The Annals of pharmacotherapy
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Multicenter Study
Assessment of clinical pharmacists' interventions in French hospitals: results of a multicenter study.
The development of clinical pharmacy activities in most European countries is underway; however, data on these activities are still poorly reported. Multicenter studies are necessary to standardize and demonstrate the value of clinical pharmacy activities in these countries. ⋯ In French hospitals, pharmacists contribute to preventing DRPs during medication order validation. This study suggests that a few types of drugs and errors constitute a substantial proportion of PIs. Knowledge of the most frequent DRPs could significantly increase the efficiency of clinical PIs.
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Preventing significant oxygen desaturation and hypotension through adequate analgesia and sedation during nonemergent intubation in neonates is desirable. However, in many neonatal intensive care units, elective intubations occur without adequate premedication. There is significant variation in the choice of premedication agent(s) and doses, and an ideal regimen for use during nonemergent intubation has not been developed. ⋯ A systematic approach to premedication during nonemergent intubation successfully prevented acute physiological changes.
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To summarize key changes in the 2007 American College of Cardiology/American Heart Association (ACC/AHA) guideline recommendations for pharmacologic therapy as they relate to antiplatelets and anticoagulants, and to evaluate the evidence from several landmark trials that was used to support the guideline updates for these agents. ⋯ Clinicians should be familiar with the updated 2007 ACC/AHA guidelines and the clinical trial evidence that serves as the basis for these recommendations. It is paramount for institutions to outline a preferred and consistent treatment approach. These decisions should involve a review of established efficacy, bleeding risk, need for anticoagulant reversal, costs, and clinician familiarity with different treatment regimens.
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Case Reports
Treatment of Citrobacter koseri infection with ciprofloxacin and cefotaxime in a preterm infant.
To report a case of successful treatment of Citrobacter koseri infection in a preterm infant as a means of challenging the current treatment recommendations on the basis of pharmacodynamic and pharmacokinetic considerations. ⋯ Ciprofloxacin and meropenem should be considered antibiotic treatment options for systemic infection or meningitis caused by C. koseri.
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While medication reconciliation (MR) has been shown to reduce medication errors by limiting errors of transcription, omission, and duplicate therapy, its impact on the provision of unnecessary prophylaxis is largely unknown. ⋯ The strategy of MR alone will not decrease the incidence of prolonged SUP in hospitalized patients. Other techniques should be evaluated to encourage appropriate use of acid-suppressive agents.