重症肺囊虫性肺炎的药物治疗方案调整

目的：探讨重症肺囊虫性肺炎（pneumocystis carinii pneumonia,PCP）的抗感染治疗方案。方法：通过参与免疫功能抑制病人重症PCP的药物治疗全过程,监测疗效及药品不良反应（ADRs）,调整治疗方案。结果：免疫功能抑制合并肺部感染病人在初始抗感染治疗时需注意覆盖PCP。当病人无法耐受高剂量复方磺胺甲唑（SMZ-TMP）或SMZ-TMP初始治疗无效时,临床药师建议可联合卡泊芬净治疗重症PCP。结论：SMZ-TMP与卡泊芬净联合治疗重症PCP,起效快,临床疗效更好,且可减少相关ADRs的发生。...

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Bibliographic Details
Published in药学服务与研究 Vol. 18; no. 1; pp. 63 - 66
Main Author 童伟;吴静;黄兴富;陈虹;方洁
Format Journal Article
LanguageChinese
Published 江西省肿瘤医院药剂科,南昌,330029%浙江省杭州市妇产科医院药剂科,杭州,310008%云南省曲靖市第一人民医院药剂科,云南曲靖,655000%上海交通大学医学院附属瑞金医院呼吸科,上海,200025%上海交通大学医学院附属瑞金医院药剂科,上海,200025 2018
Subjects
临床药师
免疫缺陷
肺炎,肺囊虫
药物治疗方案
药物治疗方案
临床药师
肺炎,肺囊虫
pneumonia
免疫缺陷
clinical pharmacists
drug treatment regimens
immunodeficiency
pneumocytis carinii
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ISSN1671-2838
DOI10.5428/pcar20180116

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Summary:目的：探讨重症肺囊虫性肺炎（pneumocystis carinii pneumonia,PCP）的抗感染治疗方案。方法：通过参与免疫功能抑制病人重症PCP的药物治疗全过程,监测疗效及药品不良反应（ADRs）,调整治疗方案。结果：免疫功能抑制合并肺部感染病人在初始抗感染治疗时需注意覆盖PCP。当病人无法耐受高剂量复方磺胺甲唑（SMZ-TMP）或SMZ-TMP初始治疗无效时,临床药师建议可联合卡泊芬净治疗重症PCP。结论：SMZ-TMP与卡泊芬净联合治疗重症PCP,起效快,临床疗效更好,且可减少相关ADRs的发生。
Bibliography:31-1877/R
Objective：To investigate the drug treatment regimens for critical patients with pneumocytis carinii pneumonia（PCP）.Methods：Through direct involvement of clinical pharmacists in the whole drug treatment of 2 immonosuppressed patients,the drug treatment regimens for critical patients with PCP were adjusted,and therapeutic drug efficacy was evaluated and adverse drug reactions were closely monitored in the process.Results：The initial anti-infection treatment of immonosuppressed patients with pulmonary infection should cover PCP.When patients were unable to tolerate high doses of sulfamethodxazole-trimethoprim（SMZ-TMP）or initial treatment with SMZ-TMP was invalid,the combination of SMZ-TMP with caspofungin could be recommended to treat critical PCP.Conclusion：Combination of SMZ-TMP with caspofungin for the treatment of severe PCP had the advantages of faster response,better clinical efficacy,and more importantly,lower incidence of adverse drug reactions.
pneumonia;pneumocytis carinii;drug treatment regime
ISSN:1671-2838
DOI:10.5428/pcar20180116