CAJ | 학술논문

1例75岁女性患者，因脑膜瘤诱发意识不清入院，入院后行手术治疗，术后发生深静脉导管相关感染。临床医生结合疾病特点经验性给予万古霉素抗感染治疗，效果欠佳，血培养及导管尖端培养回报为弗氏柠檬酸杆菌，根据药敏试验结果及患者病情变化，临床药师建议先后给予注射用头孢曲松钠、注射用亚胺培南西司他丁钠、注射用头孢曲松钠升级、降阶梯、序贯治疗，同时对深静脉导管相关感染的经验治疗、目标治疗进行药学监护，对应用注射用亚胺培南西司他丁钠可能存在的潜在风险提出建议。经有效的抗感染治疗15 d后，患者痊愈出院。
1례75세녀성환자，인뇌막류유발의식불청입원，입원후행수술치료，술후발생심정맥도관상관감염。림상의생결합질병특점경험성급여만고매소항감염치료，효과흠가，혈배양급도관첨단배양회보위불씨저몽산간균，근거약민시험결과급환자병정변화，림상약사건의선후급여주사용두포곡송납、주사용아알배남서사타정납、주사용두포곡송납승급、강계제、서관치료，동시대심정맥도관상관감염적경험치료、목표치료진행약학감호，대응용주사용아알배남서사타정납가능존재적잠재풍험제출건의。경유효적항감염치료15 d후，환자전유출원。
[ABSTRACT]One 75-year-old female patient was admitted to hospital because of unconsciousness induced by meningioma. The patient received a surgical operation while deep venous catheter related infection occurred later. Vancomycin for anti-infection treatment was empirically given according to the disease of the patient, but with no obvious effect. Microbiological result showed Citrobacter freundii in both blood and the deep venous catheter tip culture. Ceftriaxone sodium for injection was given ifrst, and followed by imipenem and cilastatin sodium for injection, then ceftriaxone sodium for injection was given again in the sequential therapy according to the susceptibility test and the change of disease. The clinical pharmacist provided pharmaceutical care on empiric and targeted therapy including the potential risk of epilepsy caused by imipenem and cilastatin sodium for injection. The patient recovered and discharged after anti-infection treatment for 15 days.