Anti-infective treatment and pharmaceutical care for a patient with hematologic tumor complicated with Klebsiella pneumonia infection
10.12173/j.issn.1005-0698.202408067
- VernacularTitle:1例血液肿瘤患者并发碳青霉烯类耐药肺炎克雷伯菌感染的治疗与药学监护
- Author:
Baiqian XING
1
;
Zhen LI
;
Nianfang LU
;
Zhongdong LI
Author Information
1. 首都医科大学电力教学医院(国家电网公司北京电力医院)药剂科(北京 100073)
- Publication Type:Journal Article
- Keywords:
Carbapenem-resistant Klebsiella pneumonia;
Hematologic tumor;
Colistin sulfate;
Omacycline;
Anti-infection treatment;
Pharmaceutical care
- From:
Chinese Journal of Pharmacoepidemiology
2024;33(12):1436-1444
- CountryChina
- Language:Chinese
-
Abstract:
This paper presents the treatment process of carbapenem-resistant Klebsiella pneumoniae in an elderly patient with acute myeloid leukemia.Based on the pathophysiological characteristics of infection in the patients,and in conjunction with the relevant guidelines,a collaborative study was conducted by clinical pharmacists and physicians to develop a treatment plan.Based on the microbiological culture results,next-generation sequencing(NGS)results of the metagenome,and imaging examination results,the treatment regimen included colistin-based combination therapy,sequentially combined with meropenem,meropenem+teicoplanin,omacycline for anti-infection management.In case of recurrent episodes,teicoplanin in combination with carpofungine was administered instead.Additionally,clinical pharmacists provided pharmaceutical care encompassing adverse reaction monitoring and colistin sulfate serum concentration monitoring.Eventually the patient's infection was effectively controlled,body temperature returned to normal,white blood cell counts and platelet counts remained within the normal range,serum high-sensitive C-reactive protein,procalcitonin,and other inflammatory indicators significantly decreased.No adverse reactions were observed during treatment.Clinical pharmacists assist clinicians in formulating advanced and rational anti-infective protocols and carry out pharmacological monitoring to ensure the effectiveness and safety of clinical drug therapy.
