title: [Effect of pharmacists' intervention on the antibiotic therapy for the methicillin-resistant Staphylococcus aureus (MRSA) infectious diseases in the intensive care unit].
abstract: Pharmacists are providing pharmaceutical care in general wards, but it is still not common in the intensive care unit (ICU). However, we have worked in ICU, and recommended the rational dosage regimen of the antibiotics to the physicians during the treatment period. Especially, the patients who were infected with methicillin-resistant Staphylococcus aureus (MRSA) in ICU should be provided appropriate antibiotic therapy, otherwise they have a poor prognosis. The aim of this study is to evaluate usefulness of the pharmacists' intervention on the antibiotic therapy for MRSA infectious diseases in the ICU. We investigated retrospectively the period of anti MRSA drugs administration, the medical cost, which includes cost of anti MRSA drugs and hospital charge, and the initial trough concentration of vancomycin (VCM). The patients with MRSA pneumonia were classified into two groups according to the pharmacists' intervention. The number of the patients who the pharmacists performed dosage regimen of anti MRSA drug was 11 (intervention group) and that of the patients who the pharmacists performed no intervention was 47 (control group). The average period of administration of anti MRSA drugs in the intervention group was significantly decreased in 5 days. Furthermore, if the pharmacists performed dosage regimen of anti MRSA drug to the patients in control group, the medical cost of 10 million yen would be saved. The initial trough concentrations of VCM were not significantly different between two groups. However, the achievement rates are 75.0% in intervention group and 66.7% in control group, if the goal of trough level of VCM is set from 5 to 15 µg/ml. Moreover, there are 75.0% in intervention group and 20.8% in control group, if the goal of trough level of VCM is set from 10 to 20 µg/ml, which is significantly different between the two groups. Therefore, it was suggested that the pharmacists in the ICU contributed to optimize the anti MRSA therapy and reduce the medical cost.
authors.affiliation: Department of Pharmacy, Saiseikai Yokohamashi Tobu Hospital, Tsurumi-ku, Yokohama, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Imaura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kohata
authors.forename: Koutarou
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Haruko
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Tomohide
authors.initials: T
authors.lastname: Akase
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics* / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D017850:Economics, Pharmaceutical; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010348:Patient Care Team; D010595:Pharmacists; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy*; D012189:Retrospective Studies; D014640:Vancomycin / Q000008:administration & dosage* / Q000191:economics* / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin