1.Pharmaceutical Care for a Patient with AECOPD Complicated with Allergic Bronchopulmonary Aspergil-losis
Jing YU ; Xiajin ZHOU ; Jizhang YANG
China Pharmacy 2017;28(20):2865-2867
OBJECTIVE:To explore the role of clinical pharmacists in the therapy for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with allergic bronchopulmonary aspergillosis (ABPA). METHODS:Clinical pharmacists participated in the therapy for a AECOPD patient with ABPA. According to patient's con-dition,clinical pharmacists suggested adjusting the inhalation order of salbutamol and budesonide aerosol inhalation;stop-ping cefatriaxone and adjusting to intravenous injection of voriconazole;and then adjusting voriconazole to oral dosage form timely,monitoring therapy duration. Clinical pharmacists paid close attention to therapeutic efficacy and ADR,and provided medication education for patients. RESULTS:Physicians adopted the suggestion of clinical pharmacists to adjust inhalation order of aerosols,the dosage and route of administration of voriconazole. The patient's condition was improved obviously,and the drug therapy was continued after discharge. CONCLUSIONS:Clinical pharmacists participating in the whole process of treatment improves therapeutic efficacy,reduces the occurrence of ADR and promotes rational drug use in clinic.
2.Report of a case of Leuconostoc lactis bacteremia following intestinal perforation with literature review
Liman HUO ; Zhangying FENG ; Juan ZHANG ; Huixian JIA ; Xiajin ZHOU ; Bin SHAN ; Juan HOU ; Wenli DU ; Ping LIANG
Chinese Journal of General Practitioners 2021;20(11):1176-1179
A 24-year female with abdominal pain and fever for 4 days was admitted. The blood culture showed Leuconostoc growth, and sputum culture showed positive Acinetobacterbaumannii. The diagnosis Leuconostoclactis bacteremia following small intestinal perforation was confirmed; surgical treatment was performed and the infection was controlled by piperacillin sodium and tazobactam combined with tegacycline. Wanfang database, CNKI, PubMed and Embase database up to September 2020 were searched with the keywords of " Leuconostoc lactis" "infection" "bacteraemia" for relevant literature. A total of 32 cases were reported in the literature, of whom 13 (39.4%) were infants, 17 (51.5%) had catheter-related bloodstream infection, and one healthy adult male had bacteremia through gastrointestinal perforation. In 20 patients treated with penicillins-based antibiotics, 18 were cured with an effective rate of 90.0%. The results suggest that Leuconostoc infection is likely to occur in the infants, but adults can still get community-acquired Leuconostoc infection. Most β-lactams are susceptible to Leuconostoc, but some exhibit resistance, so it is recommended to select antimicrobial agents based on drug susceptibility.