WANG Min,LIN Ye,ZHAO Jie,et al.Whole-process individualized pharmaceutical care for a case of melioidosis sepsis[J].ZHONGGUO YAOFANG,2024,35(01):101-106.
WANG Min,LIN Ye,ZHAO Jie,et al.Whole-process individualized pharmaceutical care for a case of melioidosis sepsis[J].ZHONGGUO YAOFANG,2024,35(01):101-106. DOI: 10.6039/j.issn.1001-0408.2024.01.18.
Whole-process individualized pharmaceutical care for a case of melioidosis sepsis
To provide reference for the adjustment of antibiotic treatment regimens, identification of adverse reactions, and individualized pharmaceutical care for melioidosis sepsis (MS).
METHODS
2
Clinical pharmacists participated in the intensive and eradicating therapeutic processes for an MS patient by using blood concentration and gene detection. Based on the literature, antibiotic treatment regimens of MS were adjusted by determining the blood concentrations of
β
-lactam and trimethoprim/sulfamethoxazole (TMP/SMZ) and calculating PK/PD parameters. The causes of adverse drug reactions were analyzed and addressed by detecting drug-related gene polymorphisms through high-throughput sequencing.
RESULTS
2
Clinical pharmacists used blood concentration and genetic testing methods to propose adjustments to imipenem-cilastatin sodium dosage and analyze the causes of various adverse drug reactions. PK/PD targets were calculated by measuring the blood concentrations of
β-
lactam and TMP/SMZ. Clinical pharmacists explained to clinical doctors the compliance status of patients with melioidosis in sepsis and non-sepsis stages through reviewing guidelines and literature; the results of blood concentration and genetic test were used to analyze the correlation of neurotoxicity of MS patients with IMP
c
min
, and it was found that nephrotoxicity was not related to the
c
max
of TMP/SMZ, but to the patient’s water intake. After whole-process antibiotic treatment, the patient’s condition improved and was discharged, and the adverse reactions were effectively treated.
CONCLUSIONS
2
Clinical pharmacists use blood concentration and genetic tests to assist clinicians in formulating MS treatment regimens, and provide whole-course pharmaceutical care for a MS patient. This method has improved the safety and effectiveness of clinical drug therapy.
关键词
类鼻疽脓毒症β-内酰胺类抗菌药物复方磺胺甲噁唑血药浓度基因检测药学监护
Keywords
β-lactam antibiotictrimethoprim/sulfamethoxazoleblood concentrationgenetic testpharmaceutical care
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