Pharmaceutical Practice for Treatment of Children with Pseudomonas Aeruginosa Sepsis after Bone Marrow Transplantation by Clinical Pharmacists

Yu Liting; Jiang Yuelian; Li Lan; Zhang Shunguo

doi:10.13407/j.cnki.jpp.1672-108X.2022.05.004

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Pharmaceutical Practice for Treatment of Children with Pseudomonas Aeruginosa Sepsis after Bone Marrow Transplantation by Clinical Pharmacists

更新时间：2022-06-10

- Pharmaceutical Practice for Treatment of Children with Pseudomonas Aeruginosa Sepsis after Bone Marrow Transplantation by Clinical Pharmacists
- Vol. 28, Issue 5, Pages: 14-17(2022)
- 作者机构：
  
  上海交通大学医学院附属上海儿童医学中心,上海,200127
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2022.05.004
  CLC：
- Published：2022，
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Yu Liting, Jiang Yuelian, Li Lan, et al. Pharmaceutical Practice for Treatment of Children with Pseudomonas Aeruginosa Sepsis after Bone Marrow Transplantation by Clinical Pharmacists. [J]. 28(5):14-17(2022)
DOI：

Yu Liting, Jiang Yuelian, Li Lan, et al. Pharmaceutical Practice for Treatment of Children with Pseudomonas Aeruginosa Sepsis after Bone Marrow Transplantation by Clinical Pharmacists. [J]. 28(5):14-17(2022) DOI： 10.13407/j.cnki.jpp.1672-108X.2022.05.004.

摘要

目的：为临床药师参与重度再生障碍性贫血患儿骨髓移植术后铜绿假单胞菌感染治疗提供参考。方法：临床药师参与1例重度再障患儿骨髓移植术后出现铜绿假单胞菌败血症的治疗实践，其先后使用了美罗培南、去甲万古霉素、万古霉素、阿米卡星等抗菌药物，氟康唑、伏立康唑、米卡芬净等抗真菌药物，复方磺胺甲噁唑预防卡氏肺孢子虫，症状未见明显好转，其后患儿血培养为碳青霉烯类耐药铜绿假单胞菌，临床药师参加会诊后将抗感染治疗方案调整为：头孢他啶/阿维巴坦、环丙沙星和米卡芬净。结果：治疗方案调整5 d后患者体温恢复正常，感染指标明显好转。结论：临床药师参与可为骨髓移植后患儿败血症的治疗提供更具有针对性的治疗方案。

Abstract

: Objective: To provide reference for clinical pharmacists to participate into the treatment of Pseudomonas aeruginosa infection in children with severe aplastic anemia after bone marrow transplantation. Methods: Clinical pharmacists participated into the treatment of P. aeruginosa sepsis in a child with severe aplastic anemia after bone marrow transplantation

and the initial treatment including antibacterial drugs such as meropenem

norvancomycin

vancomycin and amikacin

anti-fungal drugs such as fluconazole

voriconazole and micafennet

and compound sulfamethoxazole was used to prevent Pneumocystis carinii

yet the symptoms were not significantly improved. The blood culture of the child was carbapenem-resistant P. aeruginosa. After consultation

the clinical pharmacists adjusted the anti-infection treatment regimen to ceftazidime/avibatam

ciprofloxacin and micafenstine. Results: The body temperature returned to the normal state after 5 d of adjustment of the treatment regimen

and the infection indicators were improved significantly. Conclusion: The participation of clinical pharmacists can provide more targeted treatment for sepsis in children after bone marrow transplantation.

关键词

临床药师再生障碍性贫血骨髓移植术铜绿假单胞菌

Keywords

clinical pharmacistsaplastic anemiabone marrow transplantationPseudomonas aeruginosa

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