title: Impact of levofloxacin dose adjustments by dispensing pharmacists on adverse reactions and costs in the treatment of elderly patients.
abstract: Ensuring an appropriate dosage of renally eliminated drugs for patients with renal insufficiency is important for preventing adverse drug reactions. We investigated the effectiveness of interventions by pharmacists in a hospital pharmaceutical department. The comparative study was performed at Gifu Municipal Hospital in Japan from March to August 2011, and included an intervention (142 patients) and a control group (98 patients). Upon receiving a prescription of levofloxacin for patients aged > or = 75 years, pharmacists evaluated the patients' kidney function and adjusted the appropriate dosage at the time of dispensation. In the intervention and control groups, levofloxacin-induced adverse reactions developed in 6 of 142 (4.2%) and 13 of 98 (13.3%) patients, respectively (p < 0.05). The cost of reducing levofloxacin per patient was yen 191.1 and yen 0 in the intervention and control groups, respectively. The cost per patient for adverse reaction treatments and examinations was yen 15.5 and yen 290.0 in the intervention and control groups, respectively. The intergroup difference in the total cost per patient was yen 465.6. Dose adjustment of levofloxacin at the time of dispensation by the pharmacist for patients aged > or = 75 years resulted in a decrease in the incidence of adverse reactions and cost. These findings can be applied not only to hospitals, but also to community pharmacies, because the intervention, which is a manual system, is simply performed when pharmacists are dispensing drugs.
authors.affiliation: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan. tachi@gifu-pu.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Tachi
authors.affiliation: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Teramachi
authors.affiliation: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Asano
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fukuta
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Osawa
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Aoyama
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mizui
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Goto
authors.affiliation: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tsuchiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D003363:Cost Control; D016527:Drug Costs; D005260:Female; D006801:Humans; D064704:Levofloxacin / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008499:Medical Records; D010595:Pharmacists; D010607:Pharmacy Service, Hospital
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin