Anti-infective treatment for a severe case of Legionella pneumonia：pharmaceutical care and literature analysis
- VernacularTitle:1例军团菌重症肺炎抗感染治疗药学监护及文献分析
- Author:
Fang LI
1
;
Ning WANG
2
;
Dian JIN
1
;
Xiuying LONG
2
;
Shangxia ZENG
2
;
Jingxia WEI
1
Author Information
1. Dept. of Pharmacy，Chengdu Sixth People’s Hospital，Chengdu 610051，China
2. Dept. of Neurology，Chengdu Sixth People’s Hospital，Chengdu 610051，China
- Publication Type:Journal Article
- Keywords:
severe pneumonia;
Legionella;
pharmaceutical care;
adverse reactions;
clinical pharmacist;
WUH scoring system
- From:
China Pharmacy
2024;35(24):3081-3086
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide certain therapeutic ideas and references for the pharmaceutical care of severe Legionella pneumonia in anti-infection treatment. METHODS Clinical pharmacists participated in the entire treatment process of a patient with severe Legionella pneumonia， and assisted clinical physicians in evaluating the infecting pathogens using the WUH （Winthrop- University Hospital criteria） scoring system， based on the patient’s clinical symptoms， physical signs， and changes in pulmonary imaging. Leveraging their pharmaceutical expertise， clinical pharmacists recommended a combination of piperacillin sodium and tazobactam with moxifloxacin hydrochloride for anti-infection treatment， and closely monitored the patient’s clinical manifestations. They promptly identified delirium and abnormally elevated levels of lipase， amylase and liver enzymes， and successively suggested adjusting the treatment plan to a combination of piperacillin sodium and tazobactam with doxycycline or azithromycin for anti- infection after analyzing the causes， along with liver protection treatment， enteral nutrition， and parenteral nutrition. Additionally， clinical pharmacists closely monitor the patient’s medication adherence and provide her with medication education. RESULTS The clinical physicians accepted the recommendations of the clinical pharmacists， and the patient improved after treatment and was discharged. A follow-up examination one month later showed no recurrence. CONCLUSIONS Clinical pharmacists， when assisting clinicians in treating severe Legionella pneumonia， not only pay attention to changes in the patient’s clinical symptoms and physical signs， but also closely monitor the adverse reactions of fluoroquinolone， tetracycline， and macrolide antibiotics. They should promptly recognize adverse reactions and provide recommendations for adjusting treatment plans， as well as offer comprehensive pharmaceutical care throughout the patient’s treatment， to ensure the effectiveness and safety of clinical therapy.
