Objective: Macrolide therapy has been recommended as an effective treatment for pediatric otolaryngology patients with conditions such as chronic sinusitis and otitis media with effusion.  However, in many cases, a relapse may occur after cessation of treatment.  Therefore, patients are compelled to continue taking antibiotics.  In this paper, we examined the relationship between the duration of therapy and period to relapse on the basis of prescription information and literature research.
Methods: To evaluate the therapeutic doses, we investigated the clinical doses of erythromycin and clarithromycin used for pediatric patients in a community pharmacy from January 2009 to July 2009.  Further, we performed literature searches on the doses of both drugs using Igaku-Chuo-Zasshi databases (from 1983 to 2011) and compared the data obtained with the clinical doses.  Accordingly, the oral doses of macrolides were classified as a low dose or normal dose.  We analyzed the relationship between the administration period and the cessation period, which was defined as the period from the cessation of the treatment to relapse.
Results: Review of the 17 selected reports and the clinical doses showed that the maximum dose of erythromycin was 15 mg/kg/day and that of clarithromycin was 8 mg/kg/day during therapy.  When both cephem or penicillin antibiotics and low-dose macrolides were taken continuously during the administration period, a weak correlation was observed between the administration period and the cessation period.
Conclusion: These results may be useful for the appropriate use of antibiotics and for preventing relapse in pediatric otolaryngology patients.

Objective: In this study, we evaluated the change in degree of recognition and understanding of palliative care as pharmacy students’ years advanced.
Methods: A questionnaire survey consisting of 11 items about recognition of narcotics and 27 items about understanding of palliative care was conducted with first- to fifth-year pharmacy students.  We divided the questions about the image of narcotics into groups and classified the questions about their knowledge of palliative care into the categories based on some reports.
Results: Among the three groups of questions about the image of narcotics, the degree of “right recognition of narcotics” increased, and those of “wrong recognition of narcotics” and “sense of resistance to narcotics” decreased as pharmacy students’ years advanced.  Additionally, questions about their knowledge of palliative care were categorized into three: “basic guidelines for cancer pain relief and methods of narcotic use,” “role of pharmacists in palliative care and support for patients,” and “pharmacologic characteristics of narcotics.”  Their degree of understanding of each category increased with an increase in years.  Both the recognition of narcotics and understanding of palliative care changed in the fourth- and fifth-grade year students compared to the first-, second-, and third-year ones.
Conclusion: These results suggest that the recognition and understanding of palliative care changed along the same trends as pharmacy students’ years advanced.  Therefore, it is important that pharmacy students acquire appropriate knowledge to play an active role in palliative care.

Objective: Pharmacists need to know at what positioning a drug is recommended in clinical practice guidelines when they make prescription proposals.  However, the format of guidelines and the definition of recommendation grades differ between academic societies, making it difficult to comprehensively extract only the information one needs.  Therefore, we developed a guideline utilization system to support prescription proposals by pharmacists.
Methods: We built a database comprised of clinical practice guidelines on pharmacological therapy for breast cancer and breast cancer-related conditions.  FileMaker®was used in the development of the system.
Result: This system allows the comprehensive extraction of clinical questions and recommendations from multiple guidelines by means of standardized keywords.
Conclusion: This system supports prescription proposals by pharmacists when generating pharmacological therapy protocols or when in discussions with healthcare professionals as information on the positioning of therapeutic agents in different guidelines and recommended drugs is readily available.

In order to promote the proper use of medicines, it is important to conduct effective pharmaceutical education and establish a basic knowledge of medicines. We investigated to clarify the current situation and issues of pharmaceutical education. In June 2017, we administered surveys to 1,152 junior high school third graders and 23 health and physical education teachers who taught pharmacy in junior high schools. A total of 1,079 junior high school third graders and 23 health and physical education teachers answered the survey. We found that 6.5% of the students were taking health foods and supplements, and 17.9% always carried medicines. Further, 30.7% of the students regularly checked the effects and side effects of the medicines they took. Moreover, while only 9.0% of the students knew the word “self-medication,” 66.6% had a prescription notebook. Meanwhile, 39.1% of health and physical education teachers were conducting pharmaceutical education classes. Some of them developed their own textbook. All teachers answered that they would like to promote pharmaceutical education. As it was found that junior high school third graders take medicines daily, it is important to develop an educational system that enables them to further improve pharmaceutical education in junior high schools and to acquire correct knowledge. Therefore, it is important that school pharmacists actively participate in pharmaceutical education and promote close cooperation with physical education teachers.

In order to promote the proper use of medicines, it is important to conduct effective pharmaceutical education and establish a basic knowledge of medicines. We investigated to clarify the current situation and issues of pharmaceutical education. In June 2017, we administered surveys to 1,152 junior high school third graders and 23 health and physical education teachers who taught pharmacy in junior high schools. A total of 1,079 junior high school third graders and 23 health and physical education teachers answered the survey. We found that 6.5% of the students were taking health foods and supplements, and 17.9% always carried medicines. Further, 30.7% of the students regularly checked the effects and side effects of the medicines they took. Moreover, while only 9.0% of the students knew the word “self-medication,” 66.6% had a prescription notebook. Meanwhile, 39.1% of health and physical education teachers were conducting pharmaceutical education classes. Some of them developed their own textbook. All teachers answered that they would like to promote pharmaceutical education. As it was found that junior high school third graders take medicines daily, it is important to develop an educational system that enables them to further improve pharmaceutical education in junior high schools and to acquire correct knowledge. Therefore, it is important that school pharmacists actively participate in pharmaceutical education and promote close cooperation with physical education teachers.

Aims: This study aimed at investigating the status of polypharmacy and the experience and perception of bereaved family members of patients with advanced cancer regarding the burden of oral medication. Methods: Self-administered questionnaires were mailed to 303 bereaved family members of patients with advanced cancer, and 102 valid responses were analyzed (response rate, 33.7%). Results: The number of patients in the polypharmacy group (patients taking six or more tablets at a time) was 65 and that in the non-polypharmacy group (patients taking less than six tablets at a time) was 37. The percentage of bereaved family members who felt that the oral administration burden of patients was significantly higher in the polypharmacy group (43.1% vs. 10.8%, p<0.01). The results of the analysis indicated that the bereaved families wanted to reduce the number of tablets taken at a time for alleviating the burden of polypharmacy. The bereaved families of patients in the polypharmacy group were greatly concerned that the number of oral medications was too large. They also expressed the need for medical staff from whom they could seek explanation and counseling regarding the oral medication of patients. Conclusion: It is suggested that medical staff need to be fully aware of the concerns of patients’ families regarding drugs besides checking the compliance status.