I can see the status column text volume 119 Chapter 1.5 of unintentional insertion of Liu Sun Lien was arranged to treat patients with Dr. Hu of the Department of Neurology. Sun Lien was 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 Lien is simply the male protagonist in the Internet he usually watches. He is not very old, but he is very capable. The older generation has worked hard for a long time to figure out things, so he can point out the key points in one sentence. This is not only the male protagonist, but also the academic master.

When the protagonist wants to follow him to treat him, Dr. Hu's pressure is even greater than that of his mentor's whole process. After all, the male protagonists on the Internet are not humans, and there are many girls in the whole family who kill people at every turn. Dr. Hu's wife is beautiful and her daughter is just the second grade of high school. It's the time to be very good-looking. He was worried for five seconds before he woke up. This is his real life, not a plot on the Internet.

"Doctor Sun, this is the patient's test report." Hu Chunbo took the report and walked to Sun Lien with a little nervousness. He had read these reports several times or even dozens of times. Hu Chunbo thought he could not see any valuable reminder content in it. But if Sun Lien could see the problem at a glance... he had no place to give up his face.

Even in three months, everyone will return to their workplaces. Hu Chunbo also felt that his big face, which had nowhere to be placed, would burn for several years - he couldn't even get the standard training of the emergency department, and had he worked in the dog's stomach for so many years?

Fortunately, after reading the inspection report, Sun Lien did not point out any great mistakes. He just nodded seriously and said to Hu Chunbo, "How to deal with the medicine?"

"I plan to consult with the practicing pharmacist in our hospital." Hu Chunbo replied, "The team brought not too many medicines this time, and the special-use grades brought four types. Taineng, Meropenem, linezolid and vancomycin." He said with some worries, "Actually, I think your combination of medicine is good, but I don't know whether doxycycline and these four antibiotics have any combined effect."

The combined effect of drugs is indeed a very troublesome thing. There are many types of antibiotics used in clinical practice, and doctors cannot remember the combined effect of each drug and other drugs. To develop a suitable combination drug regimen, either doctors must check various pharmacopoeia, drug instructions or even the latest research reports, or... directly call our hospital's practicing pharmacist.

"Using relatively small doses of doxycycline for antibacterial treatment, and then treating infection with broad-spectrum antibiotics. 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 that his explanation had not been clear enough, so he emphasized, "The use of doxycycline should give us enough time, so that if quinolones are ineffective, they can also be converted into other antibiotics in a timely manner."

"I have some other ideas." Dr. Hu thought for a long time and put forward his own opinion. "Ceftriaxone is a third-generation cephalosporin, but it is not effective for Gram-negative bacilli that produces esbls. Her infection is obviously not resistant to methicillin Staphylococcus aureus, after all, that thing is easier to be cultivated."

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

"So, the most likely pathogen, that is, Gram-negative bacilli that produces esbls." Discussing this kind of thing is only useful if you say it yourself. It is better to say it once if you think about it hundreds of times. "Among the four restricted-grade antibiotics we have currently reserved, Taineng is not suitable for meningitis. Linezolid is mainly used for the treatment of Gram-positive cocci - vancomycin can only be used to fight against methicillin-resistant Staphylococcus aureus infection, so the only thing we can use is meropenem."

After Sun Lien said that "Tai Neng is not suitable for meningitis", he was already confused. He had never used linezolid even once. Seeing Dr. Hu talking in front of him, Sun Lien could only nodded. It can be seen that Hu Chunbo had long thought of using restricted antibiotics and had also read the instructions for four drugs in detail.

"What's even better is that meropenem is mainly excreted through the kidneys. This does not cause more burden on the patient's liver - even if it is used with doxycycline." Dr. Hu became more excited. "The burden on the liver of doxycycline will increase rapidly with the dose of drug use. But we use doxycycline mainly for antibacterial rather than bactericidal, so the dose is not too large."

Sun Lien nodded, he really understood this part.

There are basically only two ways of metabolism of drugs. One is to metabolize in the liver and then excrete it from the human body with feces. The other is to metabolize it through the kidneys, enter the urine and excrete it from the body.

Doxycycline needs to be metabolized in the liver, so it also causes great damage to the liver. Therefore, the drug description specifically pointed out that this drug cannot be used together with other hepatotoxic drugs.

At present, there are only meropenem, which is excreted through the kidneys and is sensitive to Gram-negative bacilli produced by esbls.

"Then use Meropenan." Sun Lien nodded. At least from Sun Lien's perspective, there was no problem with this plan. "I'll go to notify the pharmacy now?"

"Where can it be..." Dr. Hu smiled bitterly, "This is a restricted-grade antibiotic, and it must be approved by Director Liu."

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

Hu Chunbo was also confused by Sun Lien's confusion, "This... your hospital restricts the use of antibiotics, and does not require the approval of the department director?"

Sun Lien thought about it seriously, then shook his head, "I... when I used it, the prescription was taken directly."

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

"Yes." Sun Lien continued to nod, and then said embarrassedly. "When I didn't take the doctor's exam before, I used Director Liu's prescription rights. Later, Director Liu came to Africa, so I used the prescription rights of other doctors in the group..."

"And then when you think you need it, you can prescribe restricted antibiotics without the approval of the director?" Hu Chunbo no longer had a shocked expression. He began to look envious, "I said Xiao Sun..." He lowered his voice and asked seriously, "Are you still recruiting doctors from the fourth hospital now?"

.
Chapter completed!