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  • Research Progress in Hand Sanitizers*1
    CHU Bao, LIU Ze, DONG Yong, PANG Yuan-jin, ZHAO Huan, GUO Hao
    2026, 23(3): 221-224. https://doi.org/10.13493/j.issn.1672-7878.2026.03-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Hand hygiene is a fundamental measure for infection prevention, and the performance of hand sanitizers, serving as the core carrier, directly affects the killing efficacy against pathogenic microorganisms and user compliance. In recent years, research on hand sanitizers has focused on compound synergism, expansion of antiviral spectrum, anti-biofilm performance and green sustainable development. This article systematically reviews the active ingredients and action mechanisms of alcohol-based, quaternary ammonium salt-based, and guanidine-based disinfectants, with emphasis on analysis of the synergistic bactericidal effects of compound systems such as alcohol-chlorhexidine and guanidine salt-quaternary ammonium salt, and synergistic strategies including low-concentration alcohol-silver ions. Meanwhile, it summarizes novel disinfection technologies and sustainable development trends, including photocatalytic disinfection (generation of reactive oxygen species by nano-TiO2/ZnO), biodegradable matrices (chitosan, ε-polylysine), intelligent pH-responsive delivery, and life cycle assessment. In addition, it discusses the microbial tolerance mechanisms represented by the qacA/B efflux pump genes, and points out that rational rotation and combined use are important strategies to slow down the emergence of tolerance. Future research and development of hand sanitizers should focus on the construction of multi-mechanism synergistic systems, the establishment of disinfectant resistance monitoring systems, and the industrial transformation of green and sustainable disinfectants.
  • Preparation and Quality Evaluation of Extemporaneously Compounded TCM Pills from the Suzhou Academy of Wumen Chinese Medicine*1
    ZHU Hui, HUANG Yu-yu
    2026, 23(3): 225-229. https://doi.org/10.13493/j.issn.1672-7878.2026.03-002
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    Objective: To establish the preparation technology of extemporaneously compounded TCM pills from Suzhou Academy of Wumen Chinese Medicine and conduct a retrospective evaluation of their quality, so as to standardize production and ensure product quality. Methods: 30 prescriptions of extemporaneously compounded TCM pills were collected from various departments including Dermatology, Respiratory Medicine, Spleen and Stomach Diseases, and Otorhinolaryngology in 2024, numbered L1 to L30. Referring to the preparation technology of pills in hospital preparations, a retrospective evaluation was performed on the preparation technology and quality of extemporaneously compounded pills, with moisture content, weight variation, disintegration time, and microbial limit test as the test indicators. Results: Based on the preparation technology of pills in hospital preparations, the preparation technology of extemporaneously compounded TCM pills from Suzhou Academy of Wumen Chinese Medicine was established and applied, and samples numbered L1 to L30 were produced. The test results showed that the moisture content of the samples ranged from 3% to 7%, all disintegration times were less than 60 minutes, the results of weight variation and microbial limit tests all met the requirements, and the material balances were all within the reasonable range. Conclusion: The preparation technology parameters of extemporaneously compounded TCM pills fare controllable, and the product quality is stable and reliable. This study provides an experimental basis for establishing a standardized service mode for customized processing of extemporaneously compounded TCM pills from Suzhou Academy of Wumen Chinese Medicine.
  • Anti-infective Therapy and Pharmaceutical Care in a Case of Secondary Bloodstream Infection Following Percutaneous Coronary Intervention in a Patient with Acute Myocardial Infarction*1
    ZHANG Jian-wei, LI Xian-zhou, ZHU Zhao-xia, SONG Ming-hui
    2026, 23(3): 230-234. https://doi.org/10.13493/j.issn.1672-7878.2026.03-003
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    Objective: To analyze the anti-infective therapy and pharmaceutical care process of a patient with acute myocardial infarction (AMI) who developed secondary bloodstream infection after percutaneous coronary intervention (PCI), and to provide a reference for the anti-infective management of similar clinical patients. Methods and Results: A 67-year-old male patient was admitted to the hospital due to "persistent palpitation, chest tightness and precordial pain for 2 hours" and underwent emergency PCI. On the second postoperative day, the patient developed high fever, and blood culture indicated Staphylococcus aureus infection. Cefoperazone-sulbactam sodium was initially administered for anti-infective treatment. Clinical pharmacists successively suggested discontinuing cefoperazone-sulbactam sodium and switching to oxacillin or cefazolin, but the suggestions were not adopted because the patient was concurrently using Guanxinning Injection (whose instructions do not recommend combined use with penicillins) and the physician was concerned that poor infection control would lead to interventional failure. Subsequently, linezolid was added for 3 days, but the body temperature still fluctuated. The physician then adjusted the anti-infective regimen to norvancomycin. Based on the drug susceptibility test results and the patient's renal function, clinical pharmacists recommended adjusting the dosage of norvancomycin and monitoring adverse drug reactions. After 5 days of norvancomycin treatment, the patient developed abnormal liver function, which was considered to be related to norvancomycin. Therefore, the anti-infective drug was switched to oxacillin, and the liver function gradually recovered. The patient had persistent low-grade fever, and multiple blood cultures and pleural effusion cultures were negative. After excluding tuberculosis, human coronavirus OC43 (HCoV-OC43) infection was confirmed by targeted pathogen detection. Since there is no specific medicine for this virus currently, symptomatic treatment was given, and the patient's body temperature returned to normal. Conclusion: Clinical pharmacists optimized the anti-infective regimen based on drug susceptibility test results and renal function, timely detected and managed norvancomycin-related abnormal liver function, and assisted in investigating the cause of persistent fever, which fully demonstrates the value of individualized pharmaceutical care in the treatment of complex infections.
  • Pharmaceutical Care in Anti-infective Therapy of a Patient with Catheter-associated Urinary Tract Infection Caused by Chromobacterium Violaceum
    CHEN Yan-yuan, GUO Jun-fei, ZHENG Min-ling, LAI Wei-ming, LUO Ming-yong
    2026, 23(3): 235-238. https://doi.org/10.13493/j.issn.1672-7878.2026.03-004
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    Objective: To report the anti-infective therapy process of a case of catheter-associated urinary tract infection (CAUTI) caused by Chromobacterium violaceum, and to improve the clinical understanding of this rare bacterium. Methods and Results: A female patient who had an indwelling urinary catheter after extensive total hysterectomy presented with urinary irritation symptoms including frequency, urgency and burning sensation on urination 14 days after discharge. Urinalysis showed pyuria (white blood cells 8 484.30/μL) and bacteriuria (>105 CFU/mL). Two types of bacterial colonies, purplish-black and yellowish-white, were isolated from midstream urine culture, which were confirmed as Chromobacterium violaceum by morphology, biochemical reactions and various technical identification methods. The drug susceptibility test results showed that the strain was resistant to most β-lactam antibiotics such as ampicillin and ceftriaxone, and susceptible to piperacillin-tazobactam sodium, cefepime, carbapenems, aminoglycosides and quinolones. The patient was then prescribed oral levofloxacin (0.2 g, q12h) for anti-infective therapy. After 2 weeks, the patient's urinary irritation symptoms resolved, urine culture turned negative, and no recurrence was observed during 4 months of follow-up. Conclusion: Chromobacterium violaceum is a rare but severe pathogen causing CAUTI, which poses a particular threat to immunocompromised postoperative patients. Early and accurate identification and treatment with susceptible antibacterial drugs based on drug susceptibility results are the key to successful diagnosis and treatment. Standardized prevention of CAUTI should be strengthened, and microbiology laboratories should improve the capability to identify this bacterium.
  • Analysis of Adverse Drug Reactions of a Patient with Mental Disorder Induced by Fluconazole*1
    ZHAO Qing-bo, XIE Pei-tao
    2026, 23(3): 239-242. https://doi.org/10.13493/j.issn.1672-7878.2026.03-005
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    Objective: To analyze the clinical diagnosis and treatment process of a case of mental disorder induced by fluconazole and sodium chloride injection, and to provide a reference for clinical safe medication and the identification and management of adverse drug reactions. Methods and Results: A 70-year-old male patient was admitted to the hospital due to "recurrent cough, expectoration, wheezing and shortness of breath for more than 10 years, aggravated for 10 days". After admission, fungal infection was suspected, and he was given fluconazole and sodium chloride injection (0.4 g, q24h, intravenous drip) for antifungal therapy, along with methylprednisolone sodium succinate for injection, low molecular weight heparin calcium injection and other treatments. On the 6th day of medication, the patient presented with incoherent speech and nocturnal insomnia. On the 7th day, the symptoms worsened, with visual hallucinations, incoherent speech and disorientation to persons. During the ward round, clinical pharmacists considered that fluconazole induced mental disorder could not be ruled out, and recommended discontinuing the drug while continuing other treatments, which was adopted by the physician. On the 2nd day after drug withdrawal, the patient regained consciousness and no longer presented with mental disorder symptoms. No recurrence of the above symptoms was observed during the 1-month follow-up after discharge. Conclusion: Clinical pharmacists should be alert to the mental disorder potentially induced by fluconazole, especially in elderly patients. Close monitoring of central nervous system reactions is required during the administration of this drug. Once any adverse reaction is suspected to be related to fluconazole, the drug should be discontinued promptly, and continued use after dose reduction is not recommended. In addition, the dosage of fluconazole should be strictly controlled in elderly patients.
  • Analysis of Two Cases of Severe Photosensitivity Reactions Induced by Voriconazole
    YE Qiao, MAO Xiao-hong
    2026, 23(3): 243-246. https://doi.org/10.13493/j.issn.1672-7878.2026.03-006
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    Objective: To analyze the diagnosis and treatment process of two cases of severe photosensitivity reactions induced by voriconazole, and to provide a reference for the safe use of voriconazole in clinical practice. Methods and Results: Case 1 was admitted to the hospital due to "fever for 5 days and chest tightness for 3 days" and was clinically diagnosed with invasive pulmonary aspergillosis, for which oral voriconazole was administered. On the 13th day of medication, the patient developed scattered generalized erythema and papules accompanied by pruritus. Anti-allergic treatment was given but ineffective, and the drug was not discontinued. On the 21st day of medication, the skin lesions continued to worsen. After drug discontinuation and anti-allergic treatment, the patient still developed high fever, extensive generalized flushing and erosion. The patient was then treated with pulse therapy consisting of methylprednisolone (40 mg, q12h, 4 days; 30 mg, q12h, 3 days; 40 mg, q24h, 11 days) plus human immunoglobulin (20 g, q24h, intravenous injection, 3 days), and the generalized rash gradually subsided. Case 2 was admitted to the hospital due to "recurrent dizziness for 3 months and intracranial space-occupying lesion" and was clinically diagnosed with intracranial aspergillus infection, for which oral voriconazole was administered. On the 32nd day of medication, the patient developed red papules accompanied by itching on the face, neck and lower extremities. The initial anti-allergic treatment was ineffective, and the rash continued to progress after discontinuation of voriconazole, accompanied by mucosal erosions. The patient improved after pulse therapy with methylprednisolone (80 mg, once; 40 mg, q24h, 1 day; 20 mg, q24h, 5 days) plus human immunoglobulin (20 g, q24h, intravenous injection, 5 days). Conclusion: Severe photosensitivity reactions induced by voriconazole tend to be overlooked and are often exacerbated due to delayed recognition and discontinuation. During clinical use, whole-process medication monitoring should be strengthened, including risk assessment prior to treatment, close observation of skin symptoms during medication, timely serum concentration monitoring, and medication education for patients, especially emphasizing strict sun protection.
  • Pharmaceutical Care of a Pneumonia Patient with Drug-induced Hypersensitivity Syndrome Caused by Antibacterial Drugs
    WANG Xin-ran
    2026, 23(3): 246-249. https://doi.org/10.13493/j.issn.1672-7878.2026.03-007
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    Objective: To analyze the diagnosis and treatment process and pharmaceutical care key points in a case of drug-induced hypersensitivity syndrome (DIHS) caused by antibacterial drugs, and to provide a reference for the safe clinical use of β-lactam antibiotics and the early identification and intervention of DIHS. Methods and Results: A 76-year-old patient was admitted to the hospital due to pneumonia and was given piperacillin-tazobactam for anti-infective therapy. After 14 days of medication, the patient developed rash, fever and elevated eosinophils. Clinical pharmacists considered it a drug allergic reaction, recommended discontinuing the suspected drug and avoiding the use of cross-allergic β-lactam antibiotics. After drug withdrawal, the patient still developed high fever, persistent elevation of eosinophils and renal impairment, which met the diagnostic criteria for DIHS. Clinical pharmacists recommended initiating glucocorticoid combined with human immunoglobulin therapy and discontinuing anti-infective drugs. After treatment, the patient's rash, fever and eosinophil levels gradually improved. During the treatment, gastrointestinal bleeding occurred. Clinical pharmacists analyzed that it might be related to the combination of glucocorticoids and anticoagulants, and recommended discontinuing glucocorticoids and administering somatostatin and proton pump inhibitors. The bleeding was then controlled. After gradual tapering of glucocorticoids and symptomatic supportive treatment, the patient's rash subsided and renal function improved. Conclusion: The early manifestations of DIHS are atypical and easily misdiagnosed as aggravated infection. By sorting out the medication history and identifying key clues such as elevated eosinophils and rash, clinical pharmacists can assist in early diagnosis, avoid the use of cross-allergic drugs, optimize the treatment regimen of glucocorticoids and immunoglobulin, and provide early warning and intervention for hormone-related complications, thus ensuring the medication safety of patients.
  • Efficacy and Safety Evaluation of Colistin Sulfate in Treatment of Patients with HAP/VAP
    YAO Chao-fan, ZHOU Xiao, CHEN Tian, BIAN Ya-hong, HAO Mao-juan, CHENG Fei-fei
    2026, 23(3): 258-264. https://doi.org/10.13493/j.issn.1672-7878.2026.03-010
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    Objective: To evaluate the efficacy and safety of colistin sulfate (CS) in the treatment of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP), and analyze the factors influencing its therapeutic effect, so as to provide a reference for promoting the rational use of CS. Methods: A total of 51 patients with HAP/VAP who received CS treatment in Xinyi People's Hospital from January 2023 to June 2025 were selected as study subjects. Clinical data of the patients were collected to evaluate the efficacy and safety of CS for HAP/VAP. Results: A total of 51 patients were included, including 35 males (68.63%) and 16 females (31.37%), with an average age of (66.2±12.0) years. Microbiological culture results showed that 95 strains of pathogenic bacteria were detected from 49 patients. The top 5 pathogenic bacteria in terms of detection number were Acinetobacter baumannii (29 strains, 30.53%), Pseudomonas aeruginosa (20 strains, 21.05%), Klebsiella pneumoniae (13 strains, 13.68%), Staphylococcus aureus (4 strains, 4.21%) and Escherichia coli (4 strains, 4.21%). Regarding the administration regimen, 45 patients received intravenous administration, 36 patients received aerosol inhalation, and 30 of them received combined intravenous and aerosol inhalation. Clinical efficacy evaluation showed that 25 patients responded to treatment, with an overall effective rate of 49.02%. Univariate analysis showed that the therapeutic effect might be related to Glasgow Coma Scale (GCS) score, concomitant coronary atherosclerotic heart disease, concomitant chronic obstructive pulmonary disease (COPD), admission department, mechanical ventilation, vasoactive drug treatment, aerosol therapy, antifungal therapy, detection of Escherichia coli, and serum creatinine level (all P<0.05). Multivariate logistic regression analysis showed that admission to ICU (OR=13.388, 95%CI 3.395~52.792, P=0.001) and GCS score ≤8 (OR=4.708, 95%CI 1.051~21.083, P=0.043) were independent risk factors for treatment failure. In terms of safety, a total of 15 patients experienced adverse drug reactions (ADRs), including 8 cases of elevated serum creatinine, 7 cases of elevated transaminase, and 3 cases of elevated bilirubin. Conclusion: CS can be used as an option for anti-infective treatment in patients with HAP/VAP. Admission to ICU and GCS score ≤8 are independent risk factors for treatment failure, suggesting that enhanced efficacy monitoring and individualized dosage regimen adjustment should be implemented for critically ill patients and patients with consciousness disturbance. Large-sample, multicenter prospective studies are still needed in the future to further verify the efficacy and safety of colistin sulfate in real-world clinical practice.
  • Clinical Practice Analysis of Improving Pathogen Detection Submission Rate before Antibacterial Therapy Based on DMAIC Model*1
    XIONG Yi-ran, GAO Lu-lu, JI Na
    2026, 23(3): 265-270. https://doi.org/10.13493/j.issn.1672-7878.2026.03-011
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    Objective: To standardize the clinical practice of pathogen detection submission before antibacterial therapy, and provide a theoretical basis for optimizing the management of rational antibacterial drug use in hospitals. Methods: All inpatients who received therapeutic antibacterial drugs in Shanghai TCM-Integrated Hospital were selected as study subjects. 4 836 inpatients from January to June 2023 were included in the pre-intervention group, and 5 032 inpatients from January to June 2024 were included in the post-intervention group. Management measures based on the Define-Measure-Analyze-Improve-Control (DMAIC) model were implemented, and the changes in indicators before and after the intervention were compared. Results: After the intervention, the pathogen detection submission rate before antibacterial therapy in inpatients was significantly increased (P<0.05); the submission rate of restricted-use antibacterial drugs was significantly improved (P<0.05), and the submission rate of special-use antibacterial drugs was also increased (P<0.05); no significant change was observed in the pathogen detection submission rate related to hospital-acquired infection diagnosis (P<0.05). Conclusion: The application of the DMAIC methodology can effectively promote the standardization of pathogen detection submission before antibacterial therapy, and this quality management tool has a significant effect on improving the submission rate.