An open type of clean bench “KOACH” makes sterile surroundings at inexpensive cost. But there are no reports of aseptic preparation for injection drugs with an open type of clean bench. We confirmed that an open type of clean bench can make sterile surroundings and preparate aseptic injection drugs.

We placed solid mediums to incubate aerobic bacteria and eumycetes in an open type of clean bench for 15 minutes. Then these solid mediums were incubated under the following conditions: Aerobic bacteria were incubated at room temperature (RT) for 48 hours, eumycetes were incubated at RT for two weeks.

Injection drugs prepared with an open type of clean bench were inoculated with the solid mediums to incubate aerobic bacteria, anaerobic bacteria, and eumycetes. After these solid mediums were incubated under the following conditions: Aerobic bacteria were incubated at 35 - 37℃ for 48 hours, anaerobic bacteria were incubated at 30 - 35℃ for two weeks, and eumycetes were incubated at 30℃ for two weeks.

As a result, aerobic bacteria were not detected in an open type of clean bench. But eumycetes were detected. When we spread a polyvinyl chloride sheet on wooden bench placed an open type of clean bench, eumycetes were not detected. And we can prepare aseptic injection drugs with an open type of clean bench this time.

We have to confirm that an open type of clean bench makes sterile surroundings when we move it. An open type of clean bench can preparate aseptic injection drugs when it is placed properly.

Vancomycin is recommended for the treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) in neonates. Because vancomycin has potential to produce adverse drug reactions such as nephrotoxicity, therapeutic drug monitoring is required to optimize treatment. Therefore, this study aimed to evaluate the predictive performance of published population pharmacokinetic (PPK) models of vancomycin in neonates. Demographic and laboratory data were retrospectively collected from medical records of 54 neonatal patients who underwent vancomycin treatment. We evaluate the predictability of vancomycin concentrations by using typical pharmacokinetic parameters in pre-existing 13 PPK models. The predictive performance from two PPK models was better than that from the other PPK studies (r = 0.806, prediction error (ME) -3.24 mg/L, mean absolute prediction error (MAE) 4.58 mg/L for model of Bhongsatiern et al; r = 0.803, ME -3.48 mg/L, MAE 4.73 mg/L for model of Mehrotra et al). Finally, we constructed a suggested initial dose schedule of vancomycin. Our findings provide useful information for adjusting vancomycin dosage to improve clinical safety and effectiveness.

I performed examination about the easiness of pushing out of the tablet from press through package (PTP) using the tablet of the ethical drug so far. I manufactured the PTPs that standardized a shape this time and reported influence on easiness of pushing out by the difference of the material of the PTP and film thickness as I considered. The PTPs to become the sample manufactured it using PVC (polyvinyl chloride), PP (polypropylene) or multilayered PO (polyolefin) of the different subject matter. When I pushed a tablet out of these PTPs, the necessary power (squeeze force) was 42, 28, 18 [N] each. Similarly, the film thickness 150, 200, the squeeze force of the PTP of 250 μm were 25, 33, 42 [N] in a PVC material. Furthermore, I did 149 provided patients of the agreement with a subject among the patients who visited the community pharmacy and carried out two kinds of sensory assessment about the easiness of pushing out of the tablet from various PTPs. As a result, it became clear to feel that the elderly person was easy to push PTP of thing using multilayered PO or film thickness 150 μm to material. From this, the spread of PTPs that considered easiness of pushing out and use characteristics in the patients with impaired elderly person and fingers that it was suggested that I can improve usability is expected by difference in material of the PTP or thickness.

A woman receiving long-term steroid therapy for systemic lupus erythematosus was urgently admitted to Nara Medical University Hospital because of a lumbar compression fracture occurring in the latter half of pregnancy and gave birth under fentanyl patch treatment. After the start of treatment, the pain was gradually reduced, and she gave birth to a baby girl weighing 1,896 g by cesarean section at the gestational age of 35 weeks and 4 days. The baby had no external malformation, with Apgar scores of 9 at 1 minute and 10 at 5 minutes, and she was monitored for 72 hours after delivery, without marked neonatal abstinence syndrome. Four years later, slightly delayed language development was noted, raising concerns about adverse effects on development. Thus, in view of the long-term prognosis, cautions may be required regarding the active use of a fentanyl patch for chronic pain management during pregnancy.

Inappropriate use of antibiotics may lead to an increase of antibiotic-resistant microorganisms, increase of social medical cost and worsening of patient prognosis. Nowadays, support systems for antibiotic administration have been greatly improved by the active participation of pharmacists. The purpose of this study was to evaluate the intervention by board certified pharmacists in infection control (PIC) on patients with bacteremia. Since October 2014, the PIC has initiated an early prospective audit and feedback (PAF) when a positive result is obtained from the Gram-stain in blood culture.

A total of 716 patients were enrolled in this study. These patients were divided into two groups one year before and after the intervention (pre/post: 345/371). The rate of appropriate use of antimicrobial agents was increased from 85.3％ to 94.6％ (P = 0.034), and the rate of de-escalation was also increased from 27.8％ to 55.6％ (P = 0.014). Furthermore, there was a significant difference in survival up to 90 days before and after the intervention (P = 0.012).

These results suggest that early PAF for patients with bacteremia by PIC may contribute to an appropriate use of antimicrobial agents.