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  • Research Progress in Sulbactam-Durlobactam in the Treatment of Acinetobacter Baumannii Infections*1
    LUO Kai-ping, GU Bing, HANG Yong-fu
    2026, 23(1): 1-6. https://doi.org/10.13493/j.issn.1672-7878.2026.01-001
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    Acinetobacter baumannii, particularly carbapenem-resistant Acinetobacter baumannii (CRAB), has emerged as a critical global challenge in healthcare-associated infections due to its high-level drug resistance and treatment refractoriness. Sulbactam-durlobactam, a novel β-lactamase inhibitor combination agent that mainly targets OXA-type enzymes and penicillin-binding proteins, exhibits excellent in vitro antibacterial activity and high susceptibility against CRAB. This agent has well-defined pharmacokinetic profiles, with a favorable probability of target attainment at clinically recommended doses. Furthermore, the phase III ATTACK trial confirmed that sulbactam-durlobactam has non-inferior efficacy to colistin in the treatment of severe CRAB infections, along with lower nephrotoxicity and a higher clinical cure rate. This article conducts a systematic review of the antibacterial mechanism, in vitro activity, pharmacokinetic/pharmacodynamic characteristics, and clinical research progress of sulbactam-durlobactam, aiming to provide the latest theoretical basis and evidence-based reference for the standardized clinical treatment of multidrug-resistant Acinetobacter baumannii infections.
  • Preparation of EGFR-Targeted Photosensitive Liposomes and Evaluation of Their Photodynamic Therapeutic Efficacy against Breast Cancer*1
    SUN Rui, ZHOU Li, ZHOU Bin-bin
    2026, 23(1): 7-14. https://doi.org/10.13493/j.issn.1672-7878.2026.01-002
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    Objective: To prepare epidermal growth factor receptor (EGFR)-targeted photosensitive liposomes, and evaluate their pharmaceutical properties, cellular targeting capability, synergistic therapeutic effect, and in vivo biosafety, so as to provide a novel strategy for overcoming drug resistance and recurrence of breast cancer. Methods: The photoresponsive active-targeting liposomes (SCLP-Pep) co-loaded with photosensitizer SR780 and glutaminase inhibitor CB-839 were prepared via the film dispersion method. The morphology, particle size, polydispersity index and Zeta potential of SCLP-Pep were characterized by transmission electron microscopy (TEM) and dynamic light scattering (DLS), and the reactive oxygen species (ROS)-responsive drug release behavior was investigated. Using 4T1 cells as the model, cellular uptake, intracellular ROS generation and live/dead cell status were observed through laser confocal microscopy and inverted fluorescence microscopy. Using Kunming mice as the model, blood biochemical indexes related to cardiac, hepatic and renal functions were detected after administration, and hematoxylin-eosin (HE) staining of the main organs was performed to evaluate the safety of the formulation. Results: SCLP-Pep with uniform particle size and excellent dispersion was successfully prepared. Cell experiments demonstrated that SCLP-Pep exhibited outstanding active targeting capability, and the combination of photodynamic therapy and glutaminase inhibitor exerted a significant synergistic therapeutic effect. Animal safety experiments showed that no obvious toxic reaction was induced in any of the formulation groups. Conclusion: SCLP-Pep possesses excellent targeting property, ROS responsiveness and synergistic therapeutic effect, as well as good in vivo safety, which can provide a reliable basis for subsequent in vivo anti-tumor studies.
  • Pharmaceutical Care of Anti-infective Treatment for a Patient with Mixed Intracranial and Pulmonary Infections Caused by Carbapenem-Resistant Acinetobacter Baumannii after Neurosurgery Operation
    CHEN Qi, ZHANG Li
    2026, 23(1): 15-20. https://doi.org/10.13493/j.issn.1672-7878.2026.01-003
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    Objective: To analyze the pharmaceutical care process of anti-infective treatment for a patient with mixed intracranial and pulmonary infections caused by carbapenem-resistant Acinetobacter baumannii (CRAB) after neurosurgery operation, and to provide a reference for clinical anti-infective treatment of severe CRAB-induced infections. Methods and Results: The patient was admitted to hospital due to "vomiting accompanied by loss of consciousness". Combined with clinical manifestations, imaging findings and cerebrospinal fluid (CSF) examination, the patient was diagnosed with intracranial infection complicated with pulmonary infection. Initial empirical anti-infective therapy was administered with piperacillin-tazobactam sodium. The regimen was switched to levofloxacin due to poor therapeutic response, and further adjusted to meropenem combined with vancomycin with still unsatisfactory clinical efficacy. Subsequent etiological examination confirmed CRAB infection. Based on drug susceptibility test results, relevant guidelines and the blood-brain barrier (BBB) penetration capacity of antibacterial agents, clinical pharmacists recommended modifying the regimen to intravenous infusion of colistimethate sodium combined with high-dose, prolonged-infusion meropenem, supplemented with intrathecal injection of colistin. During treatment, the dosage of colistin was adjusted according to therapeutic drug monitoring results, with close monitoring of renal function and neurological adverse reactions. Finally, the patient's intracranial and pulmonary infections were effectively controlled, CSF parameters returned to normal, and the patient was discharged after clinical improvement. Conclusion: For multi-site CRAB infections after neurosurgery operation, the regimen of intravenous plus intrathecal injection of colistin, combined with high-dose prolonged-infusion meropenem, achieves favorable therapeutic efficacy. Clinical pharmacists play a critical role in optimizing treatment outcomes and ensuring medication safety by participating in regimen design and implementing individualized pharmaceutical care.
  • Practice of Individualized Pharmaceutical Care with Ceftazidime-Avibactam Sodium in a Patient Undergoing Continuous Renal Replacement Therapy
    LU Jing, SHI Lu, TANG Lian, PENG Xiao-jun
    2026, 23(1): 21-25. https://doi.org/10.13493/j.issn.1672-7878.2026.01-004
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    Objective: To analyze the practice of individualized drug administration of ceftazidime-avibactam sodium in a patient with severe infection undergoing continuous renal replacement therapy with the involvement of clinical pharmacists, and to provide a reference for rational clinical medication. Methods and Results: The patient was admitted due to severe pneumonia complicated with bloodstream infection. Sputum culture and blood culture results identified Klebsiella pneumoniae and Pseudomonas aeruginosa, and drug susceptibility test results showed resistance to carbapenems, thus ceftazidime-avibactam sodium was initiated for anti-infective treatment. During treatment, the patient developed acute kidney injury and received continuous renal replacement therapy. Combined with therapeutic drug monitoring and pharmacokinetic/pharmacodynamic (PK/PD) principles, clinical pharmacists assisted in adjusting the dosing regimen, and implemented full-course pharmaceutical care including efficacy evaluation and adverse drug reaction monitoring. Finally, the patient's infection was effectively controlled, and no significant drug-related adverse reactions occurred. Conclusion: For patients with severe infection undergoing continuous renal replacement therapy, clinical pharmacists can assist in formulating and optimizing the individualized treatment regimen of ceftazidime-avibactam sodium based on evidence-based data under the guidance of therapeutic drug monitoring and pharmacokinetic/pharmacodynamic theory, so as to ensure therapeutic efficacy and safety, and help reduce the risk of drug resistance.
  • Diagnosis and Treatment Analysis of One Case of Multiple Organ Dysfunction Caused by Leptospira Infection*1
    ZHENG Zi-xiang, XIANG Shi-zhao
    2026, 23(1): 26-30. https://doi.org/10.13493/j.issn.1672-7878.2026.01-005
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    Objective: To analyze the diagnosis and treatment process of a case of multiple organ dysfunction syndrome caused by Leptospira infection, and explore the clinical characteristics, diagnosis and treatment strategies of severe leptospirosis, so as to provide a reference for early clinical identification and precise treatment of the disease. Methods and Results: The patient was admitted to hospital due to "fever accompanied by anuria for 3 days", and had a history of pesticide spraying in paddy fields before the onset of the disease. At admission, the patient had developed high fever, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and hepatic insufficiency. Chest CT showed bilateral lung consolidation, and bronchofibroscopy revealed diffuse airway bleeding with yellow viscous secretions, while conventional pathogen culture was negative. Clinically, the patient was given high-flow oxygen therapy, prone positioning ventilation, bedside continuous renal replacement therapy (CRRT), and empirical anti-infective treatment with imipenem-cilastatin sodium. To clarify the etiology, metagenomic next-generation sequencing (mNGS) was further performed on bronchoalveolar lavage fluid (BALF) and blood samples. The results showed that Leptospira nucleic acid sequences were detected in blood (sequence number: 17), and Candida albicans nucleic acid sequences were detected in BALF (sequence number: 24). Then the anti-infective regimen was adjusted to penicillin G combined with voriconazole. After 7 days of treatment, the patient's condition gradually improved and was discharged after recovery. At the one-week follow-up visit, the patient underwent reexamination of chest CT, which showed no progression of pulmonary lesions. Conclusion: Leptospira infection can cause severe multiple organ damage, and its clinical manifestations are often atypical, which brings great challenges to early diagnosis. For suspected cases, detailed epidemiological history should be inquired, and molecular diagnostic techniques such as mNGS should be actively applied to confirm the pathogen.
  • Analysis of Adverse Drug Reaction of Coagulopathy Induced by Tigecycline in a Patient with Severe Pneumonia
    ZHAO Han-zhen, WANG Guo-hua, XU Jin-hui, TANG Lian
    2026, 23(1): 31-34. https://doi.org/10.13493/j.issn.1672-7878.2026.01-006
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    Objective: To analyze the diagnosis and treatment process of coagulopathy induced by tigecycline in a patient with severe pneumonia, and to provide a reference for the safe clinical use of tigecycline. Methods and Results: The patient was admitted to hospital due to severe pneumonia, and sputum culture indicated extensively drug-resistant Acinetobacter baumannii infection. After admission, anti-infective therapy with colistimethate sodium combined with meropenem and tigecycline was administered. After 5 days of treatment, the patient's prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) were prolonged, accompanied by hypofibrinogenemia. Clinical pharmacists suspected that the coagulopathy was associated with tigecycline. Therefore, the dosage of tigecycline was adjusted, therapeutic drug monitoring (TDM) was performed, and supplementary treatment with human fibrinogen was given simultaneously. The monitoring results of tigecycline plasma concentrations showed a trough concentration of 0.448 mg/L, a peak concentration of 0.756 mg/L, a medium concentration of 0.675 mg/L, and an area under the plasma concentration-time curve over 24 hours (AUC0-24h) of 15.24 μg∙h/mL. Clinical pharmacists recommended discontinuing tigecycline, and all coagulation parameters of the patient returned to the normal range 10 days after drug withdrawal. Conclusion: Coagulopathy is a common adverse drug reaction of tigecycline. In clinical practice, the monitoring of coagulation function should be strengthened, and TDM should be carried out when necessary, to timely identify and manage such adverse drug reactions and ensure the medication safety of patients.
  • Mining and Analysis of Adverse Drug Event Signals of Oral Vancomycin for Clostridioides difficile Infection Based on the FAERS Database
    ZHANG Ya-juan, ZHAO Guo-lian, MEI Jiang-tao
    2026, 23(1): 35-42. https://doi.org/10.13493/j.issn.1672-7878.2026.01-007
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    Objective: To mine and evaluate the adverse drug event (ADE) signals of oral vancomycin in the treatment of Clostridioides difficile infection based on the FDA Adverse Event Reporting System (FAERS) database, and to provide a reference for safe clinical medication. Methods: ADE report data of oral vancomycin in the treatment of Clostridioides difficile infection were collected from the FAERS database spanning from the marketing of vancomycin to the fourth quarter of 2024. Reports in which vancomycin was listed as the primary or secondary suspected drug were screened for inclusion. The preferred terms (PT) of ADEs were standardized and coded by System Organ Class (SOC) using the Medical Dictionary for Regulatory Activities version 26.1 (MedDRA v26.1). The reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN) and Empirical Bayes Geometric Mean (EBGM) methods were jointly used for ADE signal screening and data mining. Results: A total of 1,007 valid reports were finally included. Most of the reports were from the United States (625 reports, accounting for 62.07%). The number of involved female patients (429 cases, 42.60%) was slightly higher than that of male patients (358 cases, 35.55%), and patients aged over 60 years accounted for 38.53% (388 cases). Reports with a daily dose of 625 mg were the most common (264 cases, 26.22%). A total of 74 suspicious ADE signals were detected, involving multiple SOCs. The top 3 SOCs ranked by signal quantity were Gastrointestinal Disorders (20 signals), General Disorders and Administration Site Conditions (14 signals), and Infections and Infestations (11 signals). ADEs with high signal strength included colonic dilatation, intestinal dysbiosis, pseudomembranous colitis, linear IgA bullous dermatosis, vancomycin infusion reaction, and Weissella infection. Conclusion: In addition to common gastrointestinal reactions, oral vancomycin carries potential risks of ADEs involving the skin, kidney, hematological system and severe infections due to systemic absorption. In clinical practice, monitoring should be strengthened for high-risk populations, especially elderly patients, those receiving high-dose therapy, and patients with concurrent inflammatory bowel disease, and attention should be paid to rare ADE signals.
  • Case Analysis and Pharmaceutical Care of a Patient with Grade Ⅳ Myelosuppression Complicated with Febrile Neutropenia Induced by Etoposide Combined with Carboplatin
    WANG Run
    2026, 23(1): 43-48. https://doi.org/10.13493/j.issn.1672-7878.2026.01-008
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    Objective: To analyze the pharmaceutical care process for a patient with grade Ⅳ myelosuppression complicated with febrile neutropenia induced by etoposide combined with carboplatin, and to provide a reference for reducing adverse drug reactions and complications caused by cytotoxic drugs. Methods and Results: The patient was readmitted to hospital due to "confirmed small cell lung cancer (SCLC) for more than 1 year and cough for 1 week". Based on the previous diagnosis and various examination results, the original chemotherapy regimen (etoposide 130 mg, d1-d3; carboplatin 440 mg, d1, q3w) was maintained. To improve blood cell counts, recombinant human granulocyte colony-stimulating factor (rhG-CSF, 200 μg) and recombinant human interleukin-11 (rhIL-11, 24 million IU) were subcutaneously injected once daily for 2 consecutive days before chemotherapy. Approximately 1 month after admission, the patient developed grade Ⅳ myelosuppression with symptoms of pharyngalgia and dry cough, accompanied by chills and fever. Blood culture was performed, and empirical anti-infective therapy with cefoperazone-sulbactam sodium was administered to cover common potential pathogens. After 3 days, the patient's fever persisted with negative blood culture results. Considering the poor efficacy of the initial empirical anti-infective therapy, cefoperazone-sulbactam sodium was discontinued and switched to imipenem-cilastatin sodium to expand antibacterial spectrum coverage. After another 4 days, the patient's body temperature returned to normal and the pharyngalgia was relieved. The next day, the patient developed grade Ⅲ thrombocytopenia with bleeding risk, and platelet transfusion was given after communication with the patient and his family members. One day later, the patient had fever again, with obvious moist rales audible in both lungs, white pseudomembrane covering the pharyngeal mucosa, and Candida albicans detected in routine stool examination. Fluconazole and sodium chloride injection was added to the regimen subsequently. After that, the degree of myelosuppression was significantly relieved, the neutrophil count returned to the normal range, blood culture result was negative, and the body temperature returned to normal. Imipenem-cilastatin sodium and fluconazole and sodium chloride injection were then discontinued. Conclusion: By focusing on individualized pharmaceutical care, chemotherapy-related adverse reactions can be effectively managed through medication reconciliation and optimization of medication regimens, which reflects the important value of clinical pharmacists in the comprehensive treatment of tumors.
  • Clinical Diagnosis and Treatment Analysis of One Case of Sporotrichosis Treated with Itraconazole Combined with Photodynamic Therapy*1
    LI Shan-shan, WU Min-zhi, XU Ya-ting, XU Yu-xuan, WANG Hong-wei, WANG Xiu-li, LI Jing-jing
    2026, 23(1): 53-55. https://doi.org/10.13493/j.issn.1672-7878.2026.01-010
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    Objective: To analyze the diagnosis and treatment process of a case of sporotrichosis, and provide a reference for the clinical diagnosis and treatment of sporotrichosis. Methods and Results: The patient presented to the hospital due to "rash on the right upper extremity for more than 3 months", with a medical history of diabetes mellitus. The patient had received oral administration treatment with terbinafine, moxifloxacin and doxycycline previously, but no therapeutic effect was achieved. After admission, relevant examinations were completed, and both bacterial culture and nontuberculous mycobacteria (NTM) identification showed negative results. Fourteen days later, the patient reported new-onset rashes with no significant improvement of symptoms. Tissue biopsy and fungal culture were performed on the new rashes, NTM identification was reexamined; meanwhile, oral itraconazole was administered for antifungal therapy. For some thick rashes, pretreatment with carbon dioxide laser was performed first, followed by photodynamic therapy (PDT). After treatment, the patient's rashes were improved without new onset, and partial skin lesions shrank. The patient reported a history of untreated traumatic injury during farm work before the onset of the rash. Based on the trauma history and clinical manifestations, the patient was clinically diagnosed with sporotrichosis, and the second session of PDT was administered. Another 23 days later, the patient's symptoms were significantly improved, and the third session of PDT was performed. Conclusion: Sporotrichosis has various clinical manifestations, which easily leads to diagnostic difficulties, and the awareness of this disease should be raised in clinical practice. For elderly patients, patients with underlying diseases such as diabetes mellitus, or patients with immunosuppressive status, itraconazole combined with photodynamic therapy may have more advantages, which is worthy of further clinical exploration and application.
  • Case Report of Incompatibility between Human Albumin and Cefoperazone-Sulbactam Sodium and Literature Analysis
    WANG Wen-yun, JIN Yan-hong
    2026, 23(1): 56-60. https://doi.org/10.13493/j.issn.1672-7878.2026.01-011
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    Objective: To systematically retrieve the relevant literature on the incompatibility between human albumin and cefoperazone-sulbactam sodium, provide an evidence-based basis for the safety of clinical drug compatibility, and fill the gaps in existing drug package inserts and in vitro compatibility test data. Methods: A clinical case of milky white turbidity developed from clear liquid in the infusion line after sequential infusion of cefoperazone-sulbactam sodium following human albumin administration was reported. Taking this case as the clue, Chinese and English databases were systematically retrieved with search terms including "human albumin compatibility", "cefoperazone sulbactam sodium compatibility" in English and corresponding terms in Chinese, and the relevant literature was summarized and analyzed. Results: A total of 61 literatures were retrieved, and 40 valid literatures were included after screening. The results showed that 4 drugs had definite incompatibility with human albumin, 19 drugs had definite incompatibility with cefoperazone-sulbactam sodium, and there was incompatibility between human albumin and cefoperazone-sulbactam sodium. Conclusion: There is incompatibility between human albumin and cefoperazone-sulbactam sodium. To avoid similar adverse drug events during clinical infusion, it is recommended that medical institutions establish and improve the institutional intravenous drug incompatibility database as soon as possible, integrate it into the doctor's order system to realize active early warning, and strictly standardize line flushing procedures or replace the infusion set when sequential infusion is mandatory.