RESUMO
Objective To analyze the clinical characteristics of pyogenic liver abscess(PLA)and explore the rationality and the duration of antibacterial treatment. Methods The clinical data of patients diagnosed as pyogenic liver abscess in our hospital from January 1,2020 to December 31,2022 were analyzed to explore their clinical characteristics. The rationality of antibacterial treatment was evaluated by setting evaluation criteria. The duration of antibacterial use in different treatment outcomes was counted. Results A total of 89 patients were included in the analysis. The average age was (62.0±15.6) years old, with the male accounting for 61.80%. Diabetes for 53.9% was the most common complication. Among 59 patients (66.3%)with positive culture of pos or blood, 51 cases (57.3%) were Klebsiella Pneumoniaes. Among the empirical and target treatment, 45 cases (50.6%) and 17 cases (28.8%)of antibacterial regimens were evaluated as unreasonable, respectively. Recovery treatment time was (17.0±7.6)d,and actual treatment time was (21.1±7.3) d. Conclusion Diabetes was the most common high-risk factor of PLA, and Klebsiella Pneumoniae was the main pathogenic bacteria. It is necessary to strengthen the management of antibacterial drugs, explore the appropriate duration of antibacterial treatment, and reduce the overuse of antibacterial drugs.
RESUMO
OBJECTIVE To provide reference for safe drug use in patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). METHODS Clinical pharmacists participated in the diagnosis and treatment of a patient with ALK-positive NSCLC who developed bilateral pleural effusion and hemolytic anemia after taking alectinib; regarding symptoms such as pleural effusion and hemolytic anemia in the patient, clinical pharmacists investigated the patient’s history of medication and disease, as well as potential drug interaction; to consider the correlation between the patient’s use of alectinib and the duration of pleural effusion and hemolytic anemia, clinical pharmacists suggested that clinical doctors discontinued alectinib and used reduced dose treatment after the pleural effusion improved, but the patient suffered from bilateral pleural effusion and hemolytic anemia again; after evaluating the correlation between alectinib and bilateral pleural effusion and hemolytic anemia using the Naranjo’s assessment scale, clinical pharmacists recommend permanent discontinuation of alectinib and jointly recommend replacement with ensartinib with clinical physicians. RESULTS Physicians adopted the suggestions of clinical pharmacists. The pleural effusion subsequently regressed and hemolytic anemia improved after replacing the drug. The correlation between alectinib and bilateral pleural effusion and hemolytic anemia was confirmed. CONCLUSIONS Clinical pharmacists participate in pharmaceutical monitoring of ALK-positive NSCLC patients, assist clinical doctors in developing personalized medication recommendations, and ensure the safety of patient medication.