akinohanayuki ブログ

学位を持っても、センスのない、感染制御専門薬剤師のブログ.  I have Ph.D. but less sense ID pharmacist.

Pharmacy-driven Interventions

Core Elements of Hospital Antibiotic Stewardship Programs
 
実習生と復習しました。
アメンバーの薬剤師は、リーダーシップが重要ですが、個々の薬剤師として以下の項目は出来るだけ関わって欲しいです。
 

 

Pharmacy-driven Interventions

 
Automatic changes from intravenous to oral antibiotic therapy in appropriate situations and for antibiotics with good absorption (e.g., fluoroquinolones, trimethoprim-sulfamethoxazole, linezolid, etc.), which improves patient safety by reducing the need for intravenous access
最近はまっている、スイッチ。勇気と責任が必要で、地味面白い項目。奥深いです。
 
Dose adjustments in cases of organ dysfunction (e.g. renal adjustment)
はじめの一歩
 
Dose optimization including dose adjustments based on therapeutic drug monitoring, optimizing therapy for highly drug-resistant bacteria, achieving central nervous system penetration, extended-infusion administration of beta-lactams, etc. 
はじめの一歩
 
Automatic alerts in situations where therapy might be unnecessarily duplicative including simultaneous use of multiple agents with overlapping spectra e.g. anaerobic activity, atypical activity, Gram-negative activity and resistant Gram-positive activity 
主治医と協議
 
Time-sensitive automatic stop orders for specified antibiotic prescriptions, especially antibiotics administered for surgical prophylaxis.
まずは、クリパスを工夫?
 
Detection and prevention of antibiotic-related drug-drug interactions- e.g. interactions between some orally administered fluoroquinolones and certain vitamins.
地味だけど、確認ポイント