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  • 2021 Volume 18 Issue 5
    Published: 25 May 2021
      
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  • Research Progress on Pharmacologic Effects of Matrine on Blood Vessels
    ZHANG Ming-fa, SHEN Ya-qin
    2021, 18(5): 619-623. https://doi.org/10.13493/j.issn.1672-7878.2021.05-001
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    Matrine not only could counteract the damage of vascular endothelial cells induced by bacterial endotoxin, ischemia reperfusion and fibrinogen degradation products, but also could inhibit the proliferation and apoptosis of vascular smooth muscle cells induced by platelet-derived growth factor, angiotensin II and oxidized low density lipoprotein (ox LDL), and even could resist the advanced glycation end products to induce the transformation of vascular smooth muscle cells to contractile phenotype, thereby producing vascular protection and improving vascular function. Matrine has a hypotensive effect by blocking ganglia, improving cholinergic nerve action and promoting nitric oxide （NO） synthesis and release as well as improving cardiac function. In addition, matrine could inhibit monocrotaline induced pulmonary hypertension and pulmonary vascular remodeling, as well as high-fat diet induced atherosclerosis. In this paper, the literatures on the pharmacological effects of matrine on blood vessels have been reviewed, and the research progress of matrine has been analyzed.
  • Analysis on Current Situation and Related Factors of Potential Inappropriate Medication in 82 Elderly Inpatients in a Hospital and Countermeasures
    CHEN Yu-hong, TANG Ye-qiu
    2021, 18(5): 628-633. https://doi.org/10.13493/j.issn.1672-7878.2021.05-003
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    Objective: To investigate the current situation of potentially inappropriate medications (PIM) in elderly inpatients in a hospital, and to analyze the related factors influencing PIM. Methods: The medical records of 82 hospitalized patients aged ≥60 years old from July to December in 2020 were collected. Based on the Criterion for the PIM in the elderly in China (2017 Edition), the contents of inappropriate drug use were statistically analyzed, and independent sample (t test) and Pearson correlation analysis were used to determine the risk factors for PIM. Results: In 82 elderly patients, there were between 2 and 8 kinds of co-morbidity diseases and 1 and 19 kinds of therapeutic drugs. In them, 52 patients greater than or equal to 1 PIM were detected, accounting for 63.41%, and 97 PIM were involved. 11 cases of disease-related PIM accounted for 13.41%; PIM involves 19 drugs in 11 categories such as nervous system and endocrine system (insulin, estazolam and other drugs rank in the TOP). Compared with non-PIM group, PIM group had older age (76.0 years vs 72.1 years), longer hospital stay (11.1 days vs 6.7 days), co-morbidity diseases (3.5 vs 2.4 kinds) and more drug types (7.9 vs 4.4 kinds), and the difference between the two groups was statistically significant (P<0.05). There was a strong positive correlation between the occurrence of PIM and the number of diseases and types of drugs (P<0.01). Conclusion: The incidence of PIM in elderly inpatients was higher, and the same disease and the number of drugs used were the risk factors for PIM. Hospital management departments should adopt information means and relevant standards to strengthen pre-intervention. Doctors and pharmacists should pay attention to PIM, reduce the amount of drug usage, and pay close attention to the individualized administration of drug supervision as well as care for patients with multiple diseases and drugs, so as to ensure medication safety and rationality of drug use in elderly patients.
  • Analysis on Distribution and Drug Resistance of Pathogenic Bacteria Infected in 663 Patients of ICU in a Hospital From 2016 to 2019*1
    FANG Hai-hong, ZENG Zhen-hua
    2021, 18(5): 634-639. https://doi.org/10.13493/j.issn.1672-7878.2021.05-004
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    Objective: To analyze the distribution and drug resistance characteristics of pathogenic bacteria in ICU patients from 2016 to 2019, and to provide reference for the formulation of antibacterial medication program. Methods: The relevant data of etiological detection in the medical records of 663 patients with severe infection admitted to ICU from January 2016 to August 2019 were selected, and the culture, distribution and drug sensitivity test results of the pathogens in each specimen of the patients were statistically analyzed; the distribution of the pathogens and the characteristics of their resistance to different antibacterial agents were analyzed. Results: In the 663 patients with severe infection, 1 055 strains of pathogenic bacteria were isolated, of which 55.73% were Gram-negative bacilli (Acinetobacter), 22.75% were Gram-positive cocci (Enterococcus faecium) and 21.52% were fungi (Candida albicans).Drug sensitivity test results showed that most of the pathogens were multi-drug resistant organism (MDRO), MDRO and Pan-drug resistant Acinetobacter to ampicillin, aztreonam, cefazolin resistance rate were all up to 100.00%, Pseudomonas aeruginosa to ampicillin, cefazolin, amoxicillin-clavulanate, ampicillin-sulbactam resistance rate was up to 100.00%. Conclusion: hospital ICU drug-resistant bacteria infection had increased tendency, with acinetobacter and methicillin-resistant coagulase negative Staphylococcus infection was given priority to, this may be related to new antibacterial drugs (such as tigecycline and so on) increase in the number of widely used and invasive operation; clinically, drug resistance detection of pathogenic bacteria should be strengthened, and rational use of antibacterial agents should be used to curb the generation of drug-resistant strains
  • Influence of Pathogen Culture and Drug Sensitivity Results on Antimicrobial Medi-cation in Postoperative Airway Fistula Secretion of Patients with Laryngeal Cancer
    PENG Dan
    2021, 18(5): 639-643. https://doi.org/10.13493/j.issn.1672-7878.2021.05-005
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    Objective: To analyze the influence of pathogen culture and drug sensitivity test results on antibacterial medication in postoperative airway fistula secretion of patients with laryngeal cancer. Methods: The clinical data of 74 patients with laryngeal cancer who received surgical treatment from May 2017 to January 2020 were selected to analyze the results of pathogen culture and drug sensitivity test in their secretions, as well as the usage of antibacterial drugs. Results: Among the 74 patients' secretions, 38 patients had positive samples (the positive rate was 51.35%) and 38 strains of pathogenic bacteria were detected, including 14 strains of Gram-positive bacteria and 24 strains of Gram-negative bacteria, all of which were multi-drug resistant. The drug resistance rates of Gram-negative bacteria were high, while those of Gram-positive bacteria were relatively low. After operation, 30 patients were treated with antibacterial drugs alone, accounting for 40.54%, and 44 patients were treated with dual drugs, accounting for 59.46%. Conclusion: The incidence of postoperative infection in patients with laryngeal cancer surgery was relatively high, and the infective pathogenic bacteria were mainly Gram-negative bacteria with extensive drug resistance. Therefore, two-combination antibacterial drug therapy was adopted, and antibacterial drug therapy with low drug resistance rate and wide antibacterial spectrum was selected in combination with drug sensitivity test results to ensure its curative effect.
  • Analysis on Distribution and Drug Resistance of Pathogenic Bacteria in 350 Patients of Urinary Calculi with Urinary Tract Infection
    ZHOU Hang, WU Shi-ping, XIE Ming, JIAN Yue-huang, HU Dong-hua, LIU Yue-hui
    2021, 18(5): 644-647. https://doi.org/10.13493/j.issn.1672-7878.2021.05-006
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    Objective: To investigate the distribution characteristics and drug resistance to pathogenic bacteria in urinary calculi patients with urinary tract infection. Methods: Clinical data of 350 patients with urinary calculi admitted to our hospital from January 2019 to June 2020 were selected. The results of bacterial culture and drug sensitivity test in clean middle urine samples were counted, and the distribution characteristics of pathogenic bacteria and drug resistance to urinary tract infection were analyzed. Results: Of the 350 patients with urinary calculi, 79 patients developed urinary tract infection (22.57%).In the urine samples of patients with urinary tract infection, 79 strains of pathogenic bacteria were detected, in which Gram-negative bacteria (68.35%), Gram-positive bacteria (17.72%), fungi (11.39%) and Ureaplasma infection (2.53%) were detected. Based on the results of drug sensitive test of Gram-negative bacterium E. coli to piperacillin, ampicillin, amoxicillin, ticarcillin, moxifloxacin and ciprofloxacin, have higher percentages of compound sulfamethoxazole (greater than 70%), of the imine southern culture, E.faecalis to amoxicillin clavulanic acid potassium, the sensitive rate of amikacin was high (greater than 85%); Enterococcus faecium in Gram-positive bacteria to penicillin, gentamicin, ampicillin and oxacillin, have higher percentages of schering (greater than 70%), with nitrofurantoin, vancomycin, ampicillin-sulbactam sodium, piperacillin-tazobactam sodium, linezolid, levofloxacin, moxifloxacin sensitive rates were high (greater than 78%). Conclusion: The pathogens of urinary calculi accompanied by urinary tract infection were mainly caused by Gram-negative bacteria, some patients were caused by Gram-positive bacteria and fungi, and a few patients were caused by ureaplasma infection. In order to ensure good antibacterial effect, antibacterials should be selected reasonably based on the results of drug sensitivity test.
  • Analysis on Serotype Distribution and Drug Resistance of Haemophilus Influenzae, Moraxella Catarrhalis and Streptococcus Pneumoniae in 6 312 Pre-school Children
    HU Hai-hui
    2021, 18(5): 648-651. https://doi.org/10.13493/j.issn.1672-7878.2021.05-007
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    Objective: To analyze the serotype distribution and drug resistance of Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae in pre-school children in Luoyang area. Methods: The medical records of 6 312 children under 6 years old with respiratory tract infection in our hospital from January 2017 to December 2019 were selected to analyze the influence of pathogen culture, serotype identification and drug sensitivity test results on drug use. Results: 8 936 strains of pathogenic bacteria were isolated from the sputum samples of 6 312 children, including 3 802 strains of Haemophilus influenzae (42.54%), 2 463 strains of Moraxella catarrhalis (27.56%), 1 346 strains of Streptococcus pneumoniae (20.00%) and 1 483 strains of other strains (9.90%). The serotypes of Streptococcus pneumoniae were mainly 19A (30.87%) and 6A (25.50%), with the percent vaccine coverage rate (PVC 7) of 57.16%, PVC 11 of 60.01% and PVC 13 of 75.00%. The resistance rates of Haemophilus influenzae to trimethoprim-sulfamethoxazole and ampicillin were high, but no resistance to ceftriaxone, ceftazidime, cefotaxime and meropenem. The resistance rates of Moraxella catarrhalis to azithromycin, erythromycin and clarithromycin were high, but no resistance to amoxicillin clavulanate. Streptococcus pneumoniae showed higher resistance rates to clindamycin, erythromycin, tetracycline and trimethoprim-sulfamethoxazole, but no resistance to non-oral penicillin and vancomycin. Conclusion: Luoyang district preschool children Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae infection, pathogenic bacteria is given priority to with Haemophilus influenzae, followed by card (bacteria, infection of Streptococcus pneumoniae, Streptococcus pneumoniae serotype classification is given priority to with 19 a, 6 a, PVC 13 coverage is higher, and Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae of cefotaxime no drug resistance, and clinical based on the drug sensitive test results, a reasonable choice of antibacterial drug treatment, to ensure its clinical efficacy.
  • Rationality Analysis on Toxic Traditional Chinese Medicine Used in 1 089 Prescriptions of Traditional Chinese Medicine Decoction Pieces in a Hospital
    JIN Qi-zhong, ZHANG Jie, SHI Yong-qiang
    2021, 18(5): 652-655. https://doi.org/10.13493/j.issn.1672-7878.2021.05-008
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    Objective: To analyze the usage and rationality of toxic traditional Chinese medicine in out-patient prescriptions of Traditional Chinese medicine (TCM) in order to provide reference for clinical safety and rational usage of toxic traditional Chinese medicine. Methods: A total of 3 374 TCM prescriptions were collected from outpatients in our hospital from July to December 2016, and the use of toxic TCM prescriptions and its rationality were statistically analyzed. Results: In 3 374 TCM prescriptions, 1 089 prescriptions of toxic TCM prepared pieces and 22 kinds of toxic and minor toxic TCM prescriptions were involved. Department of Oncology, followed by Department of Traditional Chinese Medicine and Department of Cardiology. In the prescriptions, the single prescription containing 1 kind of toxic Chinese herbal medicine was the most, followed by the prescription containing 2 kinds of toxic Chinese herbal medicine, and then the prescription containing 3 kinds or more of toxic Chinese herbal medicine was less. Aconiti Lateralis Radix Praepapata is the most widely used traditional Chinese medicine. Conclusions: The use of toxic TCM in hospital is very common, so the administrative department of hospital should formulate "the use and management norms of toxic TCM decoction pieces" to avoid the occurrence of adverse accidents, so as to ensure the safe usage of toxic TCM decoction pieces for patients.
  • Analysis on Carbapenem-resistant Enterobacteriaceae Bacteria Clinical Distribution and Drug Resistance of 158 Inpatients' Specimens
    Lou Hong
    2021, 18(5): 655-659. https://doi.org/10.13493/j.issn.1672-7878.2021.05-009
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    Objective: To analyze the clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae bacteria in 158 inpatients' specimens. Methods: A total of 158 inpatients from March 2018 to March 2020 were selected as the subjects. Samples were collected and bacteria were cultured according to the national clinical laboratory operating procedures, then the types and department distribution of pathogenic bacteria were recorded. The drug resistance rate of pathogenic bacteria was analyzed with automatic biochemical analyzer. Results: A total of 185 strains of carbapenem-resistant enterobacteriaceae bacteria were detected in 158 inpatients' samples. Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli were the top three pathogenic bacteria, accounting for 70.89%, 13.29% and 8.23% respectively. The department distribution of carbapenem-resistant enterobacteriaceae bacterial was wide, and the top three were intensive care unit (ICU), encephalopathy department and respiratory department, accounting for 50.00%, 19.62% and 7.59%. The drug resistance rate analysis of the main carbapenem-resistant enterobacteriaceae showed that the top three resistance rate drugs of Klebsiella pneumoniae were meropenem, ampicillin and amoxicillin-clavulanate potassium( accounting for 100.00%, 99.11% and 97.32%). The top resistance rate drugs of Enterobacter cloacae were ampicillin, cefazolin, amoxicillin-clavulanate potassium and meropenem, all of which were 100.00%. Conclusions: Drug resistance of carbapenem-resistant Enterobacteriaceae bacteria is serious, and its' main distributed deparement is ICU. Different departments of the hospital should strengthen joint intervention and control, thus using antibacterial agents rationally and reducing the infection rate of such bacteria.
  • Influence of Prescription Checking and Infusion Process Management Optimization on Promoting Rational Drug Use in Emergency Pharmacy in a Hospital
    HAN Qiang, HANG Yong-fu, YU Fai-kang, ZHU Jian-guo
    2021, 18(5): 660-664. https://doi.org/10.13493/j.issn.1672-7878.2021.05-010
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    Objective: To optimize the management method of prescription checking and infusion process in hospital emergency pharmacy and to analyze its influence on promoting rational drug use. Methods: After the emergency pharmacy was set next to the infusion center and the prescription checking software of the emergency pharmacy was embedded in the hospital HIS, the emergency medical orders/prescriptions from March 2019 to March 2020 were automatically monitored and reviewed, and the rationality and unreasonable reasons of its automatic mechanical dousing, pharmacists' dispensing and patients' infusion process management were analyzed. Results: Of the 186 150 emergency medical orders, 219 were unreasonable (the unreasonable rate was 0.12%), which decreased by 22.83% compared with 269 before optimization. Among them, 85 cases of unsuitable solvent selection accounted for 38.81%, 20 cases of adverse drug interactions accounted for 9.13%, 79 cases of unsuitable drug administration frequency accounted for 36.07%, and 35 cases of unsuitable drug administration route accounted for 15.98%. Zero contact between patients and drugs might avoid drug damage. Patients' satisfaction with waiting time, waiting way, waiting environment and infusion process increased by 10.71%, 13.09%, 8.33% and 13.41%, respectively. The phenomenon of "misallocation" and "omission" in dispensing drugs was basically eliminated. Conclusion: The optimization of prescription checking and infusion process management in hospital emergency pharmacy promotes rational drug use, eliminates the occurrence of "mismatching" and "missing" in dispensing drugs so as to ensure the quality and safety of infusion drugs, and also promote safety and rationality of drug use.
  • Rationality Analysis on Anti-infective Medication in a Case of Adult Adenovirus Severe Pneumonia with Respiratory Failure
    WAN Jun, WU Feng, HU Qi, CUI Jie, WU San-lan, SHUAI Shi-yuan, HUANG Yi-fei
    2021, 18(5): 665-671. https://doi.org/10.13493/j.issn.1672-7878.2021.05-011
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    Objective: To analyze the rationality of anti-infective medication in a case of adult severe adenovirus pneumonia with respiratory failure. Methods: A case of adult severe adenovirus pneumonia with respiratory failure was treated with antibacterial de-escalation therapy, antiviral therapy and immunomodulatory therapy. The whole process of anti-infective medication was analyzed, and the clinical efficacy and rationality of medication was evaluated. Results: Severe pneumonia with type I respiratory failure caused by adenovirus developed rapidly and was cured and discharged after combined treatment with a variety of antibacterials and immunomodulators with obvious curative effect. Conclusion: Immune regulation therapy should be supplemented with anti-infection therapy in patients with severe pneumonia, which could improve the clinical efficacy.
  • Analysis on Distribution and Resistance of Enterobacteriaceae Bacteria in 5 General Hospitals in Songjiang District of Shanghai from 2018 to 2019*1
    ZHANG Tian-tian, WANG Hui-feng, ZHANG Feng, JIANG Jun-fei, YUAN Xu, LI Zhi-xiao, WANG Hong, YANG Zhi-fang, LI Yu-ling, QIU Lei
    2021, 18(5): 671-675. https://doi.org/10.13493/j.issn.1672-7878.2021.05-012
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    Objective: To analyze the distribution and drug resistance monitoring results of Enterobacteriaceae bacteria in 5 general hospitals in Songjiang District of Shanghai from 2018 to 2019, and to provide reference for rational usage of antibacterial drugs. Methods: The detection results of various samples of Enterobacteriaceae bacteria screened from 5 general hospitals in Songjiang District from January 1, 2018 to December 31, 2019 were collected, and the distribution of Enterobacteriaceae bacteria and the characteristics of drug resistance to different antibacterials were analyzed. Results: 4 413 strains of Enterobacteriaceae bacteria were screened from all kinds of samples in 5 general hospitals from 2018 to 2019, in which the ESBLs detection rates of Escherichia coli and Klebsiella pneumoniae were 47.11% and 19.91%, respectively. Enterobacteriaceae bacteria (such as Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Serretia and Morganella) had a high susceptibility rate to carbapenems, but a few resistant strains appeared. The drug resistance rates of Escherichia coli to meropenem and imipenem were 0.30% and 0.30%, respectively, while those of Klebsiella pneumoniae to meropenem and imipenem were 13.10% and 4.87%, respectively. Conclusions: The drug resistance monitoring data of Enterobacteriaceae bacteria in 5 general hospitals in Songjiang District from 2018 to 2019 tends to be stable overall, but the situation is serious. The hospital should strengthen the monitoring of bacterial resistance, disinfection management and infection prevention and control, so as to avoid the drug resistance of Enterobacteriaceae bacteria.
  • Analysis on Distribution and Resistance of Non-fermentative Gram-negative Bacilli in 5 General Hospitals in Songjiang District of Shanghai from 2018 to 2019
    YUAN Xu, JIN Guo-fang, WANG Hong, QIU Lei, YANG Zhi-fang, ZHANG Tian-tian, JIANG Jun-fei, LI Ming-zhong
    2021, 18(5): 676-679. https://doi.org/10.13493/j.issn.1672-7878.2021.05-013
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    Objective: To analyze the distribution and drug resistance of Non-fermentative Gram-negative Bacilli (NFGNB) in 5 general hospitals in Songjiang District of Shanghai from 2018 to 2019, and to provide reference for rational usage of antibacterials in this District. Methods: All kinds of specimens collected from 5 general hospitals in Songjiang District from January 1, 2018 to December 31, 2019 were collected. The clinical distribution characteristics and the source of samples of NFGNB (including Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, Burkholderia cepacia and other strains) were summarized. The distribution characteristics of the NFGNB and their resistance to different antibacterials were analyzed. Results: During the two years, 1 364 strains of NFGNB were clinically isolated, and the component ratio of them from high to low was Pseudomonas aeruginosa (42.52%), Acinetobacter baumannii (36.22%), Stenotrophomonas maltophila (5.13%) and Burkholderia cepacia(2.57%). The drug susceptibility results showed that the drug resistance rates of Pseudomonas aeruginosa to cotrimoxazole and ampicillin sulbactam sodium were higher than 75%, and the drug resistance rates to meropenem and imipenem were 9.83% and 8.79%, respectively. The drug resistance rates of Acinetobacter baumannii to tigecycline were less than 5%, to meropenem and imipenem were 39.27% and 37.45%, respectively, to gentamicin and amicacin were 30.97% and 30.36%, respectively, and to minocycline were 9.72%. Conclusion: Five comprehensive hospitals clinical NFGNB infection to be reckoned with, and to strengthen the routines of medical apparatus and instruments had to disinfected, bacterial drug resistance surveillance and hospital infection prevention and control measures, curbing its pathogenic bacteria resistance and reduced the occurrence of nosocomial infection.
  • Analysis on Distribution of 2 836 Strains of Bloodstream Infection Pathogens and Drug Resistance of Main Pathogenic Bacteria in a Hospital from 2017 to 2019
    YAN Cai-xia
    2021, 18(5): 679-682. https://doi.org/10.13493/j.issn.1672-7878.2021.05-014
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    Objective: to analyze the distribution of 2 836 strains of bloodstream infection pathogens and drug resistance of main pathogenic bacteria in in a hospital from 2017 to 2019, and to provide guidance for prevention and control of the infection. Methods: The medical records of 2 400 patients with blood culture positive samples of bloodstream infection admitted to our hospital from January 2017 to December 2019 were selected to analyze the distribution of common pathogenic bacteria and the characteristics of drug resistance. Results: In 2 400 patients with positive blood culture samples, 2 836 strains of pathogenic bacteria were isolated, of which 53.14% were Gram-negative bacteria, 39.07% were Gram-positive bacteria, 4.72% were fungi and 87 were anaerobic bacteria (3.07%). Subspecies of Staphylococcus Homi in Gram-positive bacteria accounted for 10.23%, and Escherichia coli in Gram-negative bacteria accounted for 21.93%. The annual distribution of 2 836 pathogenic strains was 29.80% in 2017, 40.40% in 2018 and 29.80% in 2019. The results showed that the resistance of human subspecies of Staphylococcus hominis to oxacillin was the highest (up to 91.03%), and the resistance of Escherichia coli to ampicillin was the highest (up to 75.08%). Conclusion: Bloodstream infections disease pathogen of infection with Gram-negative bacteria infection is given priority to, including gram-positive bacteria in Staphylococcus subspecies and gram negative bacteria Escherichia coli,in the prevalence of multi-drug resistance were higher, clinical pathogen monitoring should be strengthened, and the main pathogenic bacteria should rationally use antibacterial drugs based on the results of the drug susceptibility, to ensure its clinical efficacy.
  • Therapeutic Drug Monitoring of Vancomycin in a Hospital from 2015 to 2020
    FU Xiang-jun, XIAO Jian, WANG He-fang, LAO Xing-gang, LIN Liang-mo
    2021, 18(5): 737-741. https://doi.org/10.13493/j.issn.1672-7878.2021.05-031
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    Objective: To review and analyze the situation and trend of vancomycin therapeutic drug monitoring in Hainan General Hospital from 2015 to 2020 so as to provide reference for rational clinical use of vancomycin. Methods: Patients, undergoing therapeutic drug monitoring of vancomycin from 2015 to 2020, were selected. The department distribution and vancomycin trough concentration distribution of patients, the incidence of acute kidney injury, and the distribution of AUC0~24 h/MIC were collected and analyzed. Results: The number of patients and departments undergoing vancomycin therapeutic drug monitoring increased gradually. The total standard-reaching rate of vancomycin trough concentration was 39.36%（581/1 476）; the incidence of acute kidney injury was 10.65% （59/554）. AUC0~24 h/MIC monitoring was carried out in 83 patients infected with drug-resistant gram-positive bacteria, and the total standard-reaching rate was 34.45%; The standard-reaching rate of AUC0~24 h/MIC was 95.00% when the vancomycin trough concentration was 15~20 mg/L.Conclusion:The therapeutic drug monitoring of vancomycin in the hospital has been initially standardized and normalized. The next step is to standardize the detection of vancomycin's MIC and calculate the accurate AUC0~24 h/MIC so as to guide the rational use of vancomycin in clinic.
  • Pharmaceutical Care of Clinical Medication of First Septicemia Patient Caused by Campylobacter Fetus in a Hospital
    XUE Ying-yan, LIU Ying, CHEN XUE-ming
    2021, 18(5): 741-744. https://doi.org/10.13493/j.issn.1672-7878.2021.05-032
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    Objective: To explore the clinical diagnosis, treatment and the process of pharmaceutical care of first septicemia patient caused by Campylobacter Fetus (CF), and to provide reference for the rational clinical medication of septicemia patient caused by CF. Methods: Through the clinical pharmaceutical consultation and pharmaceutical care practice of the first case of septicemia caused by CF admitted to the hospital, the feasibility of the adjustment of anti-infection treatment plan, the monitoring of adverse drug reactions and the health education in the clinical treatment process were analyzed. Results: Through the treatment of CF patient, the adjustment of anti-infective treatment plan and the process of pharmaceutical care, the patient's indicators finally returned to normal, his condition improved, and he was allowed to leave hospital. Conclusion: Only by constantly improving the level of knowledge of pharmacy and medicine, and participating in the whole clinical process of drug treatment of patients, could clinical pharmacists fully display their own value and role in the process of pharmaceutical care.
  • Practice of Emergency Management Strategy for Oral Pharmacy in a Hospital at the period of COVID-19 and Its Countermeasures*1
    TAO Song, LIU Ling, WEI Xiao-hua
    2021, 18(5): 745-749. https://doi.org/10.13493/j.issn.1672-7878.2021.05-033
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    Objective: To explore the practice of emergency management strategy for oral pharmacy in a hospital at the period of COVID-19 and countermeasures so as to further improve the prevention and control of COVID-19 among pharmaceutical personnel, and effectively guarantee the supply of oral drugs to inpatients in hospitals. Methods: Using the "brainstorming" method, the emergency management strategies for COVID-19 infection prevention and control were developed and implemented. Basic knowledge of COVID-19 were popularized. Training of medical personnel on prevention and control knowledge, and implementation of three-level protection, and medical wastes were properly disposed, implementation of hierarchical management and logistics distribution personnel in the designated area to check and hand over drugs. Nurses in the ward should wear masks, hair caps, goggles and gloves before they can go to the oral pharmacy to pick up inpatients' orders and medicines. Disinfection of drug delivery vehicles to ensure that there is no risk of infection. In addition, a list of medicines for emergency protection under COVID-19 and a management process for dispensing medicines for emergency protection have been established, and online drug advisory services have been provided to hospitals on the Internet. Resultsand Conclusion: The hospital's oral pharmacy provided accurate pharmaceutical care for patients with suspected, fever and confirmed COVID-19, which ensured the implementation of the emergency management strategy and played a positive role in the implementation of the prevention, response, handling and after-care management of public emergencies.