ABSTRACT
Objective: The success rate of third-line treatment for Helicobacter pylori (H. pylori) infection has been reported to depend on the use of antibacterial agents, potassium-competitive acid blockers, and proton pump inhibitors. However, there is insufficient information on the success rate of H. pylori treatment due to the differences in the clinically used drugs. Here, the factors influencing the success rate of third-line treatment for H. pylori infection was investigated.Methods: Patients aged 20 years or older, who had received third-line treatment for H. pylori infection from January 2013 to December 2021 at the Kameda Medical Center were included. The exclusion criteria were as follows: patients with unknown treatment results and discontinuation of treatment. The primary endpoint was treatment success rate, based on the differences in the treatment regimen and drug choice, which was retroactively investigated from medical records. Confounding factors were adjusted by multivariate logistic regression analysis.Results: Treatment regimens containing sitafloxacin resulted in higher treatment success rates (p<0.05). Multivariate logistic regression analysis showed that the administration of sitafloxacin was the only statistically significant factor influencing treatment success. However, vonoprazan also tended to influence treatment success.Conclusion: Treatment with sitafloxacin and vonoprazan increases the success rate of third-line treatment against H. pylori infection.
ABSTRACT
Objective: Sodium valproate granules (VPA granules) are extremely hygroscopic, deliquesce slowly in the air, and aggregate depending on temperature and humidity conditions. Although pharmacists are required to maintain drug storage conditions until the time of dispensing, they cannot keep track of the actual storage conditions maintained by the patients thereafter. Therefore, we investigated the actual temperature and humidity of the storage conditions maintained by the patients after delivery of the VPA granules.Methods: We conducted a prospective observational study at Kameda Medical Center on pediatric outpatients who were prescribed VPA granules from July 5, 2018 to February 20, 2019. A portable data logger capable of measuring temperature and humidity for 24 h was delivered at the time of dispensation. At the following visit, the data logger was collected, and data about temperature and humidity were obtained. We defined the suitable temperature as 1.0-30.0℃ and suitable humidity as 75.0% or less.Results: In this study, 13 patients were included. In total, 18 data loggers were distributed, and the return rate was 100.0%. The storage temperature was outside the suitable range in 0.8% of the total observation time whereas the humidity exceeded 75.0% in 1.7% of the total observation time.Conclusion: Storage of medications after dispensation was evaluated, and certain temperature and humidity deviations were observed. As storing a drug in an inappropriate environment changes the nature of the drug, affecting its efficacy and safety, it is necessary to educate patients on the proper methods to store oral medications.
ABSTRACT
Objective: Ritodrine, a β agonist, is a uterine tocolytic agent used to suppress preterm labor. In 2013, the European Medicines Agency (EMA) recommended that short-acting β agonists should be used for a maximum of 48 h. However, in Japan, they are widely used for long-term therapy (＞48 h). The EMA recommendation was informed to physicians by pharmacists. We retrospectively evaluated the safety of ritodrine by comparing outcomes before and after the provision of drug information (DI). We investigated whether the physicians' knowledge of the DI of ritodrine influenced performance, and affected the dose administered and the number of side effects reported.Methods: Women administered ritodrine for preterm labor between November 2011 and December 2015 were included in this single-centered retrospective study, which comprised two groups: before (Pre, from November 2011 to November 2013) and after (Post, from December 2013 to December 2015) DI provision. The frequency of cardiovascular side effects was the primary endpoint and the rate of long-term use was the secondary endpoint. The chi-squared test was used for statistical comparison and p＜0.05 was considered to indicate a significant difference.Results: The study comprised 91 patients administered ritodrine for preterm labor: 43 in the Post and 48 in the Pre. The frequency of cardiovascular side effects was 48.8 and 45.8 % in the Post and Pre, respectively (p＝0.64). The rate of long-term use was 65.1 and 79.2 % in the Post and Pre, respectively (p＝0.13).Conclusion: The DI provided by pharmacists increased physicians’ awareness of ritodrine use, which may have improved the safety of the drug. Thus, the provision of DI by pharmacists may enhance patient safety by promoting behavioral change in physicians.
ABSTRACT
Recently, the number of outpatients who visit the hospital only for the examination is increased in Ofuna Chuo hospital. It is important that the pharmacists manage the contrast media used to these outpatients for the rational drug therapy. However, there are a few hospitals where the pharmacists work in the laboratory. Therefore, we investigated the effect of the providing drug information by pharmacists to the patients received magnetic resonance cholangiopancreatography (MRCP) in the laboratory. The subjects were consisted of 38 patients who were taken with Bothdel®Oral Solution 10 during receiving MRCP. The pharmacist instructed the patients about Bothdel®Oral Solution 10 before MRCP. The percentage of patients who were already treated with the other drugs was 92.0%. The 4 patients were taken the drugs interacted with Bothdel®Oral Solution 10 and then were able to prevent the drug interaction by the pharmacist. Also, the patients were taken the questionnaire form about the adverse events of this drug and sent it to the pharmacy by mail after more than 5 days. As the results, the gastrointestinal symptoms such as a loose stool and a diarrhea were reported 28.5% of the patients. In addition, as the adverse events other than listed in the package insert, epigastric distress, heaviness of the head and hot flash, were shown in each of a patient, respectively. In conclusion, it was very important that the pharmacists provide the information of rational use of contrast media to the patients who received examination.