Pharmaceutical care of Pneumocystis jirovecii pneumonia secondary to a case of dermatomyositis with previous sulfonamide allergy
10.12173/j.issn.1005-0698.202311029
- VernacularTitle:对1例既往磺胺过敏的皮肌炎患者继发耶氏肺孢子菌肺炎的药学监护
- Author:
Fangqing XIE
1
,
2
;
Yuan MA
;
Yang SHU
;
Shibo LIN
;
Wei CHEN
;
Jie FANG
Author Information
1. 上海交通大学医学院附属瑞金医院药剂科(上海 200025)
2. 成都市第二人民医院临床药学科(成都 610021)
- Keywords:
Pneumocytis jirovecii pneumonia;
Cytomegalovirus infection;
Sulfonamides;
Sulfonamides desensitization test;
Pharmaceutical care
- From:
Chinese Journal of Pharmacoepidemiology
2024;33(5):578-584
- CountryChina
- Language:Chinese
-
Abstract:
A patient with a history of sulfonamide allergy and dermatomyositis was admitted to the hospital due to secondary infection.After admission,a comprehensive examination confirmed the presence of Pneumocystis jirovecii pneumonia(PJP)along with cytomegalovirus(CMV)and Klebsiella pneumoniae infections.Clinical pharmacists actively participated in the treatment process by referring to relevant clinical guidelines.For patients with Pneumocystis jirovecii infection,compound sulfamethoxazole(TMP-SMX)should be considered as the primary choice,while desensitization treatment is recommended for those with a history of sulfonamide allergy.Prior to treatment,the patient had pre-existing liver insufficiency and was on long-term glucocorticoid therapy,with complex medications.The clinical pharmacists provided individualized pharmaceutical care for this case,assisting clinicians in formulating scientifically and reasonably tailored drug treatment plans.They also offered new insights and references for selecting appropriate drugs considering the patient's previous sulfonamide allergies.After sulfonamide desensitization,the patients were administered a combination of TMP-SMX and carpofungin for anti-PJP treatment,along with ganciclovir for anti-CMV treatment,resulting in favorable therapeutic outcomes.
