Pharmaceutical Care Approach to Treating Pneumonia among the Elderly with Intravenous Azithromycin

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  • Kon Takashi
    Department of Pharmacy, Sendai City Medical Center
  • Mori Masayuki
    Department of Pharmacy, Sendai City Medical Center
  • Hashimoto Takanao
    Department of Pharmacy, Sendai City Medical Center
  • Iijima Hideya
    Respiratory Medicine, Sendai City Medical Center
  • Sato Hiroshi
    Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences Department of Nephrology, Endocrinology and Hypertension, Tohoku University Hospital
  • Tochikubo Katsuyuki
    Department of Pharmacy, Sendai City Medical Center

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  • 高齢者肺炎に対するアジスロマイシン点滴静注用の使用実態調査

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<p>We retrospectively evaluated the effects of intravenous azithromycin (AZM) in 76 elderly patients (mean age, 72.8 y) with pneumonia based on Nursing and Healthcare-associated pneumonia (NHCAP) guidelines for a mean of 5 days between April 2012 and March 2013.</p><p>Those who met the NHCAP guidelines (NHCAP; n = 30) were significantly older than those with community-acquired pneumonia (CAP; n = 46) (82.7 vs. 66.3 years, P < 0.05), and had higher A-DROP scores. The NHCAP group was distributed among inpatients categories B to D in the NHCAP guidelines. The ratio of patients with anti-Pseudomonas aeruginosa activity treated with a combination of antibiotics was higher among the NHCAP, than the CAP group (P = 0.02). We excluded 13 patients with missing AZM data and then 22 of 52 among the remaining 63 patients for whom AZM was effective, continued therapy with concomitant antibiotics. Among 11 patients for whom AZM was ineffective, one died and nine were switched to fluoroquinolones. Azithromycin significantly reduced the levels of C-reactive protein, whiteblood cell and neutrophil counts in the patients for whom AZM was effective (all P < 0.05).</p><p>Pharmaceutical care approach to clinical AZM administration could extend understanding of the phamacotherapy of infectious diseases among pharmacists.</p>

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