title: [Effects of early pharmacist intervention on antimicrobial therapy for severe hospital-acquired pneumonia].
abstract: Hospital-acquired pneumonia (HAP) is defined as pneumonia that occurs 48 hours or more after admission, and is an important factor in the high mortality seen in hospital-acquired infections. Recently, pharmacist intervention, such as adjustment of dosing and monitoring for adverse effects, has been reported to improve the effects of infectious disease therapy. The aim of this study was to evaluate the usefulness of early pharmacist intervention during antimicrobial therapy for severe HAP. We retrospectively investigated the reduction rate of C-reactive protein (CRP) levels and duration of antibiotics administration. Patients with severe HAP were classified into 2 groups according to pharmacist intervention from the initial phase of therapy, with 15 in the intervention group and 23 in the control group (no pharmacist intervention). The reduction rate of CRP levels during the 7-day period after initiating antimicrobial therapy was 66.5 ± 17.3% in the intervention group and 35.9 ± 53.9% in the control group, which was significantly different (p<0.05). In addition, the average duration of antibiotics administration in the intervention group was significantly decreased as compared to the control group: the decreased period was 8 days. Our results suggest that pharmacist intervention contributed to reduce inflammation in the early phase and to shorten the duration of antimicrobial therapy.
authors.affiliation: Department of Clinical Evaluation of Drug Efficacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Imaura
authors.forename: Haruko
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kohata
authors.forename: Takashi
authors.initials: T
authors.lastname: Igarashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanno
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* / Q000009:adverse effects / Q000493:pharmacokinetics; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004346:Drug Information Services; D004347:Drug Interactions; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010595:Pharmacists; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy*; D024382:Professional Role; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein