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1例46岁女性患者,因术后颅内感染静脉滴注哌拉西林钠他唑巴坦钠4.5 g,1次/8 h。用药第13、15天外周血白细胞计数从用药前的10.61×109/L分别降至1.79×109/L和1.00×109/L。立即换用其他抗菌药物,同时给予重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)150μg皮下注射,1次/d。改变治疗后4 d,血白细胞计数升至6.95×109/L。改变治疗后6 d脑脊液白细胞数由首次用药后15 d的8×106/L升至56×106/L,再次给予哌拉西林钠他唑巴坦钠4.5 g静脉滴注,1次/8 h,rhGM-CSF剂量未变。用药6 d颅内感染治愈,遂停用抗菌药物。治疗第2、5天白细胞计数分别为2.67×109/L和1.65×109/L。第8天停用rhGM-CSF后为5.75×109/L,第15天为4.56×109/L。
A 46-year-old female patient received intravenous piperacillin sodium tazobactam sodium 4.5 g once / 8 h after intracranial infection. On the 13th and 15th days of treatment, the peripheral blood leukocyte count decreased from 10.61 × 109 / L before treatment to 1.79 × 109 / L and 1.00 × 109 / L, respectively. Immediately switch to other antibiotics, given recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) 150μg subcutaneous injection, 1 time / d. 4 days after treatment, the white blood cell count rose to 6.95 × 109 / L. Six days after treatment, the number of leukocytes in cerebrospinal fluid increased from 8 × 106 / L at 15 days after the first administration to 56 × 106 / L, and then given 4.5 g piperacillin sodium and tazobactam sodium intravenously once / 8 h , rhGM-CSF dose did not change. Medication 6d intracranial infection cured, then discontinued antibacterials. The 2nd and 5th white blood cell counts were 2.67 × 109 / L and 1.65 × 109 / L, respectively. On day 8, rhGM-CSF was 5.75 × 109 / L after rhGM-CSF withdrawal and 4.56 × 109 / L on day 15.