Objective: At Kitasato Institute Hospital, Kitasato University (henceforth, the hospital), the first edition of an antimicrobial use guidebook (henceforth, the guidebook) was produced in 2000.  This time, the Pharmaceutical Department’s members on the hospital’s Infection Control Committee (ICC) took the lead and revised the guidebook so that it better conforms to clinical conditions and assessed the guidebook they created.
Methods: A Working Group (WG) consisting of two ICC Pharmaceutical Department members and two members of the Medical Products Information Office staff examined the items to be listed in the guidebook.  These items were approved by the ICC and then assigned to physicians and pharmacists to be written up.  A questionnaire survey was conducted on the physicians and pharmacists in the hospital as to their assessment of the content and the conditions of use of the guidebook created.
Results: In the revised edition, “Antimicrobials PK/PD,” “TDM,” “Empiric Therapy for Infections in Each Department,” etc. have been added, the physicians wrote “Empiric Therapy for Infections in Each Department” and everything else was written by the WG.  The return rate of the questionnaire was 65.7% (N=99), and the guidebook utilization rate was 75.4%.  Frequently viewed items were “List of Antimicrobials Used In-Hospital,” “How to Administer Medication during Decreased Renal Function,” “Empiric Therapy for Infections in Each Department,” etc. by the internal medicine physicians, “List of Antimicrobials Used In-Hospital” and “How to Administer Medication during Decreased Renal Function,” etc. by the surgeons, and “Classification of Antimicrobials,” “List of Antimicrobials Used In-Hospital,” “When Renal Function is Decreased,” “TDM,” and “Empiric Therapy for Infections in Each Department,” etc. by the residents.  Furthermore, there were no items deemed “not necessary for inclusion” for a clear reason.  As to be expected in this guidebook, 72.3% of all respondents mentioned it was “a source of information on basic antimicrobial use” and next, “a source of information for treating infections outside one’s area of specialty.”
Conclusion: The items listed in the guidebook are thought to be appropriate, and its usage conditions are also good.  As they are specialists on antimicrobials, the pharmacists playing a central role while cooperating with the physicians on the ICC led to the creation of a highly useful guidebook.

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Objective: The hospital is changing its formulary reference from paper-based to intranet.  There was concern that both paper-based and intranet versions of the formulary would be necessary.  Revising the paper-based hospital formulary each time package inserts are revised is difficult.  For your review we report on the creation of the iPhone® electronic formulary which enables rapid off-line formulary retrieval and easy updates while at the same time providing low cost service in a light device.
Methods: The CSV (Comma Separated Value) of the hospital formulary dictionary was made using a standard personal computer.  The CSV data file was converted using JAMES2DIC into a HTML file format.  Next, the converted HTML file is transformed into the EPWING (Electronic Publishing WING) format using EBStudio.  Finally, we forward the EPWING dictionary file from the personal computer to the iPhone®.  The retrieval becomes possible by using EBPocket for iOS of EPWING/electronic book viewer software for the iPhone®.  The number of items was assumed to be 29 items thought for a lot of inquiries to exist.
Results: We compared the paper-based formulary with the iPhone® electronic formulary.  As a result, the iPhone4® electronic formulary shortened the retrieval time, was smaller, lighter, and excellent at a lower price.
Conclusion: The iPhone4® electronic formulary enables the user to perform complex full-text searches and retrieve information at a much higher speed than is possible with paper based formularies.  It has the additional advantage of seamless integration and deployment of formulary additions or reference material revisions.  We believe we have successfully created a practical electronic formulary.

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