前交叉韧带重建术后患者感染治疗方案的选择与个体化用药的思考

目的:探讨临床药师在前交叉韧带重建术后感染患者个体化药物治疗方案中的作用，为临床合理用药提供参考。方法: 临床药师参与前交叉韧带重建术后感染患者的药物治疗，根据患者情况，协助医师制订初始抗感染及结合万古霉素血药浓度监测和群体药动学模型拟合，进行个体化治疗方案的调整，对患者用药全程进行药学监护，评价药物治疗效果。结果: 临床药师及时根据血药浓度监测结果，给出医师换药的建议，治疗效果佳。结论:临床药师通过参与前交叉韧带重建术后患者感染的治疗过程，为患者制定个体化的用药方案，保证了患者用药的安全、有效、合理。

Role of clinical pharmacists in the anti-infective therapy after anterior cruciate ligament reconstructions: an individualized medicine perspective

AIM: To explore the role of clinical pharmacists participating in the individualized anti-infective therapy after anterior cruciate ligament reconstruction. METHODS: Clinical pharmacists participated in the therapy for a patient with staphylococcus aureus infection after anterior cruciate ligament reconstruction. According to patient's condition, clinical pharmacist assisted physicians to formulate preliminary anti-infection plan.Embarking on drug sensitivity test, clinical pharmacist carried out individualized medication for patient by vancomycin serum concentration monitoring and population pharmacokinetic modeling. Close pharmaceutical care were conducted throughout the therapy. Moreover, clinical pharmacist assisted physicians to evaluate the therapeutic efficacy. RESULTS: According to vancomycin serum concentrations, clinical pharmacist suggested physician to change the anti-infection plan, and received a good therapeutic effect. CONCLUSION: Clinical pharmacists participate in the anti-infective therapy after anterior cruciate ligament reconstruction, and the designs of individualized dosing regimens contribute in the safety and effectiveness of drug use in patients with serious infection.