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Medical Diagnosis 2025
1例艾滋病合并播散性隐球菌病患者的药学监护
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Abstract:
目的：探讨临床药师在艾滋病合并播散性隐球菌病患者中的药学服务方法。方法：临床药师参与1例艾滋病合并播散性隐球菌病患者的药物治疗全过程，对抗真菌治疗、ART启动时机及方案、合并感染的抗菌药物选择及药物不良反应的处理及上报等方面进行了全程的药学监护。结果：患者顺利完成了抗真菌诱导期的治疗，病原学结果转阴，启动了ART，好转出院。结论：临床药师应积极参与到临床药物治疗中，开展药学服务，保障用药安全。
Objective: To explore the pharmaceutical method of clinical paharmacists in patients with AIDS complicated with disseminated cryptococcus. Methods: Clinical paharmacists participated in the whole process of drug therapy for a case of AIDS patients with disseminated cryptococcus, and conducted pharmaceutical care in the whole process of antifungal therapy, the timing and program of ART initiation, the selection of antibacterial drugs for co-infection, the treatment and reporting of adverse drug reactions, etc. Results: The patient successfully completed the antifungal induction phase of treatment, the etiological results turned negative, ART was activated, and the patient was discharged with improvement. Conclusion: Clinical pharmacist should actively participate in clinical drug treatment, carry out pharmaceutical care, and ensure drug safety.
| [1] | “十三五”国家科技重大专项艾滋病机会性感染课题组. 艾滋病合并隐球菌病临床诊疗的专家共识[J]. 西南大学学报(自然科学版), 2020, 42(7): 1-19. |
| [2] | Yao, Z., Lu, X., Shen, C. and Lin, D. (2014) Comparison of Flucytosine and Fluconazole Combined with Amphotericin B for the Treatment of HIV-Associated Cryptococcal Meningitis: A Systematic Review and Meta-Analysis. European Journal of Clinical Microbiology & Infectious Diseases, 33, 1339-1344. https://doi.org/10.1007/s10096-014-2074-2 |
| [3] | 汪复, 张婴元. 实用抗感染治疗学[M]. 第2版. 北京: 人民卫生出版社, 2015: 667. |
| [4] | 王学莉, 伏添, 王成立, 等. 两性霉素B治疗侵袭性肺部真菌感染的临床分析[J]. 中国真菌学杂志, 2014, 9(3): 163-166. |
| [5] | 鲁雁秋, 邱丹, 陈耀凯. 艾滋病合并新型隐球菌性脑膜炎患者的综合治疗[J]. 中华临床感染病杂志, 2018, 11(2): 156-160. |
| [6] | Decloedt, E.H., Rosenkranz, B., Maartens, G. and Joska, J. (2015) Central Nervous System Penetration of Antiretroviral Drugs: Pharmacokinetic, Pharmacodynamic and Pharmacogenomic Considerations. Clinical Pharmacokinetics, 54, 581-598. https://doi.org/10.1007/s40262-015-0257-3 |
| [7] | 中国疾病预防控制中心性病艾滋病预防控制中心. 国家免费艾滋病抗病毒药物治疗手册[M]. 第4版. 北京: 人民卫生出版社, 2016: 45. |
| [8] | 张磊, 曹明雪, 张彩平, 等. 1例艾滋病合并新型隐球菌性脑膜炎患者抗真菌治疗的药学监护[J]. 解放军医学院学报, 2018, 39(9): 832-833. |
| [9] | Xu, L., Tao, R., Wu, J., Dai, X., Hu, C., Huang, Y., et al. (2019) Short-Course Rather than Low-Dose Amphotericin B May Exert Potential Influence on Mortality in Cryptococcal Meningitis Patients Treated with Amphotericin B Plus Flucytosine Alone or in Combination with Fluconazole. Frontiers in Microbiology, 10, Article 2082. https://doi.org/10.3389/fmicb.2019.02082 |
