Pharmacy practice of clinical pharmacists involved in the treatment of a case of bullous pemphigoid and pulmonary aspergillosis combined with disseminated Nocardia farcinica infection
- VernacularTitle:临床药师参与1例大疱性类天疱疮、肺曲霉病合并播散性皮疽诺卡菌感染治疗的药学实践
- Author:
Tiying DENG
1
;
Min LIN
2
;
Zhimin HU
3
;
Liang ZOU
4
;
Zhihong WU
4
;
Jianmin LIU
1
;
Lei HUANG
1
Author Information
1. Dept. of Pharmacy，Wuhan No. 1 Hospital，Wuhan 430022，China
2. College of Artificial Intelligence （School of Computer Technology and Software Engineering），Wuhan Polytechnic University，Wuhan 430074，China
3. Microbiology Laboratory，Wuhan No. 1 Hospital，Wuhan 430022，China
4. Dept. of Rheumatology and Immunology，Wuhan No.1 Hospital，Wuhan 430022，China
- Publication Type:Journal Article
- Keywords:
Nocardia farcinica infection;
bullous pemphi-
- From:
China Pharmacy
2024;35(16):2038-2043
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for the adjustment of antibacterial drug regimens， identification of adverse reactions， and personalized pharmaceutical care for patients with bullous pemphigoid and pulmonary aspergillosis combined with disseminated Nocardia farcinica infection. METHODS Clinical pharmacists participated in the entire treatment process of a patient with bullous pemphigoid and pulmonary aspergillosis combined with disseminated N. farcinica infection. Evidence-based medicine was used to assist in the selection of an initial combined drug regimen against nocardiosis， and timely communication with the microbiology laboratory to provide early antimicrobial susceptibility data. When the patient exhibited epilepsy， the suspected drugs were identified， and it was reminded that imipenem-cilastatin sodium could affect the efficacy of valproic acid. It was suggested to replace valproic acid with levetiracetam for anti-epileptic treatment and to discontinue imipenem-cilastatin sodium. During treatment， it was recommended to monitor the blood concentrations of voriconazole and linezolid， and assist in adjusting the dosage promptly based on the monitoring results. RESULTS The physicians accepted the recommendations of the clinical pharmacists. The patient’s condition improved， and they were discharged with medication. CONCLUSIONS Based on evidence-based medical evidence， antimicrobial susceptibility test results， and blood concentration monitoring data， clinical pharmacists assist clinicians in selecting a sensitive anti-infective regimen for the patient， identifying adverse reactions， adjusting the treatment regimen and providing full-course medication monitoring to ensure the safety and efficacy of clinical drug therapy.
