Analysis of anti-infective therapy in a fulminant myocarditis patient under extracorporeal membrane oxygenation
WANG Lu
LUO Can
LIU Dong
Abstract：One 36-year-old female patient was admitted to hospital in ICU due to chest tightness with wheezing for 6 days and aggravation for 2 days, appeared respiratory failure. Clinical diagnosis was fulminant myocarditis. After hospitalization, the patient received the extracorporeal membrane oxygenation therapy to improve cardiopulmonary bypass. But catheter associated infection occurred later. Vancomycin (1 g, q 12 h, ivgtt) with meropenem (1 g, q 8 h, ivgtt) for anti-infective treatment was empirically given to the patient. Clinical pharmacist carried out pharmaceutical care. The serum concentration of vancomycin was abnormal and failed to reach the effective concentration, the effects of extracorporeal membrane oxygenation and explosive myocarditis on drug metabolism were comprehensive analysis, clinical pharmacists suggested to adjust the dosage of vancomycin to 0.5 g, q 6 h, ivgtt and extend meropenem infusion time to 3 h in order to optimize the therapeutic regimen. Moreover, the adverse drug reactions were monitored regularly. The infection gradually subsided, the patient was transferred to the general ward after 6 days treatment and discharged from hospital ifnally.
Keywords：Fulminant myocarditisExtracorporeal membrane oxygenationVancomycinMeropenemTherapeutic drug monitoring
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 284-286 )