Helen LoSasso,
Clinical Manager of Pharmacy Services at Kennedy Health System, prepared
an extensive update on some changes on the clinical practice guidelines
for the treatment of community-acquired pneumonia. Her paper in length
can be viewed at www.njshp.org or for a copy, please contact Stella
Williams at 609-936-2205. Here’s an excerpt:
| Three organizations, the CDC, the American Thoracic Society and The Infectious Diseases Society of America, have published separate clinical practice guidelines for the treatment of community- acquired pneumonia. These clinical practice guidelines provide evidence-based recommendations for clinicians to optimize therapy. In December 2003, the Infectious Diseases Society of America published an update of CAP. The purpose of the update is to answer questions arising from evolving antimicrobial resistance and advances in technology. The IDSA update provides information in tabular format, | along with text. IDSA guidelines update the criteria for initial selection of site of therapy; initial empiric therapy; changes in the MIC for extended spectrum cephalosporins; diagnostic test updates; SARS; bioterrorism and prevention. Here are some areas of change to note: For all inpatients, initial therapy should occur after blood and sputum cultures are obtained and the first doses of antibiotics should be administered within four hours of the decision to admit. Initial therapy for most patients remains as a macrolide with or with out a beta-lactam; or a respiratory fluoroquinolone | (gatifloxacin, levofloxacin, moxifloxacin, or gemifloxacin). An extended spectrum cephalosporin (cefotaxime or ceftriaxone) is still the recommended agent for penicillin resistant streptococcus pneumonia. The MIC has been revised for nonmeningococcal isolates of S. pneumonia. A MIC <= 1 mcg/ml is now considered sensitive, MIC = 2 mcg/ml is intermediate, MIC > 4mcg/ml is resistant. The prior MIC breakpoints were reflective of the need to maintain higher concentrations to cross into the CNS. Pharmacists should consider the new MIC breakpoints when making recommendations. |
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The Student Scene |
News & Notes |
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| By Daniel T. Abazia, President, NJSHP Student Chapter |
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 As the President of the NJSHP student Chapter, I am often asked, “What does the Student Chapter do”? More often than not, I describe our monthly meetings, student attendance at monthly state chapter meetings, activities that occur each semester as well as promote the Annual meeting. However, I now believe I can proudly respond to the above question with, “…what the students want”! Case in point, at the end of each of our monthly meetings, the floor is opened to all those who attended so that I can find out if anyone has ideas for new activities or speakers for the future. Silence often follows as people make their way on home. However, after our first meeting this past September, I was approached by several student members who wanted to know more about rotations, especially a student’s perspective (experiential learning that occurs during the 6th-year of pharmacy school at Rutgers). I thought this was a good idea, ran it by my officers for their approval, and put it on the back burner while we proceeded with coordinating and executing previously planned events. However, as November approached and we completed the annual ASHP Clinical Skills Competition and Halloween Children’s visit, I began to think about what to do for November. Then it hit me, we should do what the members want! Thus, I proceeded with all of the necessary details to organize an event as well as finding current 6th-year NJSHP members to speak. Also, we decided to invite several faculty members who take students on rotations so that the audience could hear their perspectives on rotations. Needless to say, the NJSHP Student Chapter’s November event entitled, “Perspectives on Rotations,” was one of the most successful programs created by the student chapter during my four years as a member of NJSHP. I have since received only positive feedback from students in attendance as well as the 6th-year students and two outstanding faculty members |
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Continued on back cover |
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