胡天鑫

    [摘要]目的对1例蛛网膜下腔出血术后并发耐碳青霉烯类肠杆菌科细菌(CRE)肺炎患者的抗感染治疗进行分析，探讨抗感染治疗药物选择，为临床合理用药提供参考。方法临床药师通过药学会诊的方式参与一例颅脑术后合并肺部感染耐碳青霉烯肺炎克雷伯菌的抗感染方案的制订、优化和监护。结果当最低抑菌浓度(MIC)≤8μg/ml 时可考虑给予碳青霉烯联合替加环素的治疗方案，增加替加环素剂量，同时延长碳青霉烯的输注时间。通过实施优化的治疗方案，患者得到有效治疗，临床症状好转，病原学结果转阴。结论临床药师深入临床实践，对患者药物治疗过程进行药学监护，能更好地发挥自身的价值。

    [关键词]临床药师;药学监护;肺部感染;耐碳青霉烯肺炎克雷伯菌

    [中图分类号] R961 [文献标识码] A? [文章编号]2095-0616(2021)22-0235-03

    Pharmaceutical care by clinical pharmacists： a case of pulmonary infection with carbapenem-resistant Enterobacteriaceae upon subarachnoid hemorrhage surgery

    HU? Tianxin

    Department of Pharmacy， Tangdu Hospital， Air Force Medical University， Shaanxi， Xi'an 710038， China

    [Abstract] Objective To analyze the anti-infection treatment of a patient with a complication of carbapenem- resistant Enterobacteriaceae (CRE) pneumonia upon subarachnoid hemorrhage surgery， and to explore the selection of anti-infection treatment drugs， so as to provide reference for clinical rational drug use. Methods Clinical pharmacists participated in the formulation， optimization and monitoring of the anti-infection scheme on the patient with pulmonary infection of carbapenem-resistant Klebsiella pneumoniae after craniocerebral operation through pharm aceuticalconsultation . Results? When m inim al inhibitory concentration (MIC)≤8μg/ml ......