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BACKGROUND: As the prevalence of antimicrobial-resistant pathogens increase, the concern for the impact of it enlarged. Antimicrobial resistance not only leads to high mortality and morbidity but also increases the cost of patient care. METHOD: A retrospective case-control study was conducted to examine the economic impact of methicillin resistant Staphylococcus aureus (MRSA) bacteremia among patients in 3 hospitals in Seoul, Korea. Thirty-one cases were defined as patients with MRSA bacteremia, whereas 31 controls were methicillin susceptible Staphylococcus aureus (MSSA) bacteremia patients. RESULT: The median hospital charge was higher for cases with MRSA bacteremia than for controls with MSSA bacteremia. The median hospital stay of patient with MRSA bacteremia was 28 days and that of patient with MSSA bacteremia was 18 days. CONCLUSION: Methicillin resistance in S. aureus bacteremia is associated with increase in hospital charges.

The aim of this study was to investigate the effect of fluvastatin on the pharmacokinetics of nicardipine in rats. Pharmacokinetic parameters of nicardipine were determined after an oral administration of nicardipine (12 mg/kg) to rats coadministered with fluvastatin (0.5 and 1.5 mg/kg). Compared with the control (given nicardipine alone), coadministration of fluvastatin (0.5 mg/kg) significantly (p<0.01) increased the area under the plasma concentration (AUC) and peak plasma concentration (Cmax) of nicardipine. The toral plasma clearance (CL/F) of nicardipine was decreased significantly (p<0.01, 0.5 mg/kg) compared to the control group. The relative bioavailability (RB%) of nicardipine increased from 1.23- to 1.68-fold. However there were no significant changes in tmax, Kel and t1/2 of nicardipine. The enhanced oral bioavailability of nicardipine suggests that intestinal-mediated CYP3A4 metabolism of nicardipine are competitively inhibited by fluvastatin. Based on these results, the concurrent use of fluvastatin significantly enhanced the oral exposure of nicardipine in rats.

Purpose: This study was to evaluate the factors on bleeding complications and thromboembolism in patients on warfarin with mechanical heart valves visiting emergency center. Methods: Among 560 patients who were operated at Y Cardiovascular Hospital between November 2001 and October 2006, we reviewed the records of 83 patients who had mechanical heart valve and visited emergency center. Results: There were 6 major thromboembolic events, 18 major bleeding events and 25 minor bleeding events from 83 patients who visited emergency center. The mean international normalized ratio (INR) was 4.30±13.29 in patients visiting emergency center, 6.07±3.86 in patients with major bleeding, and 5.89±2.80 in patients with minor bleeding complication. There was statistically significant difference in INR between bleeding complication groups and no bleeding groups (p = 0.001 in patients with major bleeding, p<0.0001 in patients with minor bleeding). However, there was no difference in time in therapeutic range (TTR) when the therapeutic target range of INR was 1.8~3.0 (p = 0.730). With risk analysis, serum albumin level was significantly low and weekly warfarin dose was significantly high in patients with bleeding complication (p≤0.05). Conclusions: There were differences in the values of INR, albumin and weekly warfarin dose among major bleeding, minor bleeding and no complication groups even though TTR was not significantly different among the groups. To reduce anticoagulation related complications, close monitoring and systemic anticoagulation education should be offered by experienced and knowledgeable pharmacists.

To investigate the causing factors for surplus stock in a pharmacy, we carried out a survey among pharmacists. Our analysis revealed that it was caused by uncooperative clinicians, poor-management by pharmacies. It was also induced by excessive competition between pharmaceutical companies and wholesalers. The fundamental causes were large scale of medical package units and frequent changes of prescriptions by clinicians. From the results, we could suggest that a use of generics through measures such as generic prescribing and generic substitution, and encourage pharmaceutical companies to utilize effectively the take-back system.

Background: The systematic retrieval processing is essential to search articles, especially, in pharmacoeconomics area. However, there has been limited information and knowledge about features and differences among medical search engines. Objectives: This study was aimed to compare four major retrieval engines (PubMed, Ovid MEDLINE, and EMBASE) frequently used for drug literature search to collect clinical data for pharmacoeconomic evaluation. Methods: Four major retrieval engines were compared in terms of search results. The pharmacoeconomic evaluation senario was made that pharmacoeconomic evaluation of two oral medicines for smoking cessation, bupropione and varenicline. Free text keyword search was conducted with bupropione, varenicline, and smoking cessation. Search limits included period, types of study designs (randomized controlled trials and systemic reviews), language. SAS 9.1 and Excel 2002 were used for statistical analysis. Results and Conclusions: EMBASE provided the largest number of articles in each search step among four engines. EMBASE also had many unique articles that were retrievable exclusively from its engine and Medline and EMBASE retrieved many common articles in most of search process. Articles from US were more than 50% in EMBASE and Medline. EMBASE has greater number of articles originated from Europe.

Use of Statistics are involved in various stages of research such as research design at the beginning stage, determination of adequate sample size, random group allocation, data collection/management/analysis, and writing and interpretation of statistical results. As access to user -friendly statistical packages gets easier, it is more likely that wrong analyses are made due to mistakes by lack of fundamental knowledge of Statistics, which might lead to wrong study conclusions. In this paper, correct use of Statistics will be presented to prevent or minimize ethical or scientific problems.

Although atopic dermatitis (AD) is one of the most common skin disease, specially in children, it is poorly characterized of pathogenesis and is having difficulty for the development of therapeutic agent. Therefore we reviewed previous studies for atopic dermatitis biomarkers and screening method for the measurement of clinical severity, and suggest a development direction of atopic dermatitis therapeutic agent. Biomarkers for AD was investigated in terms of immune and genomic biomarkers, and main biomarkers of AD were focused on immune biomarkers based on the pathogenesis mechanism. The available immune biomarkers of AD were IgE, IL-4, IL-5, IL-6, IL10, IL-12 and IL18; the genomic biomarkers were chromosome 5q31-33, chromosome 16p12 and HLA-DRB1*15 gene. The screening method of AD has not been established, but SCORAD index was only applicable. SCORAD index measures three parameters, such as extent, intensity, subjective symptom, and is the most accurate and objective method to measure AD severity, and to identify the efficacy of therapeutic agent. Finally, this review article suggests good biomarkers and screening method for AD, and those would contribute to understand the pathogenesis of AD and to develop therapeutic agents.

The carbapenem class such as imipenem (as I), meropenem (as M), and ertapenem(as E), is the most potent and widest spectrum of antimicrobial activity among many structurally distinct β-lactams. The aim of this study is comparatively to evaluate for imipenem, meropenem, versus ertapenem for various infections in a community hospital. This study was performed retrospectively on total 250 cases with I(153), M(88) or E(9) for longer than 3 continuous days at Chungbuk National University Hospital from January 1st thru December 31st, 2005. The major treating microorganisms were E. coli (16.0%), K. pneumoniae (16.0%), A. calcoaceticus-baumannii complex (12.6%), P. aeruginosa (12.0 %) and others (less than 10%), etc. Major diagnoses were sepsis (I26.8%, M63.6% and E33.3%), pneumonia (I35.3% and M13.6%), and intra-abdominal infections (I18.3% and E66.7%), etc and I(5), M(5), and E(4) cases were not met the criteria based on the culture results. In carbapenem monotherapy, the efficacy was I37.3% and M33.0%. All dosage were also appropriate. The mean durations of therapy were all within 14 days. Adverse drug reactions were reported for total 25 cases such as seizure (I4 and M7) or diarrhea (I8, M5, and E1) cases. Uses of carbapenem for inpatient infections were appropriate according to this study and will be recommended in the future.

The aim of the present study was to evaluate the bioequivalence of two erdosteine preparations. We used Erdos capsule (Daewoong Pharmaceutical Co., Korea.) as a reference drug for bioequivalence of Ellotin capsule (Dongkoo Pharmaceutical Co., Korea), and performed this whole study according to the guidelines of Korea Food and Drug Administration (KFDA). Twenty four healthy male volunteers, 23.3±2.8 years in age and 69.5±6.6 kg in body weight, were divided into two groups and a randomized 2×2 cross-over study was employed. After three capsules containing 300 mg of erdosteine (total erdosteine 900 mg) was orally administered, blood was taken at predetermined time intervals and the concentrations of erdosteine in serum were determined using HPLC with UV-detector. The analytical method was validated in specificity, accuracy, precision and linearity. The pharmacokinetic parameters such as AUCt and Cmax were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed AUCt and Cmax. Mean±SD of AUCt and Cmax value for reference drug and test drug were 5.41±1.55 (μg/mL·hr) and 2.67±0.75 (μg/mL), and 5.05±1.30 (μg/mL·hr) and 2.59±0.59 (μg/mL), respectively. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(1.25) for AUCt and Cmax, respectively. These results indicate that Ellotin capsule is bioequivalent to Erdos capsule.

Purpose of this study was to analyze consumer behavior in the purchase of taurine-containing health supplements and to find out pharmacist's role to ensure safe use of health functional foods. A survey analysis was performed with a hundred consumers who visited community pharmacies. TV advertisement was the major information source for consumers and it was the most powerful direct reason for purchasing a specific brand of the taurine-containing product. This trend was more prominent in firm employed young male adult who were less than 40 years old. Interestingly, however, in-depth analysis revealed that small business owners, homemakers, and consumers older than 40 years used pharmacists or doctors for their information source, and their purchase behavior was significantly more affected by recommendation of the health professionals compared to TV advertisement. This contrast was consistent with trustability rating from the consumers. Furthermore, the above subpopulation trusted pharmacists more than doctors while the opposite subpopulation trusted doctors more than pharmacists. The reason for pharmacists' being the supreme trustable resource to the above subpopulation seems to be associated with trust relationship, which is constructed by close communication and sharing most part of daily life with the consumers.

The purpose of the present study was to evaluate the efficacy and safety of Block and burn®, a 4:1 mixture of Phaseolus vulgaris and Garcinia cambogia extracts, in reducing body weight, as the main outcome measure. Secondary measures of the study were body composition change in overweight human subjects. A randomized, double-blinded, placebocontrolled study was conducted on 52 pre-selected, slightly overweight volunteers, whose weight had been essentially stable for at least 2 weeks, The volunteers were divided into two groups, homogeneous for age, gender, and body weight. The test product (1.2 g) containing Phaseolus vulgaris (200 mg) and Garcinia cambogia (50 mg) and the placebo (1.2 g) were taken 6 tablets per day for 56 consecutive days, respectively. Each subject's body weight, body mass index (BMI), body fat, body fat ratio, and waist hip ratio (WHR) were measured. After 56 days (8 weeks), subjects receiving Block and burn ® had significantly greater reduction of body weight. Moreover, a significant changes of the BMI, body fat, and body fat ratio were observed in the test group compared to placebo. However, WHR was not statistically different between groups. These results indicated that Block and burn® produced significant decrements in body weight and suggested decrements in fat mass in the face of maintained lean body mass.

Sexual dysfunction is rising one of major diseases on modern society and it decreases the quality of life. Sildenafil, phosphodiesterase (PDE) inhibitor is a major medication for sexual dysfunction such as erectile dysfunction, uncomfortable sensation, or libido decrease. However, an antidepressant, trazodone which is serotonin-reuptake inhibitor is using for sexual dysfunction as the “unlabeled use” in Korea even the efficacy and safety of trazodone were not approved yet. Therefore, we tried to evaluate and compare the efficacy and safety of both trazodone and sildenafil for sexual dysfunction. This study was performed retrospectively based on the medical records of each 30 patients with one of drugs in Department of Urology, Chungbuk National University Hospital, from July 1st, 2006 to April 30th, 2007. All the prescribed doses were appropriate as trazodone 25 mg twice a day, sildenafil 50 or 100 mg daily. And efficacy were each at 14 patients (46.7%) per trazodone and 6 patients (20%) per sildenafil, respectively. Adverse drug reactions were showed at 5 patients (16.7%) in trazodone and 2 patients (6.7%) in sildenafil, respectively. In conclusion, the “unlabeled use” of trazodone for sexual dysfunction treatment is necessary for some selected patients by doctor's decision in Korea even though PDE inhibitors are still first choice. However, both medications are still recommended to monitor adverse drug reaction during the use.

Meloxicam has been used for the treatment of rheumatoid arthritis and related inflammatory diseases. Although to date several literatures addressed the pharmacokinetics of meloxicam in Caucasian, Indian, South African, etc, no information has been reported on that in Korean. Therefore, the present study was designed to investigate the pharmacokinetic characteristics of meloxicam in Korean and to compare it with those previously published in other races. Following a single oral administration of meloxicam 15 mg in 20 Korean healthy male volunteers, blood samples were serially collected up to 72 hrs. Plasma concentration of meloxicam was determined by liquid chromatography coupled to a tandem mass spectrometry (LC/MS/MS). Peak plasma concentration was 1.8±0.4 mg/L at about 4 hr, and it declined by a monophasic pattern with about 20 hr of a half-life, which was similar to those in South African. Interestingly, however, systemic exposure of meloxicam in Indian was just a half of that in Korean and German represented a slow absorption (ka, 0.36 h-1) up to 8 hr. One-compartment model with a first order absorption could describe the plasma meloxicam concentration-time profile, and ka, ke and Vd/F were estimated to be 0.95±0.62 h-1, 0.038±0.007h-1 and 9.05±2.11 L, respectively. One has to pay attention to refer the previous data from other races for a new study design in Korean, and it would be necessary to have our own data on each drug.