. The patients’ general condition, site of infection, bacterial culture and drug sensitivity test were analyzed statistically as well as drug regimen before and after consultation, disease condition, lab indexes and nutritional status. RESULTS: A. baumannii were found in sputum culture of all patients, among which there were 11 cases of multiple resistant bacteria (28.2%), 13 cases of pan resistant bacteria (33.3%), 8 cases of drug resistant A. baumannii (20.5%) and 7 cases of non-multiple resistant bacteria (17.9%). The most widely used drug was minocycline (average dose of 0.2 g/d), followed by cefoperazone-sulbactam (average dose of 9 g/d), ceftazidime (average dose of 6 g/d), etimicin (average dose of 0.27 g/d), amikacin (average dose of 0.4 g/d). The antibacterial daily doses were higher than before. 3 patients were recommended to use fosfomycin. Before consultation, 2 patients didn’t received antibiotics (5.1%), and there were 13 cases of single drug (33.4%), 22 cases of two-drug combination (56.4%) and 2 cases of three-drug combination (5.1%). After consultation, none of patients didn’t received antibiotics (0), and there were 7 cases of single drug (17.9%), 26 cases of two-drug combination (66.7%) and 6 cases of three-drug combination (15.4%). After the consultation, body temperature, symptom and infection indexes of patients got better. Clinical pharmacists adjusted nutrition program of 12 patients (30.8%) and expecterant program of 9 patients (23.1%). Compared with before consultation, oubumin level of 11 patients (28.2%) and prealbumin level of 20 patients (51.3%) were all increased. CONCLUSIONS: Clinical pharmacist should formulate reasonable therapeutic regimen and reduce irrational drug use according to infection and physical condition. They should provide anti-infective regimen, at the same time, pay attention to the adjustment of expectorant regimen and nutrition support program.
关键词
临床药师会诊鲍曼不动杆菌合理用药
Keywords
Clinical pharmacistConsultationAcinetobacter baumanniiRational drug use