ABSTRACT
BACKGROUND AND PURPOSE: Specializations within doctor of pharmacy (PharmD) programs allow student pharmacists to advance their knowledge and expertise in a specific area of pharmacy. The purpose of this manuscript is to expand the knowledge of pharmacy specializations within a PharmD program by describing two patient care specializations at a school of pharmacy and their assessment strategies. EDUCATIONAL ACTIVITY AND SETTING: A pediatric pharmacotherapy and acute care pharmacotherapy specialization are described. The development of the specializations and assessment strategies are discussed. Student feedback in addition to postgraduate training and employment in specialization area are used to continually assess the specializations. FINDINGS: Sixty students completed the patient care specializations by completing the specialization coursework, which included extra assignments and a research project. A total of 34 students (57%) who completed the specializations also completed postgraduate year one training. SUMMARY: Patient care specializations allow students to develop skills used in specialty areas, and these added skills may help them be successful in finding postgraduate training related to the specialization. Creating detailed specialization requirements and assessment strategies may ensure that the specialization is of appropriate rigor to enhance specialty-specific skills and knowledge. This report can help other schools of pharmacy with their plans for developing a specialization at their institution.
Subject(s)
Education, Pharmacy, Graduate , Education, Pharmacy , Pharmacy Service, Hospital , Pharmacy , Humans , Child , CurriculumABSTRACT
Melioidosis is rare in the United States and endemic to Southeast Asia and Australia. Treatment includes an initial intensive phase of intravenous ceftazidime or meropenem monotherapy depending on severity. The following report describes a case of persistent bacteremia with ceftazidime failure and prolonged meropenem therapy on a ceftazidime-susceptible strain of Burkholderia pseudomallei.
Subject(s)
Obesity, Morbid , Pulmonary Embolism , Venous Thromboembolism , Venous Thrombosis , HumansABSTRACT
BACKGROUND: Bacterial meningitis is responsible for significant morbidity and mortality, but early appropriate therapy is expected to improve outcomes. National treatment guidelines were published in 2004, but no assessment of their utilization in the U.S. has been reported. OBJECTIVES: To measure adherence to meningitis treatment guidelines and describe patient outcomes in relation to recommended antibiotic and dexamethasone use. METHODS: Retrospective chart reviews were performed on patients with bacterial meningitis who presented to emergency departments at two community teaching hospitals. Timing and appropriateness of antibiotic and dexamethasone use were assessed according to national guidelines. Patient outcomes of mortality, length of hospitalization, and neurological complications were analyzed based on therapies received. RESULTS: A total of 161 cases were identified; 38 met inclusion criteria. Recommended antibiotic regimens were administered to 52.6% of patients, while 26.3% received that regimen within eight hours. Dexamethasone was used in 44.7% of patients, but was administered prior to antibiotics in only 10.5% of cases. Mortality was numerically lower with recommended antibiotic therapy but did not reach statistical significance (5.0% versus 16.7%; P = 0.33). Median length of stay was eight days for patients who received recommended antibiotics and 11 days for those who did not (P = 0.69). One patient who received dexamethasone had a neurological complication at discharge compared with four patients not receiving dexamethasone (5.9% versus 19.0%, P = 0.35). CONCLUSION: Current treatment guidelines provide clinicians with direction on optimal care for patients with bacterial meningitis, and an opportunity exists to improve implementation of these recommendations, which could improve patient outcomes.
