[Comparison of the effects of prophylactic antibiotic therapy and cost-effectiveness between cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway].

The present study was designed to investigate the effects of prophylactic antibiotic therapy and the cost-effectiveness of Cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway. 157 patients (62 in the CEZ group and 95 in the SBT/ABPC group), who underwent surgery for gastric cancer at the First Department of Surgery of our hospital, were investigated. There was no significant difference between the groups with regard to sex, age, incidence of complication, stage of cancer, surgical method, operative time and blood loss, length of hospitalization, the appearance of systemic inflammatory response syndrome (SIRS), changes body temperature, white blood cell count (WBC), C-reactive protein (CRP), or clinical outcome of postoperative care by a nurse during post-operation for 7 days. The prophylactic effect of infection was also no different between the CEZ (69.4%) and SBT/ABPC (69.5%) groups. In contrast, decision analysis strongly indicated that the anticipate cost of antibiotics was higher in the latter group (yen 20402) than in the CEZ group (yen 15556), suggesting that the prophylactic effect of CEZ may be more cost-effective. Thus, evaluations of pharmacotherapy from the aspect of cost may be one of the important responsibility of hospital pharmacists in the future.

[The analysis of prescription frequency and the factors on adverse reactions of NSAIDs for post-operative pain in orthopedic patients].

Recently, adverse reaction of non-steroidal anti-inflammatory drugs (NSAIDs) is the critical problem, although NSAIDs are one of the most commonly used classes of medications worldwide. Therefore, it is worthwhile to investigate the prescription frequency and the factors on adverse reactions of NSAIDs for post-operative pain in orthopedic patients of our hospital. In orthopedic field, loxoprofen was most prescribed in various kinds of NSAIDs. Logistic regression analysis strongly indicated that previous adverse reaction or allergy caused by drugs (not NSAIDs) or food is the important role in the adverse reaction of NSAIDs. In addition, significant correlation was observed between previous illness of gastrointestinal ulcer and gastrointestinal complication of NSAIDs. Moreover, the present study point out that pharmacist clinical intervention against the adverse reaction of NSAIDs may be saved on medical costs. Although further investigation may be needed, these present studies provide the good information for our medication management and instruction tasks (i.e. pharmaceutical care and counseling for inpatients) for post-operative pain of orthopedic patients.