1例注射用美罗培南联合注射用万古霉素致严重骨髓抑制的药学监护

doi:10.19803/j.1672-8629.20220160

中国药物警戒 ›› 2023, Vol. 20 ›› Issue (3): 339-342.
DOI: 10.19803/j.1672-8629.20220160

1例注射用美罗培南联合注射用万古霉素致严重骨髓抑制的药学监护

刘保华^1,2, 沈爱宗², 苏丹^2,*

¹马鞍山市中医院药剂科,安徽马鞍山 243000;
²中国科学技术大学附属第一医院药剂科,安徽合肥 230000

收稿日期:2022-04-14 出版日期:2023-03-15 发布日期:2023-03-17
通讯作者: ^* 苏丹,女,在读博士,主任药师,临床药学及抗感染药物研究。E-mail: dansu@ustc.edu.com
作者简介:刘保华,女,硕士,药师,临床药学。
基金资助:
国家科技重大专项重大新药创制（2020ZX09201-004）；安徽省重点研究与开发计划（202004j07020023）；2018国家卫计委药政司委托研究课题-各级医疗机构用药目录共同性研究（药政[2018]购2号）；安徽省卫生健康软科学研究项目（2020WR0301）。

Pharmaceutical care for a case of severe myelosuppression induced by meropenem injection combined with vancomycin injection

LIU Baohua^1,2, SHEN Aizong², SU Dan^2,*

¹Department of Pharmacy, Ma'anshan Hospital of Traditional Chinese Medicine, Ma'anshan Anhui 243000, China;
²Department of Pharmacy, University of Science and Technology of China First Hospital, Hefei Anhui 230000, China

Received:2022-04-14 Online:2023-03-15 Published:2023-03-17

摘要/Abstract

摘要： 目的提示临床注射用美罗培南联合注射用盐酸万古霉素使用过程中需加以关注可能引起的粒系骨髓抑制不良反应。方法报道1例脑出血术后患者治疗期间发生严重粒系骨髓抑制,通过不良反应相关性分析鉴别该患者粒系骨髓抑制不良反应发生的可能药物。结果患者不良反应严重程度为骨髓抑制程度Ⅳ级,排除患者病情和合并用药情况,判断引起患者严重骨髓抑制的药物为联用的抗菌药物注射用美罗培南和注射用盐酸万古霉素,不良反应相关性评价为“很可能”,立即予以停药并对症处理后患者好转。结论联合使用的注射用美罗培南和注射用盐酸万古霉素引起的Ⅳ级骨髓抑制不良反应报道少见,临床药物治疗过程中应加以识别。

关键词: 美罗培南, 粒细胞减少, 严重骨髓抑制, 万古霉素, 多黏菌素-B

Abstract: Objective To remind clinicians of possible adverse reactions of granulocytic myelosuppression induced by meropenem and vancomycin injections in clinical use. Methods One case of severe granulocytic myelosuppression was reported in a patient after cerebral hemorrhage surgery. Correlation analysis of the adverse reactions was conducted to identify the possible drug responsible for the occurrence of granulocytic myelosuppression in the patient. Results The severity of the adverse reactions was grade IV myelosuppression. The patient's condition and concomitant medication were excluded before the cause of severe myelosuppression was determined to be the combined use of antibacterial meropenem and vancomycin injections. The relevance of adverse reactions was evaluated as “probable”. The drug was immediately discontinued and the patient was improved after symptomatic treatment. Conclusion Adverse reactions of grade IV myelosuppression induced by the combined use of antibacterial meropenem and vancomycin injections are rarely reported and should be identified during clinical drug treatment.

Key words: meropenem, granulocytopenia, severe myelosuppression, vancomycin, polymyxin-B

中图分类号:

R978.1

刘保华, 沈爱宗, 苏丹. 1例注射用美罗培南联合注射用万古霉素致严重骨髓抑制的药学监护[J]. 中国药物警戒, 2023, 20(3): 339-342.

LIU Baohua, SHEN Aizong, SU Dan. Pharmaceutical care for a case of severe myelosuppression induced by meropenem injection combined with vancomycin injection[J]. Chinese Journal of Pharmacovigilance, 2023, 20(3): 339-342.

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1例注射用美罗培南联合注射用万古霉素致严重骨髓抑制的药学监护

Pharmaceutical care for a case of severe myelosuppression induced by meropenem injection combined with vancomycin injection

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