临床药师参抗感染治疗药学监护切入点.pdfVIP

临床药师参与抗感染治疗的药学监护切入点 1 2 1 1 余爱荣 范星 周帆 辛华雯 广州军区武汉总医院 临床药理科 肾内科 武汉 （ 1. 2. 430070 ） [通讯作者]余爱荣， Tel: 027，E-mail: yarfwy@163.com 摘要 目的：探讨临床药师参与抗感染治疗的药学监护切入点。方法：以临床药师对感染患者的 药学监护为例，分析抗感染治疗中的药学监护切入点。结果：临床药师可结合临床具体情况， 以判断是否有使用抗菌药的指征、协助制定抗感染治疗方案（包括抗菌药物品种、剂量与溶媒 的选择、PK/PD 参数的优化、输液速度）、重视病原学检查、关注药物相互作用、药物不良反应 与疗效的监测、加强患者用药教育等为切入点开展药学监护。结论：临床药师参与抗感染治疗， 制订个体化的用药监护，可保证患者用药安全、有效。 关键词 临床药师；抗感染治疗；药学监护；切入点 Approaches for Clinical Pharmacists to Develop Pharmaceutical Care in the Anti-infection Treatment 1 2 1 1 Yu Airong , Fan Xing , Zhou Fan , Xin Huawen (1.Department of Clinical Pharmacology, 2.Department of Nephrology, Wuhan General Hospital of Guangzhou Command, China) ABSTRACT Objective: To explore how to carry out pharmaceutical care in anti-infection treatment. Method: The pharmaceutical care points were discussed combined with some anti-infection cases. Result: Clinical pharmacists carried out pharmaceutical care in such aspects as judge whether the use of antibacterial drugs indications, supplying advices on drug therapeutic regimens (including antibiotics, dosage, solvent selection, the optimization of the PK/PD parameters, and the infusion speed ), pay attention to bacterial culture, concerning about drug interactions, drug adverse reaction and effect monitoring, providing patient medication education. Conclusion: Clinical pharmacists participate in anti-infection treatment and carry out individual pharmaceutical care can ensure the safety and effectivity of treatment. KEYWORDS Clinical pharmacist; Anti-infection treatment; Pharmaceutical care; Approach 如何规范化治疗感染性疾病是目前临床用药的重点与难点问题，涉及到多方面的内容：是 否需要进行抗感染治疗？是细菌、真菌还是其他病原体感染？用哪一类抗感染药物？药物能否 达到感染部位？是否会引起二重感染或出现耐药菌？因此，抗感染治疗被称为“临床上最困难 [1] 的用药决