著者

新井 亘 上田 恵子 岡添 進 矢吹 直寛 小林 理栄 松木 祥彦 矢嶋 美樹

出版者

Japanese Society for Infection Prevention and Control

雑誌

日本環境感染学会誌 (ISSN:1882532X)

巻号頁・発行日

vol.27, no.2, pp.142-148, 2012

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上尾中央医科グループ薬剤部では,感染制御専門薬剤師を育成する支援として,2006年度から定期的に研修会を開催している.2010年度からは,日本病院薬剤師会の感染制御専門薬剤師または感染制御認定薬剤師にて運営委員会を結成した.年度始めに研修会の参加者を募り,感染制御チームの活動や感染症治療の症例の提出を依頼した.<br>   2010年度は19施設から36名の参加者があり,47事例を収集した.その中から運営委員会の委員(以下,運営委員)にて薬剤師が日常的に遭遇する16事例を選択し,発表者を定めるなどの年間計画を立案した.事前に運営委員にて研修資料を基準に基づいて内容の確認を行い,必要に応じて修正を依頼した.研修会は年間4回開催し,少人数による討論形式で行った.36名中25名が4回通して継続した参加であった.参加者を対象とした研修後の調査では,薬剤師の感染制御に関する関心が高かった.年度末に行った感染に関連する業務の実施率の調査では,研修会参加施設群において不参加施設群と比較して高かった.研修によって施設間の情報の共有や感染対策の支援体制が促進し,対応の多様性を検討することができる内容であると思われる.感染制御専門薬剤師または感染制御認定薬剤師が研修会を運営することは,専門特化した人材育成のために重要な任務を担っているといえる.<br>

著者

松木 祥彦 塚本 哲也 細山田 真 渡部 多真紀 渡辺 茂和 土屋 雅勇

出版者

Japanese Society of Drug Informatics

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.15, no.2, pp.51-56, 2013 (Released:2013-09-05)

参考文献数

17

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Objective: In previously reported comparisons of aminoglycoside antimicrobials administered once daily versus multiple administration, toxicity was found to be equal or lower while efficiency remained high.  However, there are few reports on the clinical condition of targeted elderly persons.  The objective of this study was to evaluate the once-daily dosing regimen of 400 mg of AMK involving elderly pneumonia patients aged 75 years or older with regard to clinical evaluation including the efficacy and toxicity.Methods: A survey to clinically evaluate the efficacy and toxicity of 400 mg AMK administered once daily for 30 min at 24 h intervals was carried out.  One hundred twenty-seven patients with pneumonia and who were 75 years or older at Funabashi General Hospital were targeted, with the aim of an expected clinical effect of Cmax/MIC≥ 8-10.  Serum concentration monitoring was carried out after administration began.Results: There were 121 patients (95.3%) of controlled AMK concentration with a trough serum concentration of <10 μg/mL, which is a safe concentration range.  There were 6 patients (4.7%) where trough serum concentration in the toxic range >10 μg/mL, with an average at 15.1±5.0 μg/mL, and the average administration days were 7.5 ± 3.3 days.  Moreover, before/after AMK administration, there were 3 patients (2.4%) where CRE values increased more than a 150% over the previous values, and were evaluated as renal dysfunction.  Average trough serum concentration at that time was 3.6 ± 1.1 μg/mL, and average number of days of administration were 13 ± 1.4 days.  Patients of trough serum concentration in the toxic range >10 μg/mL were not included.  The average peak serum concentration calculated by Winter’s pharmacokinetic parameter and the 1-compartment model was 35.3 ± 8.0 μg/mL, and the average Cmax/MIC which correlates with the AMK effect was 9.9 ± 2.2.  The treatment was effective for 83 (65.4%) of the 127 patients.Conclusion: By once-daily administration of AMK 400 mg to aged persons 75 years or older, change in trough serum concentration into a safe range and Cmax/MIC≥ 8-10, the level at which clinical effectivity can be expected, could be achieved.  This administration method is shown to be useful in maintaining AMK in the target serum concentration range for aged persons.