YAKUGAKU ZASSHI
Online ISSN : 1347-5231
Print ISSN : 0031-6903
ISSN-L : 0031-6903
Symposium Reviews
Effects of Pharmacist Intervention on the Treatment of Infectious Diseases in Critically Ill Patients
Masaharu Imaura
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2017 Volume 137 Issue 12 Pages 1431-1437

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Abstract
 The pathological conditions of patients who require intensive care are usually complex and extremely severe; their health and life are in a critical state. Therefore, correct, rapid treatment of these conditions is indispensable. Furthermore, the selection of drugs and adjustment of their dosage for an immediate effect are important. Moreover, most patients are immunocompromised and present an extremely high level of risk for complications involving infectious diseases. Since such complications may lead to life-threatening outcomes, a rational dosage regimen to achieve sufficient antimicrobial activity from the initial stage of treatment is essential. However, most critically ill cases are complicated by several factors: fluid retention including edema, pleural effusion, and ascites; increased vascular permeability and hypoalbuminemia; and dysfunction of various organs. These factors cause significant changes in the pharmacokinetics of antimicrobials, making it particularly difficult to design a dosage regimen at the time of initial administration. Thus, we focused on the importance of a rational dosage regimen for antimicrobial drugs in the treatment of infectious diseases. We conducted a retrospective study of severe cases of pneumonia with a high death rate; patients were divided into two groups according to the pharmacist intervention procedures and a comparative study of treatment efficacy was performed. Furthermore, for antimicrobial agents to exert a sufficient effect from the initial stage of treatment, we examined the theoretical methodology underlying the initial administration.
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© 2017 The Pharmaceutical Society of Japan
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