This article presents the anti-infective treatment and pharmaceutical care of an elderly patient with liver cirrhosis complicated with severe psittacosis.Based on the pathophysiological characteristics of infection in patients with severe liver diseases and in combination with relevant guidelines,the combined regimen of omadacycline+moxifloxacin was adopted to treat psittacosis.In case of recurrent episodes,Aspergillus fumigata was detected in the metagenomic next-generation sequencing of bronchoalveolar lavage fluid.Initially,voriconazole was administered for treatment,and later switched to posaconazole.Additionally,clinical pharmacists provided pharmaceutical care encompassing adverse reaction monitoring and voriconazole therapeutic drug monitoring.The patient's infection was effectively controlled,body temperature returned to normal,white blood cell counts and platelet counts basically returned to normal range,serum high-sensitive C-reactive protein,procalcitonin,and other inflammatory indicators significantly decreased,and the patient was discharged.Clinical pharmacists assisted clinicians in formulating a reasonable anti-psittacosis treatment plan and provided individualized pharmaceutical care to ensure the effectiveness and safety of clinical drug treatment.

This article presents the anti-infective treatment and pharmaceutical care of an elderly patient with liver cirrhosis complicated with severe psittacosis.Based on the pathophysiological characteristics of infection in patients with severe liver diseases and in combination with relevant guidelines,the combined regimen of omadacycline+moxifloxacin was adopted to treat psittacosis.In case of recurrent episodes,Aspergillus fumigata was detected in the metagenomic next-generation sequencing of bronchoalveolar lavage fluid.Initially,voriconazole was administered for treatment,and later switched to posaconazole.Additionally,clinical pharmacists provided pharmaceutical care encompassing adverse reaction monitoring and voriconazole therapeutic drug monitoring.The patient's infection was effectively controlled,body temperature returned to normal,white blood cell counts and platelet counts basically returned to normal range,serum high-sensitive C-reactive protein,procalcitonin,and other inflammatory indicators significantly decreased,and the patient was discharged.Clinical pharmacists assisted clinicians in formulating a reasonable anti-psittacosis treatment plan and provided individualized pharmaceutical care to ensure the effectiveness and safety of clinical drug treatment.

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.

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.

OBJECTIVE:To investigate the occurrence of ADR induced by Shuxuening injection in Beijing area,and to pro-vide reference for rational drug use in clinic. METHODS:ADR induced by Shuxuening injection in Beijing area during 2003-2013 was classified statistically in respects of population,organs/systems involved in ADR,clinical manifestations,occurrence time, drug combination and prognosis. RESULTS:Of 1648 ADR cases,the incidence of ADR in the elderly patients was higher than young patients,and that of female patients (60.92％) was higher than that of male patients (39.14％). Multiple organs/systems were involved in Shuxuening injection-induced ADR,and top 3 were nervous system (422 cases,21.33％),skin and its appen-dants (411 cases,20.78％) and others (305 cases,15.42％). Clinical manifestations were skin rash,itching,dizziness and ner-vousness,palpitation,arrhythmia,etc. ADR mostly occurred within 5-30 min after medication. In ADR reports,there were a vari-ety of drugs combined with Shuxuening injection. Shuxuening injection combined with Alprostadil injection was most common(61 cases,accounting for 23.46％ of drug combination). Among 1648 ADR cases,there were 622 cured cases and 1039 cases im-proved,4 cases were not improved,3 cases had sequelae and 1 case died. CONCLUSIONS:Clinical application of Shuxuening in-jection should strictly follow the indications of drug package inserts;differentiation of symptoms and signs is based on specific dos-age,solvent,route of administration,etc. It is necessary to strengthen the prescription check,and strengthen the observation after medication especially for the elderly and other special groups so as to reduce and avoid ADR.