摘 要 1例右下肺肺炎合并慢性胆囊炎急性发作的62岁男性患者，因对其的初始治疗方案没有完全覆盖胆囊炎的常见病原菌，胆囊炎未获控制且又出现胆道梗阻，进而发生了血行感染大肠埃希菌性败血症。临床治疗团队经综合考虑患者的职业和病原菌的耐药情况等，制定了个体化的治疗方案，最终控制了感染。患者在治疗期间曾出现抗生素相关性腹泻。在不能停用抗感染治疗的情况下，药师推荐使用活菌制剂酪酸梭菌活菌片处理腹泻。最后，患者的腹泻停止、感染得到控制，顺利出院。

    关键词 败血症 抗生素相关性腹泻 大肠埃希菌

    中图分类号：R575.61； R515.3 文献标识码：C 文章编号：1006-1533(2015)11-0064-03

    Abstract A 62-year-old man who was hospitalized due to pneumonia and cholecystitis-acute-episode suffered from hematogenous infection of Escherichia coli by the reason of the obstruction of biliary tract and the unsuitable initial anti-infection therapeutic regimen that led to the uncontrolled cholecystitis. The clinical team made an individualized treatment after evaluating the patient’s profession and bacterial resistance and the infection was controlled. Clinical pharmacist suggested Miya-BM containing Clostridium butyricum by the main reason that the patient was suffered from antibiotic-associated diarrhea in the course of treatment. When the antibiotic-associated diarrhea was cured ......