1.Participation of Clinical Pharmacists in Pharmaceutical Care for a Child with Subglottic Talaromyces marneffei Infection
Yinqing CHEN ; Weizhe WU ; Yanling HE ; Fan HE ; Hanjing CEN
China Pharmacy 2020;31(12):1511-1515
OBJECTIVE:To investigate the role of clinical pharmacists on the individualized treatment of children with subglottic Talaromyces marneffei infection. METHODS :The clinical pharmacists participated in the medication procedure for a case of subglottic T. marneffei infection child . The clinical pharmacists suggested that Budesonide suspension for inhalation should be stopped,according to the subglottic infection pathogen type (T. marneffei );Itraconazole oral solution should be chosen and taken orally 2.5 mg/kg,q12 h,and indicators as liver function ,blood potassium should be monitored regularly. However ,as Itraconazole oral solution needed to be applied for temporary purchase ,Itraconazole capsules 2.5 mg/kg,q12 h,p.o.,was administrated temporarily ;clinical pharmacists suggested that Itraconazole capsules should be taken after meal ,and the doctor changed the feeding mode of milk from q 4 h to continuous pumping. After purchased ,Itraconazole oral solution was used instead 2.5 mg/kg,q12 h in fasting state ,and according the clinical pharmacist ’s suggestion ,the doctor changed the nursing method to q 4 h milk pumping. After purchasing and using oral solution instead ,clinical pharmacists suggested taking it at fasting state ;according to the monitoring results and target range (0.5-1 mg/L),oral dose of Itraconazole oral solution was finally adjusted to 8.3 mg/kg, q12 h. In view of the diarrhea during the treatment ,clinical pharmacists suggested to continue the original treatment after considering the effectiveness and importance of the treatment ;at the same time ,discharge medication education should be carried out. RESULTS : The doctors adopted the suggestions of the clinical pharmacists. The child got a clinical improvement and was discharged after 48 days. CONCLUSIONS :Clinical pharmacists participate in the treatment of children with T. marneffei infection,timely assist physicians to adjust and improve the medication regimen ,which improve the efficacy and safety of medication for children.