市中肺炎に対する薬学的管理手法の構築と臨床評価

Abstract

We developed a pharmaceutical management system for community acquired pneumonia which uses a standard care plan and a worksheet based on pneumonia diagnosis, treatment and antibiotic use guidelines. The system was introduced in clinical practice and its effectiveness evaluated using the findings for twenty patients hospitalized for community acquired pneumonia at Toho University Medical Center Ohashi Hospital from January to December 2005. Written informed consent was obtained from all of them.There was an increase in the numbers of pharmaceutical problems noted and pharmacist interventions compared to before introducing the system and there was a significant increase in the frequency of providing pharmaceutical care. A particular finding was that monitoring a patient's subjective symptoms and clinical laboratory test results using the worksheet made it possible for pharmacists to switch from intravenous to oral antibiotics. This also enabled patients to learn how to use antibiotics properly. The increase in the frequency of pharmaceutical care provided also enabled the conditions of patients to be determined at an earlier stage and helped prevent adverse effects. Our pharmaceutical management system for community acquired pneumonia also allowed the selection criteria for antibiotics and the effects of treatment using them to be easily determined. The findings of this study suggest that our system would be a useful tool in promoting the proper use of antibiotics.