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  • 2022 Volume 19 Issue 4
    Published: 25 April 2022
      
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  • Progress in Preventive and Therapeutic Effects Of Cortex Magnoliae Officinalis and Its Effective Components Magnolol and Honokiol on Oral Infectious Diseases*1
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(4): 461-466. https://doi.org/10.13493/j.issn.1672-7878.2022.04-001
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    Cortex magnoliae officinalis and its effective components magnolol and honokiol have broad-spectrum antiviral, antifungal, anticoccidial and antibacterial effects. For oral infectious diseases, the topical application of cortex magnoliae officinalis extract, magnolol and honokiol can produce antioxidative and anti-inflammatory effects to protect oral epithelial cells and inhibit oral pathogenic bacteria, thus preventing the occurrence and development of dental caries and periodontitis, and preventing dental loosening by blocking bone resorption of alveolar bone. This paper reviews the preventive and therapeutic effects of cortex magnoliae officinalis and its effective components magnolol and honokiol on oral infectious diseases, and analyzes the research progress.
  • Methodological Study on Determination of Particle Size of Nifedipine Active Pharmaceutical Ingredient by Laser Scattering Method*1
    XIAO Yan, GAO Yong-jian, LIANG Si-yun, ZHAO Shu-jing, LIANG Biao-zhi, SHI Zi-juan, QU Shu-yun
    2022, 19(4): 467-471. https://doi.org/10.13493/j.issn.1672-7878.2022.04-002
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    Objective: To establish a laser scattering method for determination of particle size of nifedipine active pharmaceutical ingredient (NAPI) and verify the feasibility of the method. Methods: The laser scattering method for determination of particle size of NAPI was established by using LS-909 laser particle size analyzer and investigating the conditions of dispersion medium, dispersant, sonication time, absorption rate of sample material, refractive index of sample material, sonication intensity, stirring speed, stirring time and shading rate, etc. Results: Both the repeatability and intermediate precision of the laser scattering method in determining the particle size of NAPI complied with the specifications when the water was used as a dispersion medium, 0.05% sodium dodecyl sulfate was used as the dispersant, the sonication time was 4 min, the absorption rate of sample material was 0.1, the refractive index of sample material was 1.584, the sonication intensity (i.e. no sonication) was 0, the stirring speed was 2,000 r/min, the stirring time was 20s and the shading rate was 8%-15%. The cumulative particle size distributions (d0.1, d0.5, d0.9) of nifedipine samples from three batches (051912007, 051912018, 052007019) were 1.398 μm, 1.651 μm, 1.672 μm, 9.227 μm, 12.726 μm, 13.944 μm and 41.209 μm, 43.133 μm, 41.983 μm respectively, and their RSD values were less than 5%. Conclusion: The laser scattering method has good reproducibility and high accuracy in determining the particle size of NAPI, and is easy for operation, so it can be used to determine the particle size of NAPI.
  • Analysis of Drug Resistance Changes of Klebsiella Pneumoniae in a Hospital and Its Correlation with Use of Antimicrobial Drugs*1
    CHEN Hu, XU Rong
    2022, 19(4): 472-476. https://doi.org/10.13493/j.issn.1672-7878.2022.04-003
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    Objective: To analyze the detection and the drug resistance changes of Klebsiella pneumoniae (KP) in the hospital as well as its correlation with the use of antibacterial drugs, and provide reference for clinical treatment on KP-induced infections. Methods: The medical records of inpatients with microbiological culture results of KP in Yichun People's Hospital from January 2016 to December 2020 were collected, the sources of KP specimens and the drug resistance over the years were counted, and the correlation between drug resistance changes of KP and use of antimicrobial drugs was analyzed by Spearman correlation analysis. Results: A total of 1250 KP strains were isolated from specimens of inpatients in the hospital from January 2016 to December 2020, and the number of strains isolated over the years was 182, 240, 272, 290 and 266, with the largest number detected from respiratory specimens (853 strains, accounting for 68.24%). During the five years, the resistance rates of KP to piperacillin-tazobactam sodium, cefoperazone-sulbactam sodium, imipenem, gentamicin and amikacin remained low (<25.00%), and the resistance rates to piperacillin-tazobactam sodium, imipenem and gentamicin showed a decreasing trend year by year. During the five years, the defined daily doses (DDDs) of the second generation of cephalosporins, quinolones, carbapenems and glycopeptides increased year by year in a large amplitude (>50.00%), while the antibiotics use density (AUD) of quinolones, carbapenems and glycopeptides also increased year by year in a large amplitude (>50.00%). The results of Spearman correlation analysis showed that the resistance rates of KP to cefotaxime and compound sulfamethoxazole were in positive correlation to the DDDs and AUD of monocyclic drugs and AUD of macrolides (P<0.05), and in negative correlation to the DDDs and AUD of carbapenems and glycopeptides and the AUD of quinolones (P<0.05). The resistance rates of KP to levofloxacin and ciprofloxacin were in positive correlation to the DDDs and AUD of quinolones, carbapenems and glycopeptides (P<0.05), and in negative correlation to the DDDs and AUD of monocyclic drugs and the AUD of macrolides (P<0.05). The resistance rate of KP to ciprofloxacin was also in positive correlation to the DDDs of the second generation of cephalosporins and the AUD of tetracyclines (P<0.05) and in negative correlation to the DDDs and AUD of aminoglycosides (P<0.05). The resistance rates of KP to piperacillin-tazobactam sodium, ceftazidime, imipenem and gentamicin were in positive correlation to the AUD of penicillins (P<0.05). Conclusion: The use of carbapenems, glycopeptides and quinolones tends to induce resistance of KP to quinolones, while the high-intensity use of penicillins tends to induce the development of multi-drug resistant KP, so this situation should be sufficiently taken into account when clinically selecting antimicrobial drugs for treatment, to avoid the development of drug resistant strains.
  • Study on Drug Resistance Changes of Enterococcus Spp and Its Correlation with Use of Antimicrobial Drugs in a Hospital*1
    XU Jin, CHEN Huan, ZHENG Chun-ling, CHEN Bai-ling, LIANG Chun-yan, LIU Zhi-jun, LONG Li-na, He Ke
    2022, 19(4): 477-481. https://doi.org/10.13493/j.issn.1672-7878.2022.04-004
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    Objective: To analyze the detection of Enterococcus spp and drug resistance changes in the hospital as well as its correlation with the use of antimicrobial drugs, and provide reference for clinical treatment of Enterococcus spp infections. Methods: The medical records of inpatients with microbiological culture results of Enterococcus spp who were admitted to Yulin Orthopedics Hospital of Chinese and Western Medicine from January 2015 to December 2019 were collected, the specimen sources of Enterococcus spp and the drug resistance over the years were counted, and the correlation between drug resistance changes of Enterococcus spp and use of antimicrobial drugs was analyzed by Pearson correlation analysis. Results: From January 2015 to December 2019, 593 Enterococcus spp strains were isolated from specimens of inpatients in the hospital, including 510 Enterococcus faecalis (accounting for 86.00%) and 83 Enterococcus faecium (accounting for 14.00%); most of Enterococcus faecalis were detected from secretion specimens (418 strains, accounting for 81.96%), while Enterococcus faecium were mainly detected from secretion (44 strains, accounting for 53.01%) and urine (37 strains, accounting for 44.58%). During the five years, Enterococcus faecalis and Enterococcus faecium always had low resistance rates (<10.00%) to vancomycin and tigecycline, Enterococcus faecalis always had a low resistance rate (<10.00%) to furantoin, while Enterococcus faecium always had a low resistance rate (<10.00%) to linezolid; Enterococcus faecalis had a relatively low resistance rate (<30.00%) to penicillin, ciprofloxacin, levofloxacin and linezolid, but its resistance rate to penicillin decreased year by year and resistance rate to linezolid increased year by year; Enterococcus faecium had a high resistance rate (>50.00%) to penicillin, ciprofloxacin, levofloxacin and tetracycline; Pearson correlation analysis results showed that the resistance rate of Enterococcus faecalis to ciprofloxacin and levofloxacin was in negative correlation to the antibiotics use density of ciprofloxacin. Conclusion: The drug resistance changes of Enterococcus spp are correlated with the use intensity of some antimicrobial drugs, and the hospital should strengthen the management of antimicrobial drugs to promote the scientific and rational use of antimicrobial drugs in clinical practice and avoid or reduce drug-resistant strains.
  • Analysis of Clinical Medication for Multi-drug Resistant Organism Infections in Two Severely Obese Patients*1
    ZHANG Jian-dong, HAN Jing-jing, SHI Ying-ying
    2022, 19(4): 482-486. https://doi.org/10.13493/j.issn.1672-7878.2022.04-005
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    Objective: To analyze the clinical medication for extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBLs-KP) infection and carbapenem-producing Serratia marcescens (CRSM) infection in two severely obese patients, and provide reference for the safe and rational use of drugs in obese patients. Methods: For two severely obese patients with ESBLs-KP infection and CRSM infection who were admitted to People's Hospital of Zhengzhou, the clinical pharmacist analyzed the patients' conditions from the perspectives of pharmacokinetics and pharmacodynamics, and focused on assisting the clinician to individually formulate or adjust the patients' anti-infection and enteral nutrition treatment regimens. Results: Comprehensively considering the effect of severe obesity on the distribution and clearance of antimicrobial drugs in the body and the higher demand for nutrition, the clinical pharmacist assisted the clinician in formulating new treatment regimens by increasing the dose of antimicrobial drugs or choosing other antimicrobial drugs for combination therapy and increasing the patients' energy supply, and the infections of two patients were ultimately eliminated. Conclusion: Patients with special pathophysiological conditions usually require individualized adjustment in medication treatment, and the clinical pharmacist can assist the clinician in developing more optimal and individualized medication treatment regimens based on their professional knowledge, to reflect their professional value.
  • Analysis of Treatment of Postoperative Complications of Incisional Infection and Pulmonary Infection in a Patient with Rectal Cancer Undergoing Radical Resection
    TANG Ying-hua, CHEN Xiang-jie
    2022, 19(4): 487-489. https://doi.org/10.13493/j.issn.1672-7878.2022.04-006
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    Objective: To analyze the pharmacological treatment process of postoperative complications of incisional infection and pulmonary infection in a patient with rectal cancer undergoing radical resection, and provide reference for the rational use of clinical drugs. Methods: The clinical pharmacist, by analyzing the patient's current condition and reviewing relevant literature, assisted the clinician in optimizing and adjusting the anti-infection treatment regimens and other adjuvant treatment regimens for the postoperative complications of incisional infection and pulmonary infection in the patient with rectal cancer undergoing radical resection. Results: By analyzing the patient's microbiological culture and drug susceptibility test results, as well as the antibacterial action characteristics of tigecycline and ceftizoxime, the clinical pharmacist advised the clinician to adjust the anti-infection treatment regimens in a timely manner to cover Pseudomonas aeruginosa, and to optimize the nutrition support plan and medication courses of proton pump inhibitors, resulting in rapid improvement of the patient's condition. Conclusion: For postoperative complications of infectious diseases in such cancer patients, the clinical pharmacist should pay particular attention to the results of microbiological culture and drug susceptibility tests, comprehensively consider the action characteristics of antibacterial drugs, and assist the clinician in formulating scientific and reasonable anti-infection treatment regimens, as well as optimize adjuvant supportive treatment regimens to ensure the success of patient treatment.
  • Analysis of Use of Antimicrobial Drugs in Hospitalized Neonates at a Children's Hospital from 2018 To 2020
    ZHANG Tao, XING Hui-zi
    2022, 19(4): 490-493. https://doi.org/10.13493/j.issn.1672-7878.2022.04-007
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    Objective: To analyze the use of antimicrobial drugs in hospitalized neonates in Affiliated Children's Hospital of Zhengzhou University from 2018 to 2020, and provide reference for the rational use of antimicrobial drugs in clinical neonates. Methods: Using the hospital information system, we collected data on the use of antimicrobial drugs in all hospitalized neonates discharged from Affiliated Children's Hospital of Zhengzhou University from 2018 to 2020, conducted statistics and analysis of the defined daily doses (DDDs) and antibiotics use density (AUD) of antimicrobial drugs over the years and the concomitant medication of antimicrobial drugs. Results: From 2018 to 2020, the overall DDDs and AUD of antimicrobial drugs in hospitalized neonates were relatively stable, but the DDDs and AUD in 2020 were slightly lower than those in the previous period; during the three years, penicillins and cephalosporins were main drugs for hospitalized neonates (accounting for over 85.00% in total), of which the proportion of penicillins increased slowly year by year, and the proportion of cephalosporins significantly decreased in 2020 when compared with that in previous years (21.42% vs 28.58%); during the three years, the AUD of restricted-use class and special-use class antimicrobial drugs remained basically stable, but the AUD of non-restricted-use class antimicrobial drugs decreased significantly (25.69% vs 34.87%); during the three years, the concomitant medication of three or more antimicrobial drugs in hospitalized neonates decreased to a large extent. Conclusion: The overall use of antimicrobial drugs in hospitalized neonates is becoming more rational from 2018 to 2020, but there is a high proportion of restricted-use class drugs and concomitant medication, and the hospital still needs to enhance supervision and management of antimicrobial drugs.
  • Analysis of Distribution and Resistance of Pathogens in Respiratory Tract Specimens from Children with Postoperative Congenital Heart Disease Complicated by LRTI*1
    HUANG Xiao-jing, QI Xin-kun, DUN Yan-ting, ZHAO Hong-wei, ZHANG Ning, WANG Ai-feng, LIU Xue-lan, LI Bin
    2022, 19(4): 494-499. https://doi.org/10.13493/j.issn.1672-7878.2022.04-008
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    Objective: To analyze the distribution and drug resistance characteristics of pathogenic bacteria in respiratory tract specimens from children with postoperative congenital heart disease complicated by lower respiratory tract infection (LRTI), and provide reference for the rational use of antibacterial drugs. Methods: We selected 146 children with postoperative congenital heart disease complicated by LRTI who were admitted to Henan Provincial People's Hospital from January 2018 to December 2020 as study subjects, and conducted statistics and analysis of distribution of pathogenic bacteria and drug resistance of major pathogens in respiratory tract specimens from the children. Results: 151 pathogenic bacteria were isolated from the respiratory tract specimens of 146 children with postoperative complication of LRTI, including 115 Gram-negative bacteria (accounting for 76.16%, mainly Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae) and 36 Gram-positive bacteria (accounting for 23.84%, mainly Streptococcus pneumoniae and Staphylococcus aureus). The drug susceptibility results showed that Klebsiella pneumoniae had a low resistance rate (<30.00%) to amikacin, polymyxin B and tigecycline only, Escherichia coli had a low resistance rate (<10.00%) to cefoperazone-sulbactam sodium, piperacillin-tazobactam sodium, imipenem, meropenem, amikacin, polymyxin B and tigecycline, Enterobacter cloacae had a low resistance rate (≤30.00%) to all tested antimicrobial drugs except cefotaxime, piperacillin and cefoperazone-sulbactam sodium, Pseudomonas aeruginosa had a low resistance rate (<20.00%) to all tested antimicrobial drugs, Acinetobacter baumannii had a low resistance rate (<10.00%) to polymyxin B and tigecycline only, Streptococcus pneumoniae had a low resistance rate (<10.00%) to penicillin, chloramphenicol, levofloxacin, vancomycin and linezolid, and Staphylococcus aureus had a low resistance rate (≤10.00%) to compound sulfamethoxazole, vancomycin, linezolid, teicoplanin, gentamicin and rifampin. Conclusion: The pathogens in children with postoperative congenital heart disease complicated by LRTI are mainly Gram-negative bacteria, with Klebsiella pneumoniae, Escherichia coli and Streptococcus pneumoniae as the main pathogenic bacteria. Clinical multidisciplinary collaboration should be strengthened to clarify pathogenic species and drug resistance characteristics to improve the clinical rational use of antimicrobial drugs.
  • Analysis of Distribution and Drug Resistance of Pathogens in Bile Specimens from Patients with Obstructive Jaundice Complicated by Infection in a Hospital
    ZHAO Yang
    2022, 19(4): 500-503. https://doi.org/10.13493/j.issn.1672-7878.2022.04-009
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    Objective: To investigate the distribution and drug resistance characteristics of pathogenic bacteria in bile specimens from patients with obstructive jaundice (OJ) complicated by infection. Methods: The medical records of 219 patients with OJ complicated by infection who were admitted to the Fifth People's Hospital of Anyang from January 2018 to April 2021 were selected, and the results of microbiological culture and drug susceptibility tests of bile specimens from the patients were summarized to analyze the distribution of pathogenic bacteria and the drug resistance characteristics of major pathogenic bacteria. Results: A total of 210 pathogenic bacteria were isolated from the bile specimens from 219 patients with OJ complicated by infection, including 163 Gram-negative bacteria (accounting for 77.62%, mainly Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa), 39 Gram-positive bacteria (accounting for 18.57%, mainly Enterococcus faecalis and Enterococcus faecium) and 8 fungi (accounting for 3.81%). The drug susceptibility results showed that Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa had low resistance rates (<20.00%) to imipenem, meropenem, cefoperazone-sulbactam sodium, amikacin and piperacillin-tazobactam sodium, and Enterococcus faecalis and Enterococcus faecium had low resistance rates (<20.00%) to linezolid, teicoplanin, vancomycin and chloramphenicol. Conclusion: The pathogenic bacteria in patients with OJ complicated by infection are mainly Gram-negative bacteria, and Gram-positive bacteria are of a low proportion, so clinical antibacterial drugs should be selected rationally according to the results of microbiological culture and drug susceptibility tests to ensure the effect of anti-infection treatment.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in 75 Elderly Diabetic Patients Complicated by Urinary Tract Infection in a Hospital
    MA Hai-xia
    2022, 19(4): 504-506. https://doi.org/10.13493/j.issn.1672-7878.2022.04-010
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    Objective: To investigate the distribution and drug resistance characteristics of pathogenic bacteria in elderly diabetic patients complicated by urinary tract infection in the hospital. Methods: The medical records of 75 elderly diabetic patients complicated by urinary tract infection who were admitted to Xiuwu County People's Hospital from November 2019 to November 2020 were selected, and statistics and analysis of the distribution of pathogenic bacteria and drug resistance of major pathogens in the urine specimens of the patients were conducted. Results: A total of 87 pathogenic bacteria were isolated from the urine specimens of 75 patients with the complication of urinary tract infection, including 52 Gram-negative bacteria (accounting for 59.77%, mainly Escherichia coli and Klebsiella pneumoniae), 33 Gram-positive bacteria (accounting for 37.93%, mainly Enterococcus faecalis and Staphylococcus aureus) and 2 fungi (accounting for 2.30%); the drug susceptibility results showed that Escherichia coli and Klebsiella pneumoniae had low resistance rates (<15.00%) to meropenem, imipenem, amikacin, furantoin and piperacillin-tazobactam sodium, while had high resistance rates (>80.00%) to ceftazidime, ciprofloxacin, levofloxacin, gentamicin and cefotaxime; Enterococcus faecalis and Staphylococcus aureus had low resistance rates (both 0.00%) to linezolid and vancomycin, and had low resistance rates (<15.00%) to gentamicin and lincomycin. Conclusion: The pathogenic bacteria of elderly diabetic patients complicated by urinary tract infection are mainly Gram-negative bacteria, but there is also a certain proportion of Gram-positive bacteria, and the results of microbiological culture and drug susceptibility tests should be comprehensively considered in clinical anti-infection treatment to ensure the effect of anti-infection treatment.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Patients with Severe Infection Caused by MDRO in the Emergency Department of a Hospital
    GUO Li-fen
    2022, 19(4): 507-510. https://doi.org/10.13493/j.issn.1672-7878.2022.04-011
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    Objective: To analyze the distribution and drug resistance characteristics of pathogenic bacteria in patients with severe infection caused by multi-drug resistant organisms (MDRO) in the emergency department of the hospital, and provide reference for the rational use of clinical antibacterial drugs. Methods: 58 patients with severe infection caused by MDRO who were admitted to the emergency department of Wuzhi County People's Hospital from March 2018 to September 2020 were selected as study subjects, and statistics and analysis of the distribution of pathogenic bacteria and drug resistance characteristics of major pathogenic bacteria in patient specimens were conducted. Results: 92 strains of pathogenic bacteria were isolated from the specimens of 58 patients with severe infection caused by MDRO, among which, the most frequent strains of Acinetobacter baumannii (33 strains, accounting for 35.87%), Pseudomonas aeruginosa (15 strains, accounting for 16.30%) and Staphylococcus aureus (13 strains, accounting for 14.13%) were detected. The drug susceptibility test showed that Acinetobacter baumannii had a low resistance rate (<20.00%) to tigecycline only, and had a high resistance rate (>40.00%) to other antibacterial drugs; Pseudomonas aeruginosa had a low resistance rate (both 33.33%) to levofloxacin and imipenem only, and had a high resistance rate (≥40.00%) to other antibacterial drugs; Escherichia coli had a low resistance rate (<15.00%) to imipenem, ertapenem and tigecycline; both Staphylococcus aureus and coagulase-negative staphylococci had very low resistance rates (<10.00%) to dalfopristin, rifampin, furantoin, teicoplanin, vancomycin, and tigecycline. Conclusion: The main pathogenic bacteria of patients with severe infection caused by MDRO in the emergency department of the hospital are Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus, so clinical antibacterial drugs should be selected scientifically and reasonably according to the pathogenic species and drug susceptibility results, meanwhile, bacterial drug resistance monitoring should also be conducted from time to time to provide reference for the development of reasonable anti-infection treatment regimens.
  • Pharmacy Practice and Experience in Management of Coagulation Dysfunction and Hemocytopenia Induced by Piperacillin-tazobactam Participate by Clinical Pharmacist
    ZHI Run-na
    2022, 19(4): 573-575. https://doi.org/10.13493/j.issn.1672-7878.2022.04-032
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    Objective: To analyze the possible causes and management of coagulation dysfunction and hemocytopenia in 2 patients, and provide reference for the safe and rational use of piperacillin-tazobactam sodium in clinical treatment. Methods: The clinical pharmacist participated in the pharmacy consultation of 2 patients with coagulation dysfunction and hemocytopenia after using piperacillin-tazobactam sodium, comprehensively considered the patients' medication and pathogenetic process, analyzed the possible causes of coagulation dysfunction and hemocytopenia, and made recommendations for management. Results: After comprehensively considering the patients' medication and pathogenetic process and analyzing that coagulation dysfunction and hemocytopenia may be caused by piperacillin-tazobactam sodium, the clinical pharmacist recommended discontinuing piperacillin-tazobactam sodium and symptomatic treatment, and the patients were improved or healed quickly after the doctor accepted the recommendation of the clinical pharmacist. Conclusion: Piperacillin-tazobactam sodium has hematologic adverse reactions, so the clinical pharmacist should pay attention to relevant pharmaceutical care when carrying out clinical pharmacy practice, timely detect relevant adverse reactions, and assist the doctor in corresponding management to ensure medication safety of patients.
  • Case Analysis of Drug Fever after Use of Piperacillin-tazobactam Sodium in a Patient with Pulmonary Infection
    TAN Hao-wen, CHEN Ying, LUO Lu-ping
    2022, 19(4): 576-578. https://doi.org/10.13493/j.issn.1672-7878.2022.04-033
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    Objective: To analyze the case characteristics of drug fever caused by use of piperacillin-tazobactam sodium in a patient with pulmonary infection. Methods: The clinical pharmacist participating in the clinical ward round found that the infection symptoms of a patient with pulmonary infection were basically controlled after treatment with piperacillin-tazobactam sodium, but such patient still had recurrent fever. Results: After reviewing the relevant literature and taking the patient's condition into account, it was suspected as drug fever probably caused by piperacillin-tazobactam sodium, so the clinical pharmacist recommended discontinuing the drug, and the patient had no fever. Conclusion: Drug fever is not easily distinguishable from fever caused by other diseases, so the development of the patient's condition and the characteristics of relevant drugs should be fully considered in clinical judgment of drug fever, and the cause of fever should be identified early to formulate a corresponding treatment plan.
  • Analysis of Medications and Pharmaceutical Care in a Patient with Postoperative Complication of Capsular Bag Infection after Pacemaker Implantation
    CAO Wen-ting, SONG Wen-jing
    2022, 19(4): 579-583. https://doi.org/10.13493/j.issn.1672-7878.2022.04-034
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    Objective: To analyze the medications and pharmaceutical care in a patient with postoperative complication of capsular bag infection after pacemaker implantation, and provide reference for the scientific and rational use of clinical antimicrobial drugs. Methods: For the postoperative complication of capsular bag infection in the patient after pacemaker implantation, the clinical pharmacist assisted the clinician in formulating the anti-infection treatment regimen and actively carried out pharmaceutical care by comprehensively considering the actual condition of the patient and the pharmaceutical characteristics of alternative antibacterial drugs. Results: The patient had a postoperative complication of capsular bag infection, and the microbiological examination showed that the pathogenic bacterium was methicillin-resistant Staphylococcus aureus. After considering the patient's underlying condition and the pharmaceutical characteristics of alternative antibacterial drugs, the clinical pharmacist recommended adjusting the anti-infection treatment regimen to tigecycline, and eventually the infection was effectively controlled. Conclusion: As patients are clinically individualized and the pharmaceutical characteristics of therapeutic drugs vary, the clinical pharmacist should fully consider the patient's condition and drug characteristics in clinical work, and assist the doctor in formulating individualized treatment regimens to ensure safe and effective treatment.
  • Analysis of Prognosis Influencing Factors in Patients with Tuberculous Meningitis Based on Random Forest Model and Logistic Regression Model*1
    ZHOU Lin, LIU Jia, YE Zhi-jian, ZENG Ling-wu, WU Mei-ying, SHEN Xing-hua, BAO Zi-wei
    2022, 19(4): 596-600. https://doi.org/10.13493/j.issn.1672-7878.2022.04-038
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    Objective: To analyze the prognosis influencing factors of patients with tuberculous meningitis (TBM) by random forest model and logistic regression model, and provide a basis for the treatment and prognosis judgment of patients with TBM. Methods: The medical records of 107 patients with TBM who were admitted to the Fifth People's Hospital of Suzhou from January 2016 to January 2021 were collected, the patients were divided into a good prognosis group (79 cases) and a poor prognosis group (28 cases) according to the prognosis, and the prognosis influencing factors of patients with TBM were analyzed by random forest model and logistic regression model. Results: The analysis results of random forest model showed that cerebrospinal fluid protein content, cerebrospinal fluid adenosine deaminase level, fever, impaired consciousness, paralysis, disease duration, gender, treatment history, place of residence, diplopia or decreased visual acuity were the influencing factors with high scores. The analysis results of logistic regression model showed that high cerebrospinal fluid protein content, fever and impaired consciousness were correlated with poor prognosis in patients with TBM (P<0.05). Conclusion: The analysis based on random forest model and logistic regression model showed that cerebrospinal fluid protein content, fever and impaired consciousness were closely related to the prognosis of patients with TBM and were independent risk factors for poor prognosis of patients, so great attention should be paid to clinical management and control of such factors in patients to reduce poor prognosis of patients.