n SA Pharmaceutical Journal - An evidence-based medicine approach to optimising medication therapy in a patient with Clostridium difficile infection - forum

Volume 86 Number 6
  • ISSN : 2221-5875
  • E-ISSN: 2220-1017


Adverse drug reactions (ADRs) are one of the most common causes of morbidity and mortality and approximately 70% of ADRs can be prevented. In Europe, 6.5% of hospitalisations are due to ADRs, quite similar to the estimated prevalence in South Africa (6.3%).1,2 Globally a rise in antimicrobial resistance is evident. Approximately 9.7% of multidrug-resistant tuberculosis (TB) patients have extensively drug-resistant TB (XDR-TB). Approximately 65% of Escherichia coli isolates are resistant to ciprofloxacin. Patients with methicillin-resistant Staphylococcus aureus (MRSA) have a 64% higher risk of mortality compared to patients with methicillin-sensitive Staphylococcus aureus.3,4 Pharmacists have the potential to reduce ADRs experienced by patients, as well as to lead the fight against antimicrobial resistance, by means of the provision of pharmaceutical care. Pharmaceutical care is not a specialist function but is a universal service that can be delivered by every pharmacist. According to Helper and Strand’s 1990 definition, “pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve patients’ quality of life”.5 Thus our approach should be patient-centred, guided by the pharmaceutical care process, as depicted in Figure 1.

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