临床药师参与1例耐碳青霉烯阴沟肠杆菌血流感染致脓毒性 休克患者抗感染治疗实践

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中图分类号：R978 文章标识码：A文章编号：1001-8751（2025）02-0135-05

Clinical Pharmacist Participated in the Anti-infection Treatment of a Case of Septic Shock Caused by Carbapenem Resistant EnterobactercloacaeBloodstreamInfection

FengYa-nan，HanQian，LiuNing，TanYao-yue，MouMing （Department of Clinical Pharmacy，Dazhou Central Hospital， Dazhou ）

Abstract： ObjectiveTo provide an empirical reference forthe treatment of patients with carbapenem resistant Enterobacter cloacae（CREC） infection.MethodsClinical pharmacists participated in the anti infection treatment of a patient with septic shock caused by CREC bloodstream infection.By conducting a systematic review of the latest evidence-based medicaliteratureand integrating thepatient's pathophysiological characteristics，pharmacokinetic/ pharmacodynamic（PK/PD） parameters of antimicrobial agents and the pathogen's resistance profile，the clinical pharmacists applied pharmaceutical expertise to collaborate with the multidisciplinary team in formulating an individualized anti-infective treatment regimen. Additionally，comprehensive pharmaceutical care was provided throughout the treatment course.ResultsPer the pharmacist's recommendation，the patient Was treated by the doctor with a combination of polymyxin Band levofloxacin.The patient's infection was successfully managed， the septic shock was successully treated，and there were no adverse drug reactions during the prescribed period. ConclusionClinical pharmacists'assstance in optimizing medication plans is crucial for clinical treatment.Inthe absence of novel β -lactams（BLs） and β -lactam -lactamase inhibitors（BL/BLIs），polymyxin B-based combination therapy may be considered for patients infected with CREC producing metallo- ？β -lactamase（MBL）.

Key words： carbapenem resistant Enterobacter cloacae； metallenzymes； carbapenem resistant Enterobacter；bloodstream infection； polymyxin B

过去十年，全球范围内耐碳青霉烯类肠杆菌目细菌（CRE）感染发病率呈急速上升趋势。（剩余9373字）