Pharmaceutical practice for one case of central nervous system infection caused by Mycobacterium malmoense combined with drug-induced liver injury
- VernacularTitle:1例玛尔摩分枝杆菌致中枢神经系统感染合并药物性肝损伤的药学实践
- Author:
Shu LAI
1
;
Yi RUAN
2
;
Yao HE
2
Author Information
1. Dept. of Pharmacy，Jiulongpo District People’s Hospital of Chongqing，Chongqing 400050，China
2. Dept. of Pharmacy，the Affiliated Central Hospital of Chongqing University，Chongqing 400014，China
- Publication Type:Journal Article
- Keywords:
Mycobacterium malmoense;
central nervous
- From:
China Pharmacy
2023;34(16):2014-2017
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To introduce the drug diagnosis， treatment plan and pharmaceutical care of a case of central nervous system infection caused by Mycobacterium malmoense combined with drug-induced liver injury， and to provide a reference for clinical pharmacists to carry out pharmaceutical practice. METHODS Clinical pharmacists participated in the whole treatment of a case of central nervous system infection caused by M. malmoense combined with drug-induced liver injury. Considering the patient’s headache worsened and the skin appeared red spot again， clinical pharmacists suggested stopping isoniazid and adjusted the quadruple anti-infection regimen to Rifampicin capsules+Ethambutol hydrochloride tablets+Amikacin sulfate injection+ Clarithromycin tablets， and sending cerebrospinal fluid samples for the next-generation sequencing to identify the pathogen. After the pathogen was identified as M. malmoense， clinical pharmacists recommend continuing the above quadruple regimen. When the patient suffered from drug-induced liver injury， clinical pharmacists assisted physicians to adjust the medication plan， and suggested that Rifampicin capsules should be discontinued， Moxifloxacin hydrochloride tablets should be used for anti-infection treatment， Glutathione tablets should be used for liver protection treatment， and renal function and electrocardiogram monitoring should be performed. RESULTS & CONCLUSIONS The physicians adopted the advice of clinical pharmacists， and the patient was discharged after the condition improved. Clinical pharmacists review the patient’s medical and medication history， consult guidelines/consensus， research reports， and other literature materials， analyze the causes of adverse reactions based on the patient’s condition and the characteristics of drug action， adjust the medication plan of anti-infective drugs in a timely manner， and provide targeted treatment for adverse reactions. From a pharmaceutical perspective， they assist physicians in improving clinical treatment decisions and ensuring the efficacy and safety of clinical medication.
