I can see the status bar

Chapter 600 Unintentionally Inserting Willows

Sun Lien was arranged to treat patients with Dr. Hu from the Department of Neurology.Sun Li'en is quite used to this arrangement - this is what a regular training should look like.

But Dr. Hu Chunbo didn't think so.In his opinion, Sun Li'en is simply the male protagonist in the online novels he usually reads.Not very old, but capable.He can point out the key to the things that the older generation have worked so hard to figure out for a long time.This is not only a leading actor, but also a domineering student.

When the protagonist of the novel had to follow him for treatment, Dr. Hu's pressure was even greater than that of his own tutor who followed the group all the way.After all, the male protagonists in online novels are not human beings, and it is not uncommon for them to kill the whole family and prostitute women everywhere.Dr. Hu's wife is beautiful, and his daughter is also in the second grade of junior high school, which is the time to start looking good.He was worried for a full five seconds before waking up. This was his real life, not a plot from an online novel.

"Doctor Sun, this is the patient's test report." Holding the report, Hu Chunbo walked up to Sun Li'en with some trepidation in his heart.He has read these reports several times or even a dozen times.Hu Chunbo thought he couldn't see any valuable hints in it.But if Sun Li'en can see the problem at a glance... I have no place to put my face.

Even in another three months, everyone will return to their respective workplaces.Hu Chunbo also felt that his big face, which had no place to rest, would be scalded for several years - he couldn't even do a regular training in emergency internal medicine, so all these years of work have been done in the dog's stomach?
Fortunately, after Sun Li'en read the inspection report, he didn't point out any serious mistakes.He just nodded seriously and said to Hu Chunbo, "Then what about the medicine?"

"I'm going to consult the licensed pharmacist in our hospital." Hu Chunbo replied, "The medicines brought by the team this time are not too many, and there are only four kinds of medicines for special use. Tylenol, meropenem, linezolid and Vancomycin." He said worriedly, "Actually, I think your method of combining drugs is good, but I don't know whether there is any combined effect between doxycycline and these four antibiotics."

The combination of drugs is indeed a very troublesome thing.There are many kinds of antibiotics used clinically, and it is impossible for doctors to remember the combined effect of each drug and other drugs.To find out a suitable drug combination regimen, one has to ask the doctors to consult various pharmacopoeias, drug instructions and even the latest research reports, or... directly call the licensed pharmacist of the hospital.

"A relatively small dose of doxycycline is used for antibacterial treatment, and then broad-spectrum antibiotics are used to treat the infection. The focus of this plan is to control the progress of the disease, and to judge the sensitive type of bacteria through experimental treatment." Sun Lien was afraid of explaining himself before It was not clear enough, so he emphasized, "The use of doxycycline should buy us enough time, so that if quinolones are ineffective, we can switch to other antibiotics in time."

"I have a different idea." Dr. Hu put forward his own opinion after pondering for a long time, "Ceftriaxone is a third-generation cephalosporin, but it is not effective against Gram-negative bacilli that produce ESBLs—her infection is obviously not armor-resistant. Staphylococcus aureus, after all, that stuff is easier to culture."

Sun Lien nodded, this logic is consistent with what everyone discussed in the restaurant before.

"So, at present, it is most likely to be a pathogen, that is, a Gram-negative bacillus that produces ESBLs." To discuss this kind of thing, it is useful to speak out.Thinking about it hundreds of times in your heart is not as useful as saying it once. "Among the four restricted-use antibiotics in our stockpile, Tylenol is not suitable for meningitis, and Linezolid is mainly used for the treatment of Gram-positive cocci—vancomycin can only be used against methicillin-resistant golden Staphylococcal infection, so the only thing we can use is meropenem.”

Sun Lien has been in a daze since "Taineng is not suitable for meningitis".He didn't use linezolid even once.Seeing Dr. Hu talking eloquently in front of him, Sun Li'en could only nod in agreement.It can be seen that Hu Chunbo has long thought of using restricted-use antibiotics, and has also checked the instructions of the four drugs in detail.

"What's even better is that meropenem is mainly excreted through the kidneys. This will not cause more burden on the patient's liver - even if doxycycline is used." Dr. Hu said more and more excited, "doxycycline The burden of doxycycline on the liver will rise rapidly as the dosage of the drug changes. But we use doxycycline mainly for antibacterial rather than bactericidal, so the dosage is not too high.”

Sun Li'en nodded, he really understood this part.

There are basically only two ways for drug metabolism, one is metabolized in the liver and then excreted from the body with feces.The other is metabolized by the kidneys and excreted in the urine.

Doxycycline needs to be metabolized in the liver, so the damage to the liver is also greater.Therefore, it is specifically pointed out in the drug instructions that this drug cannot be used together with other drugs with liver toxicity.

At present, Meropenem is the only antibiotic that is excreted by the kidney and is sensitive to ESBLs-producing Gram-negative bacilli.

"Then use meropenem." Sun Lien nodded, at least from Sun Lien's point of view, there was nothing wrong with this plan. "Should I notify the pharmacy now?"

"Then where can it be..." Dr. Hu said with a wry smile, "This is a restricted-use antibiotic, and it needs to be approved by Director Liu."

"Ah?" Sun Lien blinked, he had never used Meropenem, but Sun Lien had used Tyneng more than once.In the past, when Sun Lien opened Taineng, there was never such a process.

Hu Chunbo was also taken aback by Sun Lien's confused expression, "This... you don't need the department director's approval for restricted-use antibiotics in your hospital?"

Sun Li'en thought about it seriously, then shook his head, "I... When I used it before, the prescriptions were all taken directly."

"What?" Hu Chunbo was shocked, "Have you ever prescribed this medicine?"

"That's right." Sun Li'en continued to nod, and then said embarrassedly. "When I didn't take the exam to practice medicine, I used Director Liu's prescription rights. Later, when Director Liu came to Africa, I used the prescription rights of other doctors in the group..."

"Then when you think it's necessary, you can prescribe restricted-use antibiotics without the approval of the director?" Hu Chunbo no longer had a shocked expression on his face, he began to look envious, "I said Xiao Sun..." He lowered his He raised his voice, and asked earnestly, "Does your fourth hospital still recruit doctors from Shennei?"

(End of this chapter)