Hospital Pharmacy最新文献

{"title":"Implementation of a Pharmacist-Driven Protocol to Improve Screening and Treatment of Iron Deficiency in Hospitalized Patients with Chronic Kidney Disease.","authors":"Karissa Chow, Brandon Trollinger, Matthew Blum, Sami Alasfar, Jose Manuel Monroy-Trujillo, Dannielle Brown","doi":"10.1177/00185787241267730","DOIUrl":"10.1177/00185787241267730","url":null,"abstract":"<p><p><b>Purpose:</b> While intravenous (IV) iron repletion is an effective tool to treat anemia and improve outcomes in chronic kidney disease (CKD), guideline laboratory definitions of iron deficiency differ, resulting in variability in screening and repletion strategies. This study sought to describe current practices surrounding identification and treatment of iron deficiency in CKD and then implement a pharmacist-led protocol to optimize care at a tertiary medical center. <b>Methods:</b> This single center, retrospective, pre- and post-protocol implementation study of adults with CKD admitted to the inpatient setting first analyzed historic practices for iron deficiency screening and treatment, followed by deployment of a pharmacist-driven protocol for iron deficiency screening and treatment. Iron deficiency was defined as transferrin saturation of ≤30% and ferritin of ≤500 ng/mL. Improvement in screening and repletion rates was analyzed. <b>Results:</b> Historic pre-protocol practices were reviewed in 7155 admissions of which 2559 (35.8%) included screening for iron deficiency. Over the 2 months intervention (post-protocol) period, 315 admissions were included. The average age of patients in the post-protocol cohort was 64.1 years, 53.7% were female, and 26.4% were dialysis dependent. Compared to pre-protocol, patients were 2.33 (95% CI 2.20-2.47) times more likely to be screened and deficient patients were 2.05 (95% CI 1.46-2.86) times more likely to be treated, with most receiving IV iron therapy (85.4%), in the post-protocol cohort. Patients were 3.58 times (95% CI 1.97-6.48) more likely to receive IV iron versus oral alone in the post-protocol cohort compared to pre-protocol. <b>Conclusion:</b> The frequency of patients with CKD screened and treated with iron increased after implementation of a pharmacist-driven protocol. This study underscores the need for a systematic approach to identification/treatment of iron deficiency in this population.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241267730"},"PeriodicalIF":0.8,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study on the Drug Price Revision Strategy in Japan: A Comparison Among Fiscal Years 2018, 2020, and 2022.","authors":"Naoto Nakagawa, Mizuha Konno, Masami Kashiwabara, Shinya Shimoji, Jun Mochimaru, Tadao Inoue, Leanne Lai","doi":"10.1177/00185787241267738","DOIUrl":"10.1177/00185787241267738","url":null,"abstract":"<p><p><b>Objective:</b> Japan has resumed its health technology assessment to decide how to reduce high-cost drug prices. While drug price rules in Japan are comprehensive, they do not necessarily capture differences in product characteristics. This study examined the drug price revision strategy in Japan using migraine treatment with triptans as an example. Cost data from fiscal years (FY) 2018, 2020, and 2022 were utilized. <b>Methods:</b> A cost-utility analysis was conducted from the perspective of healthcare payers, focusing on Japanese patients aged over 18 years experiencing migraines. The study employed a base-case model with probabilities derived from a network meta-analysis. Direct costs included medical and drug costs. Effectiveness was assessed using the European Quality of Life 5-dimensions-3-level questionnaire. Deterministic and probabilistic sensitivity analyses were conducted to examine the level of uncertainty. <b>Results:</b> In FY2018, sumatriptan and eletriptan were cost-effective; however, the other triptans were dominated by sumatriptan. In FY2020, sumatriptan and eletriptan were cost-effective, and rizatriptan was extended-dominated; nevertheless, the other triptans were dominated by sumatriptan. In FY2022, naratriptan and eletriptan were cost-effective; however, the other triptans were dominated by naratriptan. The hierarchy of triptan strategies varied in each fiscal year. <b>Conclusions:</b> This study provides valuable insights into the drug price revision strategy in Japan. The variations could be problematic because in Japan, formulary management of triptans, for example, those for migraine, may face revaluation every other year. Discussions regarding this issue will be further explored in the future.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241267738"},"PeriodicalIF":0.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Antimicrobial Treatment and Surgical Prophylaxis Collide: A Stewardship Opportunity.","authors":"Priscila Fiallo, Timothy Williams, Larry M Bush","doi":"10.1177/00185787241230079","DOIUrl":"10.1177/00185787241230079","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; In 2002, the Centers for Medicare and Medicaid Services (CMS) in collaboration with the Centers for Disease Control and Prevention (CDC) established the &lt;i&gt;Surgical Infection Prevention&lt;/i&gt; (SIP) project for the purposes of developing and standardizing quality improvement measures known to reduce the rates of post-operative surgical site infections (SSIs). Four years later the &lt;i&gt;Surgical Care Improvement Project&lt;/i&gt; (SCIP), an expansion of SIP, was published in governmental &lt;i&gt;Specifications Manual for National Inpatient Quality Measures and&lt;/i&gt; provided several additional initiatives applicable to the perioperative period. Central to both projects are the assurance of the timeliness, selection, and duration of peri-operative surgical prophylactic antibiotics. In support of this objective, various medical associations, such as the American Society of Health-System Pharmacists (ASHP) and the Infectious Diseases Society of America (IDSA), have developed the &lt;i&gt;Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery&lt;/i&gt;. To ensure compliance with quality measures, hospitals are required to report data to the &lt;i&gt;Physicians Quality Reporting System&lt;/i&gt;, which is then reviewed by CMS for reimbursement purposes and to measure hospital performance. To maintain optimal standards of care and satisfy all core measures, it is expected that patients undergoing most categories of surgical procedures receive prophylactic antibiotics. We recognized that patients already being administered antimicrobial therapy as treatment for the condition requiring the surgery not uncommonly also were prescribed unwarranted and redundant pre-operative antibiotics. Our study was meant to quantify such antibiotic redundancy, which only risks the development of antimicrobial resistance and adverse events, to bolster our and other hospitals antimicrobial stewardship programs. &lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis of computerized hospital records over a one-month period of time (November 2022) was conducted focusing on hospital admissions that involved surgical operative procedures. Only those patients who had received a pre-operative surgical prophylactic antibiotic were included in the analysis. &lt;b&gt;Results:&lt;/b&gt; Of the 92 surgeries that fulfilled the inclusion criteria, 38 (41.3%) were performed on patients who were already receiving therapeutic antibiotics for more than 24 hours targeted to treat the infection for which they were undergoing surgery. These included laparoscopic cholecystectomy (24), appendectomy (12), wound debridement (12), and soft tissue incision and drainage procedures (9), comprising nearly 50% of each type of these operations performed during the study time period. &lt;b&gt;Conclusion:&lt;/b&gt; These findings demonstrate a clear opportunity to strengthen both our, and presumably other, hospitals antimicrobial stewardship programs. Together with physician education, granting the pharmacy the ability to cancel unnecessary and re","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 4","pages":"460-464"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Cefepime Induced Neurotoxicity Following a Change in Infusion Time.","authors":"Kendall Stratton, Kelly W Davis","doi":"10.1177/00185787241237142","DOIUrl":"10.1177/00185787241237142","url":null,"abstract":"<p><p><b>Purpose:</b> Cefepime is an antibiotic associated with cefepime induced neurotoxicity (CIN), particularly in those with reduced renal function, or in cases of inappropriate medication dosing. This report describes a case of CIN associated with a change in infusion duration from 180 to30 minutes, which to the best of our knowledge has not been previously reported in the literature. <b>Summary:</b> A 73-year old male was treated with extended infusion cefepime over 180 minutes while hospitalized with recurrent pneumonia. On discharge, cefepime was continued as outpatient parenteral antimicrobial therapy (OPAT) administered over 30 minutes. The patient began to experience symptoms of neurotoxicity after 1 day of receiving OPAT, which subsequently led to a readmission as neurological symptoms worsened. Cefepime was discontinued and symptoms resolved within 48 hours. Renal function was stable throughout treatment and no other causes for neurotoxicity were noted. <b>Conclusion:</b> This is a unique case of CIN secondary to shortened infusion time, which is clinically relevant, particularly during transitions of care. Further investigation, including more widespread use of therapeutic drug monitoring will be beneficial to further elucidate the relationship between infusion time and CIN development.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 4","pages":"411-414"},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia Treated With Vancomycin Calculated by Area-Under-the-Curve in Patients With Elevated Vancomycin Minimum Inhibitory Concentrations.","authors":"Sarah Arnold, Dustin Orvin, Malay Patel, Katie Schoen, Jamie Wagner, Bruce M Jones","doi":"10.1177/00185787231218922","DOIUrl":"10.1177/00185787231218922","url":null,"abstract":"<p><p><b>Purpose:</b> Vancomycin is recommended as first-line treatment of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) bacteremia, dosed by area-under-the-curve (AUC) with an assumed minimum inhibitory concentration (MIC) of 1 mcg/mL via broth microdilution. The purpose of this study was to compare effectiveness of AUC-based and trough-based dosing in MRSA bacteremia with an MIC > 1 mcg/mL via Etest. <b>Methods:</b> This was a retrospective, observational cohort that compared vancomycin dosed by AUC or trough between January 1, 2017 and September 1, 2022. The primary outcome was a composite of treatment failure defined as peristent bacteremia ≥ 7 days, inpatient mortality within 90 days, or microbiologic relapse or readmission within 30 days. Secondary outcomes compared nephrotoxicity, hospital and ICU length of stay, MIC differences, and difference in exposure measured by AUC. <b>Results:</b> Twenty-four patients in each group met inclusion criteria. For the primary outcome, there was no statistical difference in treatment failure between trough and AUC groups, respectively [10 (41.7%) vs 10 (41.7%), <i>P</i> = 1.000]. There was no statistical difference in secondary outcomes, with incidence of nephrotoxicity [3 (12.5%) trough vs 2 (8.33%) AUC, <i>P</i> = 1.000] and median AUC exposure over treatment course [502.9 mcg.h/mL (454.1-599.9) vs 474 mcg.h/mL (435.3-533), <i>P</i> = .312] similar between groups. <b>Conclusion:</b> There was no statistically significant difference in treatment failure for vancomycin by AUC or trough with an Etest MIC > 1 mcg/mL. Overall exposure to vancomycin and incidence of nephrotoxicty were numerically higher in the trough group, suggesting that dosing by AUC may limit exposure without impact on treatment failure.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 3","pages":"329-333"},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an Automated, Pharmacist-Driven, Antimicrobial Patient Acuity Scoring System for Hospitalized Bacteremic Patients.","authors":"Riley Karpen, Claire Murphy, Erica Reed, Anthony T Gerlach, Kari Cape, John Mellett, Sara A Atyia","doi":"10.1177/00185787231182567","DOIUrl":"10.1177/00185787231182567","url":null,"abstract":"<p><p><b>Purpose:</b> The implementation of an automated, pharmacist-driven, scoring system within the EMR has been shown to improve patient care in patients with <i>Staphylococcus aureus</i> bacteremia by increasing the adherence to disease specific quality-of-care measures. However, there are a lack of studies evaluating the incorporation of blood culture review into standard, non-antimicrobial stewardship pharmacist workflow. Our institution implemented an automated, pharmacist-driven, antimicrobial scoring system in the electronic medical record (EMR) on August 6, 2019. <b>Methods:</b> This was a retrospective, single-center, quasi-experimental study of hospitalized, non-critically ill adult (18-89 years of age) patients with bacteremia between July 6, 2018 and July 5, 2019 (pre-implementation group) and September 6, 2019 and September 5, 2020 (post-implementation group). The primary outcome was time to directed antibiotic therapy in patients with positive blood cultures. Secondary outcomes included hospital length-of-stay, days of therapy (DOT) while inpatient, time to effective therapy, 30-day all-cause mortality, and rates of <i>Clostridioides difficile</i> infections documented within 3 months of positive culture results. <b>Results:</b> Implementation of the antimicrobial scoring system did not result in a significant change in time to directed antibiotic therapy (32.5 hours vs 37.4 hours; <i>P</i> = .757). There was also no difference found for time to effective antibiotic therapy (-12.6 hours vs -14.2 hours; <i>P</i> =.905) and no difference found for all other secondary outcomes. <b>Conclusion:</b> The implementation of the antimicrobial scoring system did not lead to an improvement in clinical outcomes. Further research is needed to better define a patient population that may benefit from this system.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"1 1","pages":"32-38"},"PeriodicalIF":0.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41262553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Tiotropium Wasted Doses After Adding Revefenacin to an Inpatient Formulary: A Single-Center Cross-Sectional Study","authors":"Paul M. Boylan, Jordan A. Fuller, Corey M Guidry, Stephen Neely","doi":"10.1177/00185787231222274","DOIUrl":"https://doi.org/10.1177/00185787231222274","url":null,"abstract":"Introduction: Revefenacin is a once-daily nebulized long-acting muscarinic antagonist (LAMA). Revefenacin is supplied as single-use nebulized vials, which may be preferable and less costly for hospital and health-system pharmacies to dispense versus multidose tiotropium inhalers. Estimates of LAMA multidose inhaler wasted doses remains unknown. Methods: This was a single-center descriptive cross-sectional study conducted between January 1 2021 and December 31 2021. Adult patients 18 years and older admitted to a 500-bed academic medical center in the southern United States and were ordered multidose tiotropium packages or single-use revefenacin vials during the study period were included. Results: Among 602 inpatients, there were 705 LAMA orders: 541 tiotropium (76.7%) and 164 revefenacin (23.3%). Four hundred ninety-five tiotropium orders (91.5%) wasted between 20% and 90% of multidose packages. Approximately $24,000 tiotropium doses were wasted versus single-use revefenacin vials. Conclusion: Multidose inhalers of tiotropium dispensed to hospitalized patients contributed to wasted doses compared to nebulized single-use revefenacin vials. Opportunities exist to minimize wasted doses of multidose long-acting inhalers dispensed to hospitalized patients.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"66 5","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valoctocogene Roxaparvovec","authors":"Terri L. Levien, Danial E. Baker","doi":"10.1177/00185787231222506","DOIUrl":"https://doi.org/10.1177/00185787231222506","url":null,"abstract":"Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"50 13","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Medication History Capture Rates In-Person Versus Hybrid: A Multisite Pilot Study","authors":"Amee Joshi, K. Smetana, Lisa Mostafavifar, Maggie Sherry, Bella H. Mehta","doi":"10.1177/00185787231222155","DOIUrl":"https://doi.org/10.1177/00185787231222155","url":null,"abstract":"Purpose: Medication history is the method many organizations use to adhere to The Joint Commission’s (TJC) National Patient Safety Goal (NPSG) to communicate accurate patient medication information. Literature is sparse comparing the number of medication histories completed in-person versus virtually. Methods: This is a single system, multi-site, retrospective observational study. Patients included were admitted through the Emergency Department during October 2022. The primary aim of this study compared the percent capture rates of medication history between 2 hybrid sites to an in-person site within a health-system. Our secondary objective compared the differences in the ‘medication history acuity score’ (MHAS), defined as the total number of edits, additions, and deletions made during a medication history. Results: The medication history capture rate at the in-person site was 74% and at the hybrid sites were 91% and 80%. There were no differences in total medications on each medication history between in-person and hybrid (11 [5-16] vs 11 [6-16]; P = .252). There were no differences in changes made on medication histories between in-person and hybrid (4 [1-7] vs 3 [1-7]; P = .595). Conclusions: Our study demonstrates that medication history capture rates and MHAS are comparable in both in-person and hybrid environments. This similarity suggests the feasibility of implementing hybrid models for medication history services in diverse healthcare settings, potentially enhancing the capacity of health systems to meet TJC NPSG. These findings indicate that hybrid models could be an effective strategy for healthcare systems to optimize their medication history services, especially in settings with varied patient volumes and site specialties.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"24 11","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139450767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Interaction Between Favipiravir and Warfarin: A Case Series","authors":"S. Pornwattanakavee, Watcharapong Priksri, Authakorn Aonkhum, Nattawut Leelakanok, Bannawich Sapapsap","doi":"10.1177/00185787231214428","DOIUrl":"https://doi.org/10.1177/00185787231214428","url":null,"abstract":"Introduction: Initiating favipiravir in COVID-19 patients with long-term warfarin use can lead to increased INR. However, data on the onset and duration of the increasing INR are limited. Method: We reviewed patient charts to include COVID-19 adult patients who received favipiravir for at least 5 days and used warfarin at the same dose for at least 12 weeks. Data on demographics, comorbidities, other medical characteristics, international normalized ratio (INR), and signs of bleeding were collected. Result: Eight patients, with a mean age of 70.88 ± 8.49 years old, received the standard dose of favipiravir. The mean maximum INR (4.30 ± 1.26) was statistically different from the baseline INR ( P = .00029) and the change was observed within 4.38 ± 1.99 days after initiating favipiravir. Warfarin was then discontinued without favipiravir discontinuation in most patients, allowing the INR to gradually decrease within 2 to 3 days. Conclusion: Concurrent use of favipiravir and warfarin led to INR prolongation within approximately 4 days. The effect of such interaction can be acute as the prolongation occurred within 1 day in 1 of the patients.","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139144251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}