Pharmaceutical care and literature analysis of patients with decompensated cirrhosis complicated with Clostridioides difficile splenic abscess
- VernacularTitle:肝硬化失代偿期合并艰难梭菌脾脓肿患者的药学监护及文献分析
- Author:
Qiufang WEI
1
;
Xinbo PAN
1
;
Miaomiao MIAO
1
Author Information
1. Dept. of Pharmacy，The No.2 People’s Hospital of Lanzhou，Lanzhou 730046，China
- Publication Type:Journal Article
- Keywords:
splenic abscess;
liver cirrhosis;
decompensation;
Clostridioides difficile;
mNGS;
pharmaceutical care
- From:
China Pharmacy
2026;37(14):1892-1897
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for pharmaceutical care in patients with decompensated cirrhosis complicated with Clostridioides difficile splenic abscess. METHODS Clinical pharmacists participated in the whole-process pharmaceutical care of one patient with the above complex conditions. Retrieved from CNKI， Wanfang Data， VIP， PubMed， Embase and Web of Science databases，relevant literature about C. difficile splenic abscess was collected and analyzed. RESULTS Based on the results of metagenomic next-generation sequencing，imaging characteristics， and tissue penetration of antimicrobial agents， the clinical pharmacist suggested switching from ceftriaxone combined with metronidazole to intravenous vancomycin combined with metronidazole. For the hypokalemia that developed in the patient， the clinical pharmacist suggested discontinuing Furosemide tablets and adding Potassium citrate granules. When the p atient requested hospital discharge， the clinical pharmacist developed a post-discharge medication education plan. The physician adopted the clinical pharmacist’s recommendations. The patient improved after treatment without renal injury. Results of the literature analysis showed that among 11 involved patients，there were 9 males and 2 females，aged 32 to 90 years old，8 patients had a history of C. difficile infection. Vancomycin and metronidazole constituted the primary anti-infective regimens， and 3 patients died after treatment. CONCLUSIONS The clinical pharmacists ensured patients’ medication safety through pharmaceutical interventions including identifying the pathogen， optimizing anti-infective regimens， monitoring adverse drug reactions， and formulating a discharge medication education plan.
