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患者停用莫西沙星后再次出现了结节性红斑,提示该不                                ment of nontuberculous mycobacterial pulmonary disease:
          良反应与莫西沙星的关联性较小,而与 NTM 感染所致                              an  official  ATS/ERS/ESCMID/IDSA  clinical  practice
          皮肤症状关联性较大,且经对症处理后,患者四肢红斑                                guideline[J]. Eur Respir J,2020,56(1):2000535.
          好转。临床药师和医师协商决定停用利福平,换用莫西                           [ 7 ]  KASPER D L,FAUCI A S. 哈里森感染病学[M]. 胡必
                                                                  杰,潘珏,高晓东,主译 . 上海:上海科学技术出版社,
          沙星抗感染,同时予谷胱甘肽保肝治疗并行肝肾功能等
                                                                  2019:578-592.
          监测。换药3 d后,患者的肝功能恢复正常。
                                                             [ 8 ]  LANGE C,BÖTTGER E C,CAMBAU E,et al. Consen‐
          4 结语
                                                                  sus management recommendations for less common non-
              近年来,各种医疗美容术式不断增多,NTM致皮肤                             tuberculous  mycobacterial  pulmonary  diseases[J].  Lancet
                                [1]
          和软组织感染也日趋频繁 。因感染菌种和受累组织不                                Infect Dis,2022,22(7):e178-e190.
          同,其用药种类和疗程也有所差异。NTM由皮肤入侵,                          [ 9 ]  LANGE  C,WAGNER  D.  Pulmonary  disease  caused  by
          播散性感染导致的中枢神经系统受累较为少见,且明确                                less  common  nontuberculous  mycobacteria:new  interna‐
          的MM致中枢神经系统感染病例更为有限,加之目前临                                tional  guidelines[J].  Dtsch  Med  Wochenschr,2022,147
          床尚无统一的治疗标准,故制定个体化抗感染方案尤为                               (17):1114-1121.
          重要。                                                [10]  MAALOULY C,DEVRESSE A,MARTIN A,et al. Coin‐
                                                                  fection of Mycobacterium malmoense and Mycobacterium
              临床药师参与本例 MM 致中枢神经系统感染合并
                                                                  chimaera  in  a  kidney  transplant  recipient:a  case  report
          药物性肝损伤患者的治疗过程,通过追踪其病史及用药
                                                                  and review of the literature[J]. Transpl Infect Dis,2020,22
          史,查阅指南/共识、研究报道等文献资料,结合患者病情
                                                                 (2):e13241.
          和药物作用特点,分析不良反应发生原因,及时调整抗                           [11]  HUANG  M  X,TAN Y  J,ZHANG  X  X,et  al.  Effect  of
          MM药物并针对不良反应进行对症处理,从药学角度协                                mixed  infections  with  Mycobacterium  tuberculosis  and
          助医师完善了临床治疗决策,从而降低了患者的用药风                                nontuberculous  mycobacteria  on  diagnosis  of  multidrug-
          险,提升了治疗效果,为临床个体化用药提供了参考。                                resistant tuberculosis:a retrospective multicentre study in
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          中国药房  2023年第34卷第16期                                              China Pharmacy  2023 Vol. 34  No. 16    · 2017 ·
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