目的：探讨临床药师在肺癌患者发生肺炎合并脓胸的降阶梯治疗中开展药学监护的方法，为合理用药提供参考。方法：剖析1例肺癌患者发生肺炎合并脓胸的抗感染降阶梯治疗过程，探讨临床药师如何在患者复杂的病情变化中，在正确的时机提出合理的用药建议。结果：临床药师协助医师制订最佳用药方案，使患者得到了及时、有效的治疗。结论：临床药师应发挥自身优势，与临床医师密切合作，为患者提供个体化药学服务，促进临床合理用药。%OBJECTIVE:To explore the approaches for clinic pharmacist to carry out pharmaceutical care for patient with lung cancer complicating pneumonia and empyema receiving anti⁃infective de⁃escalation therapy for references of rational use of drug. METHODS: Clinic pharmacist� experience with the treatment of one patient with lung cancer complicating pneumonia and empyema receiving anti⁃infective de⁃escalation therapy was analyzed, and the approaches for clinical pharmacist to offer rational medication advices based on patient�s complicated state of illness. RESULTS:Clinical pharmacist�s cooperation with physicians to work out the best therapeutic regimen resulted in timely and effective treatment for patient. CONCLUSIONS:Clinical pharmacist should bring his advantages into full play and cooperate well with clinicians to provide patients with individualized pharmaceutical care and promote clinical rational use of drugs.
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