Result Interp.
THE BOTTOM LINE
Every lab can generate results. Let your company usher in the future of laboratory medicine by generating results that come with personalized treatment recommendations. Let clients know that if they have medication questions for their patients – related to testing or not – they can contact your on-call clinical pharmacist.
Result Interp.
THE BOTTOM LINE
Every lab can generate results. Let your company usher in the future of laboratory medicine by generating results that come with personalized treatment recommendations. Let clients know that if they have medication questions for their patients – related to testing or not – they can contact your on-call clinical pharmacist.
The Value-Adding Intersection of Laboratory Medicine and Clinical Pharmacy
The Value-Adding Intersection of Laboratory Medicine and Clinical Pharmacy
Clinical pharmacists trained to interpret diagnostic tests and recommend drug therapies are in high demand but short supply. Imagine telling prospective clients they will not just receive their test results but that each sample will have prospective clinical pharmacy input to recommend appropriate, patient-specific drug therapy options. This is the laboratory-pharmacist interface physicians crave, designed to set your finished product ahead of the competition.
Our clinical pharmacist is dual board certified and specializes in critical care medicine and infectious diseases. He has helped pioneer the laboratory-pharmacist cooperative, particularly in the setting of infectious disease PCR testing, and works with providers in all healthcare settings from intensive care units to senior living facilities, urgent care clinics to outpatient urology offices.
Consider a urine PCR sample. Despite its increasing utilization, many providers are uncomfortable translating results into prescriptions. Any PCR lab can generate a result that looks like this:
| Pathogens Detected | Resistance Genes Detected |
|---|---|
| Escherichia coli, Morganella morganii | TEM-1, ermB, mefA |
Clinical pharmacists trained to interpret diagnostic tests and recommend drug therapies are in high demand but short supply. Imagine telling prospective clients they will not just receive their test results but that each sample will have prospective clinical pharmacy input to recommend appropriate, patient-specific drug therapy options. This is the laboratory-pharmacist interface physicians crave, designed to set your finished product ahead of the competition.
Our clinical pharmacist is dual board certified and specializes in critical care medicine and infectious diseases. He has helped pioneer the laboratory-pharmacist cooperative, particularly in the setting of infectious disease PCR testing, and works with providers in all healthcare settings from intensive care units to senior living facilities, urgent care clinics to outpatient urology offices.
Consider a urine PCR sample. Despite its increasing utilization, many providers are uncomfortable translating results into prescriptions. Any PCR lab can generate a result that looks like this:
| Pathogens Detected | Resistance Genes Detected |
|---|---|
| Escherichia coli, Morganella morganii | TEM-1, ermB, mefA |
A laboratory utilizing a clinical pharmacy consultant can generate a result that looks like this, making sense of the bacteria and resistance genes for the provider and recommending appropriate drug therapy:
Pathogens Detected: Escherichia coli, Morganella morganii
Resistance Genes Detected: TEM-1, ermB, mefA
Clinical Pharmacy Guidance
Polymicrobial UTI with macrolide-resistant E coli and Morganella that is producing a TEM beta lactamase. Morganella UTIs are generally considered complicated, and they are poorly covered by nitrofurantoin and fosfomycin due to intrinsic resistance. The TEM beta lactamase confers resistance to penicillins (including Augmentin) and first through third generation cephalosporins. Ciprofloxacin is likely the drug of choice. However, E coli is the predominant pathogen and the Morganella may constitute colonization. In this setting, nitrofuratoin would become the drug of choice to cover the E coli alone. Bactrim is less favorable in this seeing of ESBL but can be used when neccessary.
| Medication | Dose | Comments |
|---|---|---|
| Ciprofloxacin | 500mg PO twice daily x 5-7 days | Drug of choice if pyelonephritis suspected. GI and rash are most common AE. Tendinopathy neuropathy, and CNS effects rare but can occur with extended courses. Pregnancy category C. |
| Sulfamethoxazole-trimethoprim | 1 double strength PO twice daily | Caution in patients with folate deficiency (elderly, chronic alcohol use, receiving anticonvulsant therapy). Significant drug interactions with warfarin, phenytoin, methotrexate. Pregnancy category C. |
A laboratory utilizing a clinical pharmacy consultant can generate a result that looks like this, making sense of the bacteria and resistance genes for the provider and recommending appropriate drug therapy:
Pathogens Detected: Escherichia coli, Morganella morganii
Resistance Genes Detected: TEM-1, ermB, mefA
Clinical Pharmacy Guidance
Polymicrobial UTI with macrolide-resistant E coli and Morganella that is producing a TEM beta lactamase. Morganella UTIs are generally considered complicated, and they are poorly covered by nitrofurantoin and fosfomycin due to intrinsic resistance. The TEM beta lactamase confers resistance to penicillins (including Augmentin) and first through third generation cephalosporins. Ciprofloxacin is likely the drug of choice. However, E coli is the predominant pathogen and the Morganella may constitute colonization. In this setting, nitrofuratoin would become the drug of choice to cover the E coli alone. Bactrim is less favorable in this seeing of ESBL but can be used when neccessary.
| Medication | Dose | Comments |
|---|---|---|
| Ciprofloxacin | 500mg PO twice daily x 5-7 days | Drug of choice if pyelonephritis suspected. GI and rash are most common AE. Tendinopathy neuropathy, and CNS effects rare but can occur with extended courses. Pregnancy category C. |
| Sulfamethoxazole-trimethoprim | 1 double strength PO twice daily | Caution in patients with folate deficiency (elderly, chronic alcohol use, receiving anticonvulsant therapy). Significant drug interactions with warfarin, phenytoin, methotrexate. Pregnancy category C. |
