Pharmaceutical care on one juvenile patient using quinolone drugs for tuberculous pleurisy

CHUNYU Liu-shuang; WANG Dong-xiao; GUAN Xi-zhou; ZHU Man; PEI Fei; WANG Wei-lan; TANG Zhi-hui; CAI Le

doi:10.3969/j.issn.1672-8157.2017.01.008

Abstract：One 16-year-old male patient was diagnosed with tuberculous pleurisy. After using isoniazid + rifampin + pyrazinamide for antituberculosis treatment about two months, the patient didn't get obvious improvement. After the consultation of tuberculosis hospital, the patient was given moxilfoxacin and amikacin combined with isoniazid, rifapentine and pyrazinamide. Due to the patient's age (under 18, juvenile), considering the potential damage of joints and cartilages caused by quinolone drugs, the pharmacists suggested stopping moxilfoxacin on the 8th day of hospitalization. This advice was adopted by the physician. However, the situation of this patient did not improve. The patient still felt fatigue, and the temperature maintained at 37.2 ~ 37.3℃.The doctors from tuberculosis hospital held another consultation and insisted the former project, suggesting using quinolone drugs continuously. The pharmacists positively searched the literature, analyzed the cartilage toxicity, the value of quinolones in antituberculosis treatment, and the safety of quinolones among juvenile patients. Combining with the characteristics of the individual patient, the pharmacists analyzed the beneift and risk of using moxilfoxacin in juvenile with doctors, and told the relevant information speciifcally to the patient and his parents. On the 14th day of hospitalization, the patient's parents signed the informed consent, and the project from tuberculosis hospital was used. The patient was discharged from the hospital on the 17th day. The pharmacists continued to follow up the patient for another 5 months. So far, there's no adverse reaction and the patient is still adhering to the treatment. In the near future, the follow-up will be continued.