多黏菌素B局部给药治疗泛耐药鲍曼不动杆菌神经系统感染.PDF

多黏菌素 B 局部给药治疗泛耐药鲍曼不动杆菌神经系统感染  * 孙浩，陈闯，菅凌燕，肇丽梅 ( 中国医科大学附属盛京医院药学部，沈阳 110004) 摘要：目的 探讨泛耐药鲍曼不动杆菌神经系统感染的治疗策略。方法 结合临床药师亲身参与的 1 例泛耐药鲍曼不动 杆菌神经系统感染的治疗，介绍多黏菌素 B 在治疗中的合理应用。结果 临床药师推荐通过多黏菌素 B 局部给药方式， 加强局部组织药物浓度，提高泛耐药鲍曼不动杆菌治疗效果。同时，在多黏菌素 B 的应用剂量、途径、监护等多方面提 供了合理建议。患者感染最终得以控制，未出现肾毒性和神经毒性反应。结论 多黏菌素 B 的局部用药为泛耐药鲍曼不 动杆菌神经系统感染治疗提供了新思路。 关键词：多黏菌素 B；泛耐药；鲍曼不动杆菌；神经系统感染；临床药师 中图分类号：R969.3 文献标志码：B 文章编号：1007-7693(2017)05-0737-03 DOI: 10.13748/j.cnki.issn1007-7693.2017.05.024 引用本文：孙浩, 陈闯, 菅凌燕, 等. 多黏菌素 B 局部给药治疗泛耐药鲍曼不动杆菌神经系统感染[J]. 中国现代应用药学, 2017, 34(5): 737-739. Effect of Using Polymyxin B by Local Medication on Xdr-Acinetobacter Baumannii Infections of the Nervous System * SUN Hao, CHEN Chuang, JIAN Lingyan, ZHAO Limei (Pharmacy Department, Shengjing Hospital of China Medical University, Shenyang 110004, China) ABSTRACT: OBJECTIVE To discuss extensively drug resistant(XDR)-Acinetobacter baumannii infection treatment strategy of the nervous system. METHODS Combining with a case of XDR-Acinetobacter baumannii therapy of nervous system infection, to introduce reasonable application of polymyxin B. RESULTS According to the consensus, the clinical pharmacist recommended to use polymyxin B by local medication to strengthen the local tissue drug concentration and improve the effect of XDR-Acinetobacter baumannii treatment. At the same time, the clinical pharmacist provided the reasonable suggestions in many aspects, such as in the application of polymyxin B dosage, ways, monitoring and so on for clinician. In the end, the infection was under control without renal toxicity and nerve toxicity reaction. CONCLUSION Using polymyxin B by local medication provides a new way of thinking of XDR-Acinetobacter baumannii infections of th