著者

丹羽 隆 篠田 康孝 鈴木 昭夫 大森 智史 太田 浩敏 深尾 亜由美 安田 満 北市 清幸 松浦 克彦 杉山 正 村上 啓雄 伊藤 善規

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.38, no.5, pp.273-281, 2012-05-10 (Released:2013-05-10)

参考文献数

38

被引用文献数

1 15

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Antimicrobial resistance in hospitals is increasingly becoming a major problem worldwide, thus appropriate use of antimicrobial agents should be promoted. Since August 2009, our hospital has established a review system for checking prescriptions in all patients receiving antimicrobial injections according to the intervention and feedback of antimicrobial stewardship (AMS) guideline. The antimicrobial use density (AUD), duration of administration, length of hospital stay, and antimicrobial resistance in a year were compared before and after starting the intervention into AMS. Suggestions made by members of the infection control team (ICT) to the prescribers were for the major part the choice and dose elevation of antimicrobials. Most of the proposals (91%) were accepted by the prescribers. Although AUD was not changed after AMS intervention, the proportion of prolonged antimicrobial use (over 2 weeks) was significantly reduced from 5.2% to 4.1% (p=0.007), which led to the saving of costs for antibiotics (4.48 million yen/ year). The incidence of MRSA tended to decrease after AMS intervention (p=0.074). The median length of hospital stay was ultimately shortened by 1.0 day (p=0.0005), which led to an estimated saving of medical costs by 520 million yen/year. We consider that our intervention profoundly affects this cost saving. These findings suggest that the extensive intervention into AMS is effective in reducing the frequency of inappropriate use of antimicrobials, suppressing the occurrence of antimicrobial resistance, and saving medical expenses.

著者

松浦 克彦 杉山 正 片桐 義博

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.31, no.10, pp.832-838, 2005-10-10 (Released:2011-03-04)

参考文献数

15

被引用文献数

3 4

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A pharmaceutical study was carried out to evaluate the quality of five Sodium Ozagrel (OZG) injection products. The quality of these products initially and after 12 weeks and 24 weeks of accelerated stability testing was evaluated based on characteristics such as pH, foreign insoluble matter, content and impurities. One brand name injection and four generic injections were evaluated. The brand name product and one generic product were in freeze-dried form and the other three generic injections were in liquid form.The pH of one generic injection was higher than that of the others. No foreign insoluble matter was observed in any product during the period of the study. The OZG content of the freeze-dried injections was approximately equal to that indicated on the labels but that of the liquid injections was appreciably higher, one of them having at least 15 % more than the indicated content. In the accelerated stability testing, the OZG content was still around 100% of the initial content after 24 weeks, showing that it was very stable. Quaternary salts were detected in the brand name injection but the concentration was only 0.02%. The cis form of OZG was detected in one generic injection but the concentration was only 0.03%. Accelerated stability testing did not increase the quantities of these impurities. Two unknown impurities were detected in one generic injection and one of them was detected in the other three generic injections.Our study showed that there was a difference in quality between the generic injections and the brand name OZG injections in terms of pH, content and impurities, suggesting that not only cost but also quality should be considered when deciding whether to use generics or not.

著者

松浦 克彦 林 秀樹 杉山 正 片桐 義博

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.32, no.4, pp.306-313, 2006-04-10 (Released:2007-11-09)

参考文献数

20

被引用文献数

5 5

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A comparative study was carried out to evaluate the quality of one brand name tablet (A) and five generic tablets (B∼F) containing 5 mg of enalapril maleate (ENA). Tablet quality was evaluated based on such characteristics as content, impurities, dissolution profile, hygroscopic properties, and stability. In the purity test, we measured the quantities of degradation products such as diacid compound (DA) and diketopiperazine compound (DKP) and in the hygroscopicity test, the weight and hardness of the tablets without blister packaging was measured initially and after 2 weeks and 4 weeks of storage at 0%, 43%, 75% and 93% relative humidity (RH). To test stability, we measured the quantities of ENA, DA, and DKP in tablets stored without blister packaging at 40°C and 75% RH for 12 weeks.The ENA content in all preparations was approximately equal to the indicated content. Initially, DA was not detected in any of the preparations. About 0.3% DKP was detected in preparation B and C. The dissolution profiles of all generic tablets were similar to those of the brand name tablet. For preparations A, B, and D, a marked increase in tablet weight and decrease in tablet hardness was observed with increasing RH. In the stability test, the remaining ENA content in preparations A, B, and D after 12 weeks was significantly lower than the initial content. The DA content in preparations A and D had increased markedly after 12 weeks and so had the DKP content in preparation B.Our study showed that the quality of the generic tablets C, E, and F was comparable to that of brand name tablet A with respect to stability and resistance to humidity. We conclude that if generic manufacturers continue to produce such high quality drugs, this will lead to greater confidence in their effectiveness and an increase in their use in the clinical setting.

著者

竹元 伸之 小檜山 律 松浦 克彦 岡野 良 倉富 雄四郎

出版者

日本呼吸器内視鏡学会

雑誌

気管支学 : 日本気管支研究会雑誌 (ISSN:02872137)

巻号頁・発行日

vol.18, no.1, pp.79-83, 1996-01-25

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肺癌の気管支形成術後の吻合部狭窄に対し, バルーン拡張とNd-YAGレーザーを併用し良好な結果を得た。症例は57歳, 男性。左上大区入口部の扁平上皮癌に対し, ほぼ4/5周にわたる気管支楔状切除を伴う左上葉切除術を施行。術後46日目に吻合部が屈曲と肉芽増生および分泌物貯留によるほぼ完全な閉塞を来たし, それによる肺膿瘍・無気肺のため緊急入院となった。理学療法・抗生剤治療後, 高耐圧の血管拡張用バルーンを用いた拡張術を2回, その後Nd-YAGレーザーによる肉芽焼灼を3回(計3669J)施行し気道の開存をはかった。1ヵ月で肺膿瘍・無気肺は軽快し現在(術後18ヵ月)に至っており, 両者の併用は非常に有効であった。