000000e_胡丽丽-医院药学.docVIP

头孢曲松与其他药物联合用药实例分析 胡丽丽(徐州医学院附属医院药剂科,江苏 徐州 221002) 摘要：目的 通过实例分析头孢曲松联合其他常用药物用于临床感染预防和治疗的合理性，为临床合理用药提供参考。方法 收集头孢曲松分别与地塞米松，大环内酯类抗生素，氨曲南及加替沙星等联合用药病例共6例，分别评价其联合用药的疗效，分析不合理用药问题及导致耐药的原因。结果 阐释头孢曲松与其他药物联合用于预防及治疗感染的不合理性，阐明头孢曲松与地塞米松可联合治疗严重感染等、头孢曲松与大环内酯类联合可用于社区获得性肺炎(CAP)的治疗，提出临床合理用药建议。结论 头孢曲松与地塞米松及大环内脂类药物联用有其适应症；头孢曲松与多种药物联合运用存在不合理，应引起临床重视。 关键词：头孢曲松；联合用药；适应症；耐药性 Ceftriaxone and Other Medicine Union Application Example Analysis HU Li-Li（Department of Pharmacy; Affiliated Hospital of Xuzhou Medical College,Xuzhou , Jiangsu 221002, China ) ABSTRACT: OBJECTIVE To analyse the rationality of Ceftriaxone combinating with other antibiotic or medicines on the clinicalcare, give references for the reasonable medicine use. METHODS Collected 6 cases about Ceftriaxone and Dexamethasone, Ceftriaxone and Macrolide, Ceftriaxone and Aztreonam, Ceftriaxone and Gatifloxacin, evaluate the effectiveness of the conbinations, analyse the irrationality and the reasons of drug tolerance. RESULTS Summarize the rationality of Ceftriaxone combinating with other antibiotic or medicines on the clinicalcare, illustrate the reasonable of Ceftriaxone and Dexamethasone on severe sepsis, Ceftriaxone and Macrolide on community acquired pneumonia(CAP). Make suggests for rational administration. CONCLUSION There are indications for the medicine use: Ceftriaxone and Dexamethasone, Ceftriaxone and Macrolide. It is important to pay attention to the irrationalize of Ceftriaxone combinating with other antibiotic or medicines on the clinicalcare. 作者简介：胡丽丽 药师 硕士 研究方向：临床药学Tel:(0516 E-mail: elieven1982@163.com KEY WORDS: Ceftriaxone; drug combination; Indication; drugtolerance 医院存在较多头孢菌素类塞米松联用地塞米松联用地塞米松联地塞米松糖皮质激素类具抗炎、抗内毒素、抑制免疫、抗休克及增强应激反应等药理作用，故广泛应用于各科治疗多种疾病，如自身免疫性，过敏，炎症，哮喘疾病对大多数革兰阳性菌和阴性菌都有强大抗菌活性头孢曲松钠为β-内酰胺类抗菌药，地塞米松是以醇为溶媒的药物乙醇能加速β-内酰胺环水解，使头孢曲松钠降低药效。本药的配伍禁忌多，不宜与其它药物配伍在每次运用的时候都要做，患者即发性过敏可避免糖皮质激素与掩盖的过敏反应迟发过敏反应产生不能及时发现，导致更严重的不良反应但严重感染Konstantinos等人报道了加用地塞米松地塞米松0465071，男，67岁，患腰椎间盘突出症，脑梗塞后遗症，高血压病Ⅲ级（高危），体温正