Hospital Pharmacy

Material type: TextTextSeries: ; Hospital Pharmacy, Volume 57, Issue 3, June 2022Publication details: Los Angeles : SAGE, c2022.Description: 321-407 pages : illustrations ; 28 cmISSN:
  • 1545-1569
Subject(s):
Contents:
Strategies to Enhance Patient Care and Compliance with Pain Order Duplications and Gaps -- Pharmacy Leadership Amid the Pandemic: Maintaining Patient Safety During Uncertain Times -- Effects of Propofol on Hemodynamic Profile in Adults Receiving Targeted Temperature Management -- Psychotropic Drugs Prescription and Use among Children with Mental Disorders at a Tertiary Hospital in Vietnam -- Combination Therapy of Chloramphenicol and Daptomycin for the Treatment of Infective Endocarditis Secondary to Multidrug Resistant Enterococcus faecium -- Expansion of Pharmacy Services During COVID-19: Pharmacists and Pharmacy Extenders Filling the Gaps Through Telehealth Services -- Institutional Usage of Ferric Pyrophosphate Citrate (FPC) Delivered Via Dialysate in Reducing Erythropoiesis Stimulating Agents (ESAs) and IV Iron Cost -- Comparison of Patiromer to Sodium Polystyrene Sulfonate in Acute Hyperkalemia -- Safety and Efficacy of Urea for Hyponatremia -- Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic -- No Implementation Without Representation: Real-Time Pharmacist Intervention Optimizes Rapid Diagnostic Tests for Bacteremia at a Small Community Hospital -- Cefepime Induced Neurotoxicity Following A Regimen Dose-Adjusted for Renal Function: Case Report and Review of the Literature -- Assessment of Knowledge, Attitude, and Practice in Adverse Drug Reaction Reporting of Healthcare Professionals in Vietnam: A Cross-Sectional Study -- Impact of Pharmacist Education on Inhaler Technique and Adherence in an Outpatient Clinic.
Summary: [Article Title: Strategies to Enhance Patient Care and Compliance with Pain Order Duplications and Gaps/ Shayna Cruz, Amberene Daya, Andrea Quinn, and Amanda Ries, p. 321-322] Abstract: According to the Joint Commission every patient has a right to pain management. Due to multimodal pain management, pain orders have the potential for duplication as well as gaps in therapy. At our institution, we evaluated pain orders and implemented strategies that aimed to reduce those gaps. We found that current ordering practices permitted the use of varying visual analog scale (VAS) ranges (e.g., VAS 1-3 and 1-5) which inherently increased the potential for duplicate therapies. When gaps in therapy occurred, medication orders for corresponding VAS scores were not available and thus, therapy was delayed. Additionally, current administration policies did not take into account patient preferences for less potent agents which can also cause a delay in care. In summary, simple strategies, discussed in this article, may be implemented at the hospital level to optimize patient care while maintaining recommendations by the Joint Commission for clear medication orders. https://doi.org/10.1177/00185787211032358Summary: [Article Title: Pharmacy Leadership Amid the Pandemic: Maintaining Patient Safety During Uncertain Times/ Irene Derrong Lin, and John B. Hertig, p. 323-328] Abstract: The relentless surges of global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections that caused the Covid-19 disease had pressured researchers and regulators to develop effective treatments quickly. While studying these therapies amid the pandemic, threats to patient care were reported, including (1) maintaining adequate safeguards as clinical effectiveness and safety data evolves, (2) risks from online counterfeit medications, and (3) disruption of the global pharmaceutical supply chain. This article discusses these patient safety threats and suggests strategies that promote patient safety, foster medication intelligence, and mitigate drug shortages. As the world continues to develop safe and effective treatments for Covid-19, patient safety is paramount. In response to the World Health Organization (WHO) Global Safety Challenge: Medication Without Harm, leaders must establish effective approaches to improve medication safety during the pandemic. Successfully integrating these leadership strategies with current practices allows pharmacy leaders to implement robust systems to reduce errors, prevent harm, and advocate for patient safety. https://doi.org/10.1177/00185787211037545Summary: [Article Title: Effects of Propofol on Hemodynamic Profile in Adults Receiving Targeted Temperature Management/ W. Anthony Hawkins, Jennifer Y. Kim, Susan E. Smith, Andrea Sikora Newsome, and Ronald G. Hall, p. 329-335] Abstract: Propofol is a key component for the management of sedation and shivering during targeted temperature management (TTM) following cardiac arrest. The cardiac depressant effects of propofol have not been described during TTM and may be especially relevant given the stress to the myocardium following cardiac arrest. The purpose of this study is to describe hemodynamic changes associated with propofol administration during TTM. https://doi.org/10.1177/00185787211032359Summary: [Article Title: Psychotropic Drugs Prescription and Use among Children with Mental Disorders at a Tertiary Hospital in Vietnam/ Nguyen Thi Phuong Lan, Ngo Thi Tam, Nguyen Xuan Bach, and Le Cong Thien, p. 336-344] Abstract: Awareness of psychotropic medication and its adverse drug reactions (ADRs) can promote safe and rational use of medications, particularly in children and adolescents with mental problems. This study examined the prescription of psychotropic drugs and actual drug-drug interaction (DDI) and ADR for children with mental disorders under 18 years of age in a tertiary hospital in Vietnam. https://doi.org/10.1177/00185787211032357Summary: [Article Title: Combination Therapy of Chloramphenicol and Daptomycin for the Treatment of Infective Endocarditis Secondary to Multidrug Resistant Enterococcus faecium/ Sunish Shah, Dayna McManus, and Jeffrey E. Topal, p. 345-348] Abstract: A 38-years-old female with an aortic valve replacement presented to an outside hospital (OSH) with fevers and malaise. Blood cultures revealed VRE which was resistant to linezolid, resistant to ampicillin, non-susceptible to daptomycin (MIC of 8 mcg/mL), and exhibited susceptibility to gentamicin. The patient was therefore initiated on intravenous (IV) daptomycin 6 mg/kg q24h and gentamicin IV 1 mg/kg q8h. However, after 14 days of therapy with daptomycin and gentamicin, the patient was transferred to our institution for the management of cardiogenic shock and hypoxemic respiratory failure. Given the concern for treatment failure, her antimicrobial regimen was changed to IV chloramphenicol 12.5 mg/kg every 6 hours with IV daptomycin 10 mg/kg every 48 hours given an estimated creatinine clearance of 30 mL/minutes. In vitro susceptibilities for chloramphenicol were performed which confirmed susceptibility. A transesophageal echocardiogram revealed a possible abscess at the left coronary cusp and aortic valve dehiscence. The patient underwent aortic valve replacement with aortic root reconstruction. The aortic valve culture grew VRE susceptible to linezolid but resistant to ampicillin and doxycycline. The patient was deemed clinically cured after 42 days of combination therapy with daptomycin and chloramphenicol. After 6 years of follow-up, the patient has not had a recurrent VRE infection. To our knowledge, this is the first case of endocarditis secondary to VRE that was successfully managed with the combination of daptomycin and chloramphenicol. https://doi.org/10.1177/00185787211032364Summary: [Article Title: Expansion of Pharmacy Services During COVID-19: Pharmacists and Pharmacy Extenders Filling the Gaps Through Telehealth Services/ Catherine Liu, Khusbu Patel, Betsy Cernero, Yuliya Baratt, Nadine Dandan, Olga Marshall, Hanlin Li, and Leigh Efird, p. 349-354] Abstract: The Coronavirus 2019 (COVID-19) pandemic created a significant disruption in healthcare. In our health-system located in New York City, the provision of care in the ambulatory care setting moved to a remote model virtually overnight. We describe interventions made during the pandemic to transform ambulatory care pharmacy through expansion of telehealth services. https://doi.org/10.1177/00185787211032360Summary: [Article Title: Institutional Usage of Ferric Pyrophosphate Citrate (FPC) Delivered Via Dialysate in Reducing Erythropoiesis Stimulating Agents (ESAs) and IV Iron Cost/ Shan Wang, Louis DellaFera, Lameesa Dhanani, Brian Malone, Paula Dutka, Meredith Akerman, and Naveed Masani, p. 355-358] Abstract: Dialysis patients are often iron deficient due to a multiple factors. Ferric pyrophosphate citrate is a complex iron salt that can be given via dialysate allowing maintenance of hemoglobin (Hgb) concentration and iron balance while reducing the need for IV iron. The purpose of this study is to perform a cost evaluation of FPC and the effect it has on lowering the dose/use of ESAs and IV iron therapy. This study reviewed the same 100 hemodialysis patient’s charts before and after the use of FPC. The data points that were collected and analyzed are as follows: hemoglobin, ferritin levels, average weekly ESA dosing, and IV iron replacement therapy dose. Out of 100 patients, there was no statistical difference in the average hemoglobin, ferritin, and iron saturation levels observed in the patients before and after FPC use. The average weekly dose of darbepoetin alfa per patient was 52.74 μg before the FPC group compared to 39.27 μg in the post FPC group (P < .0001). The total dose of ferric gluconate per patient was 3290.01 mg in the before FPC group and 585.60 mg in the post FPC group (P < .0001). The average total iron sucrose dose per patient in the before FPC group was 3097.92 mg versus 1216.67 mg in the post FPC group (P < .1563). When comparing FPC’s cost and implementation into both of our outpatient dialysis centers, this yielded a net savings of $296 751.49. https://doi.org/10.1177/00185787211032363Summary: [Article Title: Comparison of Patiromer to Sodium Polystyrene Sulfonate in Acute Hyperkalemia/ Peter T. Nguyen, Vivek K. Kataria, Teena R. Sam, Katie Hooper, and Ankit N. Mehta, p. 355-358] Abstract: Patiromer and sodium polystyrene sulfonate (SPS) are cation-exchangers approved for the treatment of chronic hyperkalemia. Data regarding their efficacy acutely is lacking. Despite this, both drugs are frequently used in the emergent setting. https://doi.org/10.1177/00185787211037552Summary: [Article Title: Safety and Efficacy of Urea for Hyponatremia/ William M. Hammonds, Ellen A. Keating, Megan E. Smetana, Keaton S. Smetana, and Megan M. Bond, p. 359-364] Abstract: Urea is an alternative for treatment of hyponatremia however, its use has not been widely studied. The purpose of this study was to evaluate the safety and efficacy of urea for the treatment of hyponatremia. https://doi.org/10.1177/00185787211037548Summary: [Article Title: Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic/ Frank A. Fanizza, Jennifer Loucks, Angelica Berni, Meera Shah, Dennis Grauer, and Sarah Daniel, p. 365-369] Abstract: Modern hepatitis C virus (HCV) treatment regimens yield cure rates greater than 90%. However, obtaining approval for treatment through the prior authorization (PA) process can be time consuming and require extensive documentation. Lack of experience with this complex process can delay HCV medication approval, ultimately increasing the amount of time before patients start treatment and in some cases, prevent treatment altogether. https://doi.org/10.1177/00185787211037540Summary: [Article Title: No Implementation Without Representation: Real-Time Pharmacist Intervention Optimizes Rapid Diagnostic Tests for Bacteremia at a Small Community Hospital/ Brandon J. Tritle, Robert Watteyne, Abby Hickman, Todd J. Vento, Bert K. Lopansri, Dave S. Collingridge, and John J. Veillette, p. 370-376] Abstract: Rapid diagnostic tests (RDTs) for bacteremia allow for early antimicrobial therapy modification based on organism and resistance gene identification. Studies suggest patient outcomes are optimized when infectious disease (ID)-trained antimicrobial stewardship personnel intervene on RDT results. However, data are limited regarding RDT implementation at small community hospitals, which often lack access to on-site ID clinicians. https://doi.org/10.1177/00185787211037554Summary: [Article Title: Cefepime Induced Neurotoxicity Following A Regimen Dose-Adjusted for Renal Function: Case Report and Review of the Literature/ Michael L. Behal, Jenni K. Thomas, Melissa L. Thompson Bastin, and Breanne M. Mefford, p. 377-384] Abstract: Cefepime induced neurotoxicity (CIN) is commonly associated with renal dysfunction, however CIN can occur in patients with normal renal function or renally dose-adjusted regimens. Few reports of this kind have obtained cefepime concentrations to assist in diagnosis. https://doi.org/10.1177/00185787211046856Summary: [Article Title: Assessment of Knowledge, Attitude, and Practice in Adverse Drug Reaction Reporting of Healthcare Professionals in Vietnam: A Cross-Sectional Study/ Hai-Yen Nguyen-Thi, Minh-Thu Do-Tran, Thuyen Lu Ngoc, Thuy-Tram Nguyen-Ngoc, and Nguyen Dang Tu Le, p. 385-391] Abstract: Under-reporting is a major issue of ADR spontaneous reporting system. This study assesses the knowledge, attitude, and practice of healthcare professionals in Children’s Hospital in Vietnam and suggests solutions to enhance ADR reporting rate based on findings. https://doi.org/10.1177/00185787211046864Summary: [Article Title: Impact of Pharmacist Education on Inhaler Technique and Adherence in an Outpatient Clinic / Bianca Mayzel, Sarah Muench, and Colleen Lauster, p. 392-402] Abstract: To assess the impact that pharmacist education has on proper inhaler technique and adherence in a teaching clinic. https://doi.org/10.1177/00185787211046863
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Serials Serials National University - Manila LRC - Main Periodicals Pharmacy Hospital Pharmacy, Volume 57, Issue 3, June 2022 (Browse shelf(Opens below)) c.1 Available PER000000502

Includes bibliographical references.

Strategies to Enhance Patient Care and Compliance with Pain Order Duplications and Gaps -- Pharmacy Leadership Amid the Pandemic: Maintaining Patient Safety During Uncertain Times -- Effects of Propofol on Hemodynamic Profile in Adults Receiving Targeted Temperature Management -- Psychotropic Drugs Prescription and Use among Children with Mental Disorders at a Tertiary Hospital in Vietnam -- Combination Therapy of Chloramphenicol and Daptomycin for the Treatment of Infective Endocarditis Secondary to Multidrug Resistant Enterococcus faecium -- Expansion of Pharmacy Services During COVID-19: Pharmacists and Pharmacy Extenders Filling the Gaps Through Telehealth Services -- Institutional Usage of Ferric Pyrophosphate Citrate (FPC) Delivered Via Dialysate in Reducing Erythropoiesis Stimulating Agents (ESAs) and IV Iron Cost -- Comparison of Patiromer to Sodium Polystyrene Sulfonate in Acute Hyperkalemia -- Safety and Efficacy of Urea for Hyponatremia -- Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic -- No Implementation Without Representation: Real-Time Pharmacist Intervention Optimizes Rapid Diagnostic Tests for Bacteremia at a Small Community Hospital -- Cefepime Induced Neurotoxicity Following A Regimen Dose-Adjusted for Renal Function: Case Report and Review of the Literature -- Assessment of Knowledge, Attitude, and Practice in Adverse Drug Reaction Reporting of Healthcare Professionals in Vietnam: A Cross-Sectional Study -- Impact of Pharmacist Education on Inhaler Technique and Adherence in an Outpatient Clinic.

[Article Title: Strategies to Enhance Patient Care and Compliance with Pain Order Duplications and Gaps/ Shayna Cruz, Amberene Daya, Andrea Quinn, and Amanda Ries, p. 321-322]

Abstract: According to the Joint Commission every patient has a right to pain management. Due to multimodal pain management, pain orders have the potential for duplication as well as gaps in therapy. At our institution, we evaluated pain orders and implemented strategies that aimed to reduce those gaps. We found that current ordering practices permitted the use of varying visual analog scale (VAS) ranges (e.g., VAS 1-3 and 1-5) which inherently increased the potential for duplicate therapies. When gaps in therapy occurred, medication orders for corresponding VAS scores were not available and thus, therapy was delayed. Additionally, current administration policies did not take into account patient preferences for less potent agents which can also cause a delay in care. In summary, simple strategies, discussed in this article, may be implemented at the hospital level to optimize patient care while maintaining recommendations by the Joint Commission for clear medication orders.

https://doi.org/10.1177/00185787211032358

[Article Title: Pharmacy Leadership Amid the Pandemic: Maintaining Patient Safety During Uncertain Times/ Irene Derrong Lin, and John B. Hertig, p. 323-328]

Abstract: The relentless surges of global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections that caused the Covid-19 disease had pressured researchers and regulators to develop effective treatments quickly. While studying these therapies amid the pandemic, threats to patient care were reported, including (1) maintaining adequate safeguards as clinical effectiveness and safety data evolves, (2) risks from online counterfeit medications, and (3) disruption of the global pharmaceutical supply chain. This article discusses these patient safety threats and suggests strategies that promote patient safety, foster medication intelligence, and mitigate drug shortages. As the world continues to develop safe and effective treatments for Covid-19, patient safety is paramount. In response to the World Health Organization (WHO) Global Safety Challenge: Medication Without Harm, leaders must establish effective approaches to improve medication safety during the pandemic. Successfully integrating these leadership strategies with current practices allows pharmacy leaders to implement robust systems to reduce errors, prevent harm, and advocate for patient safety.

https://doi.org/10.1177/00185787211037545

[Article Title: Effects of Propofol on Hemodynamic Profile in Adults Receiving Targeted Temperature Management/ W. Anthony Hawkins, Jennifer Y. Kim, Susan E. Smith, Andrea Sikora Newsome, and Ronald G. Hall, p. 329-335]

Abstract: Propofol is a key component for the management of sedation and shivering during targeted temperature management (TTM) following cardiac arrest. The cardiac depressant effects of propofol have not been described during TTM and may be especially relevant given the stress to the myocardium following cardiac arrest. The purpose of this study is to describe hemodynamic changes associated with propofol administration during TTM.

https://doi.org/10.1177/00185787211032359

[Article Title: Psychotropic Drugs Prescription and Use among Children with Mental Disorders at a Tertiary Hospital in Vietnam/ Nguyen Thi Phuong Lan, Ngo Thi Tam, Nguyen Xuan Bach, and Le Cong Thien, p. 336-344]

Abstract: Awareness of psychotropic medication and its adverse drug reactions (ADRs) can promote safe and rational use of medications, particularly in children and adolescents with mental problems. This study examined the prescription of psychotropic drugs and actual drug-drug interaction (DDI) and ADR for children with mental disorders under 18 years of age in a tertiary hospital in Vietnam.

https://doi.org/10.1177/00185787211032357

[Article Title: Combination Therapy of Chloramphenicol and Daptomycin for the Treatment of Infective Endocarditis Secondary to Multidrug Resistant Enterococcus faecium/ Sunish Shah, Dayna McManus, and Jeffrey E. Topal, p. 345-348]

Abstract: A 38-years-old female with an aortic valve replacement presented to an outside hospital (OSH) with fevers and malaise. Blood cultures revealed VRE which was resistant to linezolid, resistant to ampicillin, non-susceptible to daptomycin (MIC of 8 mcg/mL), and exhibited susceptibility to gentamicin. The patient was therefore initiated on intravenous (IV) daptomycin 6 mg/kg q24h and gentamicin IV 1 mg/kg q8h. However, after 14 days of therapy with daptomycin and gentamicin, the patient was transferred to our institution for the management of cardiogenic shock and hypoxemic respiratory failure. Given the concern for treatment failure, her antimicrobial regimen was changed to IV chloramphenicol 12.5 mg/kg every 6 hours with IV daptomycin 10 mg/kg every 48 hours given an estimated creatinine clearance of 30 mL/minutes. In vitro susceptibilities for chloramphenicol were performed which confirmed susceptibility. A transesophageal echocardiogram revealed a possible abscess at the left coronary cusp and aortic valve dehiscence. The patient underwent aortic valve replacement with aortic root reconstruction. The aortic valve culture grew VRE susceptible to linezolid but resistant to ampicillin and doxycycline. The patient was deemed clinically cured after 42 days of combination therapy with daptomycin and chloramphenicol. After 6 years of follow-up, the patient has not had a recurrent VRE infection. To our knowledge, this is the first case of endocarditis secondary to VRE that was successfully managed with the combination of daptomycin and chloramphenicol.

https://doi.org/10.1177/00185787211032364

[Article Title: Expansion of Pharmacy Services During COVID-19: Pharmacists and Pharmacy Extenders Filling the Gaps Through Telehealth Services/ Catherine Liu, Khusbu Patel, Betsy Cernero, Yuliya Baratt, Nadine Dandan, Olga Marshall, Hanlin Li, and Leigh Efird, p. 349-354]

Abstract: The Coronavirus 2019 (COVID-19) pandemic created a significant disruption in healthcare. In our health-system located in New York City, the provision of care in the ambulatory care setting moved to a remote model virtually overnight. We describe interventions made during the pandemic to transform ambulatory care pharmacy through expansion of telehealth services.

https://doi.org/10.1177/00185787211032360

[Article Title: Institutional Usage of Ferric Pyrophosphate Citrate (FPC) Delivered Via Dialysate in Reducing Erythropoiesis Stimulating Agents (ESAs) and IV Iron Cost/ Shan Wang, Louis DellaFera, Lameesa Dhanani, Brian Malone, Paula Dutka, Meredith Akerman, and Naveed Masani, p. 355-358]

Abstract: Dialysis patients are often iron deficient due to a multiple factors. Ferric pyrophosphate citrate is a complex iron salt that can be given via dialysate allowing maintenance of hemoglobin (Hgb) concentration and iron balance while reducing the need for IV iron. The purpose of this study is to perform a cost evaluation of FPC and the effect it has on lowering the dose/use of ESAs and IV iron therapy. This study reviewed the same 100 hemodialysis patient’s charts before and after the use of FPC. The data points that were collected and analyzed are as follows: hemoglobin, ferritin levels, average weekly ESA dosing, and IV iron replacement therapy dose. Out of 100 patients, there was no statistical difference in the average hemoglobin, ferritin, and iron saturation levels observed in the patients before and after FPC use. The average weekly dose of darbepoetin alfa per patient was 52.74 μg before the FPC group compared to 39.27 μg in the post FPC group (P < .0001). The total dose of ferric gluconate per patient was 3290.01 mg in the before FPC group and 585.60 mg in the post FPC group (P < .0001). The average total iron sucrose dose per patient in the before FPC group was 3097.92 mg versus 1216.67 mg in the post FPC group (P < .1563). When comparing FPC’s cost and implementation into both of our outpatient dialysis centers, this yielded a net savings of $296 751.49.

https://doi.org/10.1177/00185787211032363

[Article Title: Comparison of Patiromer to Sodium Polystyrene Sulfonate in Acute Hyperkalemia/ Peter T. Nguyen, Vivek K. Kataria, Teena R. Sam, Katie Hooper, and Ankit N. Mehta, p. 355-358]

Abstract: Patiromer and sodium polystyrene sulfonate (SPS) are cation-exchangers approved for the treatment of chronic hyperkalemia. Data regarding their efficacy acutely is lacking. Despite this, both drugs are frequently used in the emergent setting.

https://doi.org/10.1177/00185787211037552

[Article Title: Safety and Efficacy of Urea for Hyponatremia/ William M. Hammonds, Ellen A. Keating, Megan E. Smetana, Keaton S. Smetana, and Megan M. Bond, p. 359-364]

Abstract: Urea is an alternative for treatment of hyponatremia however, its use has not been widely studied. The purpose of this study was to evaluate the safety and efficacy of urea for the treatment of hyponatremia.

https://doi.org/10.1177/00185787211037548

[Article Title: Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic/ Frank A. Fanizza, Jennifer Loucks, Angelica Berni, Meera Shah, Dennis Grauer, and Sarah Daniel, p. 365-369]

Abstract: Modern hepatitis C virus (HCV) treatment regimens yield cure rates greater than 90%. However, obtaining approval for treatment through the prior authorization (PA) process can be time consuming and require extensive documentation. Lack of experience with this complex process can delay HCV medication approval, ultimately increasing the amount of time before patients start treatment and in some cases, prevent treatment altogether.

https://doi.org/10.1177/00185787211037540

[Article Title: No Implementation Without Representation: Real-Time Pharmacist Intervention Optimizes Rapid Diagnostic Tests for Bacteremia at a Small Community Hospital/ Brandon J. Tritle, Robert Watteyne, Abby Hickman, Todd J. Vento, Bert K. Lopansri, Dave S. Collingridge, and John J. Veillette, p. 370-376]

Abstract: Rapid diagnostic tests (RDTs) for bacteremia allow for early antimicrobial therapy modification based on organism and resistance gene identification. Studies suggest patient outcomes are optimized when infectious disease (ID)-trained antimicrobial stewardship personnel intervene on RDT results. However, data are limited regarding RDT implementation at small community hospitals, which often lack access to on-site ID clinicians.

https://doi.org/10.1177/00185787211037554

[Article Title: Cefepime Induced Neurotoxicity Following A Regimen Dose-Adjusted for Renal Function: Case Report and Review of the Literature/ Michael L. Behal, Jenni K. Thomas, Melissa L. Thompson Bastin, and Breanne M. Mefford, p. 377-384]

Abstract: Cefepime induced neurotoxicity (CIN) is commonly associated with renal dysfunction, however CIN can occur in patients with normal renal function or renally dose-adjusted regimens. Few reports of this kind have obtained cefepime concentrations to assist in diagnosis.

https://doi.org/10.1177/00185787211046856

[Article Title: Assessment of Knowledge, Attitude, and Practice in Adverse Drug Reaction Reporting of Healthcare Professionals in Vietnam: A Cross-Sectional Study/ Hai-Yen Nguyen-Thi, Minh-Thu Do-Tran, Thuyen Lu Ngoc, Thuy-Tram Nguyen-Ngoc, and Nguyen Dang Tu Le, p. 385-391]

Abstract: Under-reporting is a major issue of ADR spontaneous reporting system. This study assesses the knowledge, attitude, and practice of healthcare professionals in Children’s Hospital in Vietnam and suggests solutions to enhance ADR reporting rate based on findings.

https://doi.org/10.1177/00185787211046864

[Article Title: Impact of Pharmacist Education on Inhaler Technique and Adherence in an Outpatient Clinic
/ Bianca Mayzel, Sarah Muench, and Colleen Lauster, p. 392-402]

Abstract: To assess the impact that pharmacist education has on proper inhaler technique and adherence in a teaching clinic.

https://doi.org/10.1177/00185787211046863

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