Anti-Bacterial Agents ; administration & dosage ; Child ; Child, Preschool ; Drug Administration Routes ; Drug Utilization ; standards ; Humans ; Infant ; Pediatrics ; Pharmaceutical Preparations ; administration & dosage ; Pharmacopoeias as Topic ; Pharmacy Administration

The purpose of this study is to develop medicine electronic order system to improve medicine logistics using information and communication technologies. The Electronic Order System of medicine using Web EDJ adopted the Internet and Web-based technologies which grows so fast lately, enables medical institutions to place an order with the pharmaceutical companies for various pharmacy and vendors to receive an order form in electronical ways and to deliver the products. It designed that every application programs installed and run at web-server, so if personal computers located in user facilities have only web-browser, user can order medicines wherever Internet is available. We can expect two effects from this system. First, it reduces cost and budget because of substituting electronical ordering the pharmacy for telephoning or faxing. Secondly, in technical side, it utilized a new kind of concept, Internet-based EDJ, not VAN(Value Added Network) EDI using the existent closed network.
Budgets ; Commerce ; Internet ; Microcomputers ; Organization and Administration ; Pharmacy

Background: Based on the 2017-2020 annual report of the Department of Health-Antimicrobial Resistance Surveillance Program, significant resistance patterns have been observed for common disease-causing pathogens. In the hospital setting, antimicrobial stewardship programs have been implemented to optimize the use of antimicrobials. Drug utilization review studies provide essential feedback to improve prescribing and use of medications. Objectives: This study aimed to review drug utilization of monitored parenteral antimicrobials among patients admitted from January to December 2019. Methods: The study employed a retrospective, cross-sectional, descriptive research design. A retrospective chart review of drugs administered to patients was conducted. : Results. A total of 821 patients charts met the inclusion criteria. The patients’ ages ranged from 18 to 98 years old and 52% were females. General Internal Medicine practitioners (28%) were the top prescribers of monitored parenteral antimicrobials primarily for the management of moderate-risk community-acquired pneumonia (39%). They were mostly indicated for empirical treatment of infections (94%) and were given for an average of 5.73 days. Only 58% of the total cases had orders for culture and sensitivity testing. Of which, principally 47% had colony cultures. Blood (29%) and sputum (27%) were the most common specimens taken for culture and sensitivity testing. The microorganisms often isolated were Escherichia coli (19%), Klebsiella pneumoniae (18%), and Staphylococcus aureus (9%). In addition, extended-spectrum beta lactamase-producing gram-negative pathogens (4%) and methicillin-resistant S. aureus (1%) were also isolated. All the microorganisms isolated showed most resistance to ampicillin (81%) and most susceptibility to colistin (100%). There were drug therapy-related problems encountered. There was one case of an adverse drug reaction (0.1%) and two cases of contraindications (0.2%). Therapeutic duplication was also observed in 5% of the cases. Moreover, 39% had instances of drug-drug interactions.Piperacillin-tazobactam had the highest consumption (79.50 defined daily doses/1,000-patient days) among the monitored parenteral antimicrobials. Some prescriptions were deemed inappropriate upon evaluation. 12% of cases were inappropriate based on the justification indicator. As for the critical indicators, duration of therapy (78%) was the main reason. Only four components of the DUE criteria indicators have met or exceeded the established threshold level.The cost analysis indicated that the total actual cost of therapy with the monitored parenteral antimicrobials amounted to ₱17,645,601.73. Considering Department of Health National Antibiotic Guidelines recommenda-tions, ideal total cost of treatment was ₱14,917,214.29. Potential cumulative cost savings of ₱2,728,387.44 could have been achieved for patients admitted last 2019. Conclusion Consumption of piperacillin-tazobactam was relatively high as compared to the other monitored parenteral antimicrobials covered in this study. Physicians at the study site seldom prescribe monitored parenteral antimicrobials as recommended by the National Antibiotic Guidelines. This is evidenced in the incidence of inappropriate therapy regimens, with inapt duration of therapy as the leading explanation.From the patient’s perspective, the main economic implication was on the direct medical costs, particularly the increased cost of the actual antimicrobial therapy prescribed to manage various infections. Adherence of physicians to the established guidelines and selection of the most cost-effective therapy could have resulted in considerable cost savings.
Drug Utilization Review ; Antimicrobial Stewardship

Drug utilization review (DUR) system has been defined as "structured, ongoing initiatives that interpret patterns of drug use in relation to predetermined criteria, and attempt to prevent or minimize inappropriate prescribing." This paper introduces the concept, purpose, and effective application of DUR in Korea. DUR can be classified as retrospective DUR, prospective DUR, and concurrent DUR based on the time direction of applying DUR. DUR can also be classified as quantitative DUR defined by retrospective DUR using databases including previously prescribed medicines, and qualitative DUR defined by DUR reflecting patient's clinical condition. We described the history of developing DUR in the United States and the Europe. Finally current status of DUR in Korea is described and the strategy of future settlement of DUR system in Korea is suggested.
Drug Utilization ; Drug Utilization Review ; Europe ; Korea ; United States

OBJECTIVE: The objective of the present study was to evaluate the effects of implementing a systematic Drug Utilization Review (DUR) system on contraindicated drug use and pharmaceutical expenditures in Korea. METHODS: A literature search was conducted using search engines such as PubMed, EMBASE, NDSL, and RISS for relevant systematic studies. The database search was performed and updated in April 2018. Two independent reviewers evaluated the abstracts to find potentially eligible articles. RESULTS: In total, 1433 potentially eligible studies were selected, and 11 articles were eventually shortlisted for inclusion in the present review system. The outcome showed that contraindicated drug use decreased after implementation of the DUR system in Korea. The analysis also showed that the DUR system contributed to a reduction in pharmaceutical expenditures. CONCLUSION: Our study showed that implementing the DUR system reduced both contraindicated drug use and pharmaceutical expenditures in Korea.
Drug Utilization Review ; Drug Utilization ; Health Expenditures ; Korea ; Search Engine

Background: The concentrated potassium chloride injection is a high-alert medication and replacing it with a pre-mixed formulation can reduce the risks associated with its use. The aim of this study was to determine the clinical characteristics of patients receiving different potassium chloride formulations available at a private institution. The study also assessed the effectiveness and safety of pre-mixed formulations in the correction of hypokalaemia. Methods: This was a retrospective observational study consisting of 296 cases using concentrated and pre-mixed potassium chloride injections in 2011 in a private hospital in Kuching, Sarawak, Malaysia. Results: There were 135 (45.6%) cases that received concentrated potassium chloride, and 161 (54.4%) cases that received pre-mixed formulations. The patients’ clinical characteristics that were significantly related to the utilization of the different formulations were diagnosis (P < 0.001), potassium serum blood concentration (P < 0.05), and fluid overload risk (P < 0.05). The difference observed for the cases that achieved or maintained normokalaemia was statistically insignificant (P = 0.172). Infusion-related adverse effects were seen more in pre-mixes compared to concentrated formulations (6.8% versus 2.2%, P < 0.05). Conclusion: This study provides insight into the utilization of potassium chloride injections at this specific institution. The results support current recommendations to use pre-mixed formulations whenever possible.
Potassium Chloride ; Electrolytes ; Drug Utilization Review

The relationship between the number of withdrawn/restricted drugs and socioeconomic, health, and welfare indicators were investigated in a comprehensive review of drug regulation information in the United Nations (UN) countries. A total of of 362 drugs were withdrawn and 248 were restricted during 1950-2010, corresponding to rates of 12.02+/-13.07 and 5.77+/-8.69 (mean+/-SD), respectively, among 94 UN countries. A socioeconomic, health, and welfare analysis was performed for 33 OECD countries for which data were available regarding withdrawn/restricted drugs. The gross domestic product (GDP) per capita, GDP per hour worked, health expenditure per GDP, and elderly population rate were positively correlated with the numbers of withdrawn and restricted drugs (P<0.05), while the out-of-pocket health expenditure payment rate was negatively correlated. The number of restricted drugs was also correlated with the rate of drug-related deaths (P<0.05). The World Bank data cross-validated the findings of 33 OECD countries. The lists of withdrawn/restricted drugs showed markedly poor international agreement between them (Fleiss's kappa=-0.114). Twenty-seven drugs that had been withdrawn internationally by manufacturers are still available in some countries. The wide variation in the numbers of drug withdrawals and restrictions among countries indicates the need to improve drug surveillance systems and regulatory communication networks.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Drug Utilization/*economics/statistics & numerical data ; Female ; Gross Domestic Product/*statistics & numerical data ; *Health Status Indicators ; Humans ; Infant ; Infant, Newborn ; Internationality ; *Life Expectancy ; Male ; Middle Aged ; Product Surveillance, Postmarketing/*economics/statistics & numerical data ; Safety-Based Drug Withdrawals/*economics/statistics & numerical data ; Social Welfare/economics/statistics & numerical data ; Socioeconomic Factors ; Statistics as Topic ; Young Adult

S +nce errors in prescription potentially result in serious outcomes but can be prevented by multiple interventions, it is very important to update the knowledge on medicines and to improve physicians' prescription for medication safety. The aim of this article is to review useful interventions to improve prescription in developed countries. The passive dissemination of drug information or clinical practice guide-lines alone is an insufficient method for improving most pre-scribing behaviors, although necessary. While the concurrent drug utilization review (DUR) could reduce inappropriate drug prescription and help physicians' prescribing decisions, retrospective DUR and penalties should not be operated in order to hold down the cost of medication.
Developed Countries* ; Drug Prescriptions ; Drug Utilization Review ; Prescriptions* ; Retrospective Studies

Among the patients visting Department of Dermatology, Chungman National University, 58 cases had various side effects due to the malpractice of skin disorders. We analysed these 58 cases and the results can be summerized as follows ; 1. 37 cases(64%) were in the second and third decades and 11 cases(19%) were under 19 years-old. 2. Drug medication from pharmacy was the most common(79%), and then local clinics(12%), herb clinics(9%) in decreasing orders. 3. In the route of administration, oral ingestion(38%) was the most common, and 47 cases (81%) were medicated with adrenocorticoids. 4. In motivation to the visit, 31 cases(53%)were by advice, 15 cases by advertizement and 12 cases (21%) by themselves. 5. Acne and psoriasis were about a half of pre-existing skin diseases. 6. Side effects due to malpractice may be divided into 5 items : systemic side effects due to adrenocorticoids (59%), aggravation of pre-existing skin diseases (22%), topical side effects due to adrenocorticoids (10%), chemical irritation and burn (7%), and mercury intoxication (2%) in decreasing orders.
Acne Vulgaris ; Administration, Oral ; Burns ; Dermatology ; Humans ; Malpractice* ; Motivation ; Pharmacy ; Psoriasis ; Skin Diseases* ; Skin* ; Young Adult

BACKGROUND: There is a lack of research on the status of clinical trial pharmacy and clinical trial pharmacist (CTP) in Korea. This study was aimed to investigate the current status of clinical trial pharmacy and clinical trial pharmacists. METHODS: The survey was performed using the 41-item questionnaire designed to investigate information on the following; (1) current status of clinical trial pharmacy designated by Korea Food and Drug Administration, (2) current status of working condition, management, and satisfaction index of CTP. Data collected was analyzed by t-test and chi2. RESULTS: Among the CTPs who responded, 92.7% belonged to department of pharmacy, and 7.3% to clinical trial center. 90.2% of the respondents were women. Forty-two point seven percents of the respondents had more than 3 years of experience in the clinical trial field. 36.6% answered that the current number of CTPs in the institution was '2'. Sixty-three point four percents answered that they subsumed an additional post. Regarding the question on "whether the equipment and working environment of your clinical trials pharmacy is adequate", 65.1% of the respondents answered as 'Inadequate'. Ninety-eight point eight percents answered that work-related education is needed. Ninety-three point nine percents answered that the quality of clinical trials is related to the improvement of the working environment of CTP. CONCLUSION: Clinical trial pharmacy's facility and number of actually working CTP were insufficient. Proper and continuous education and training for CTPs are needed to improve the quality of clinical trials conducted in Korea, with strong institution support and timely regulation change.
Cytidine Triphosphate ; Surveys and Questionnaires ; Female ; Humans ; Korea ; Pharmacists ; Pharmacy ; Silanes ; United States Food and Drug Administration