Carlson J A
Group Health Cooperative of Puget Sound, Central Hospital Pharmacy, Seattle, WA 98112.
Pharmacotherapy. 1991;11(1 ( Pt 2)):32S-35S.
Group Health Cooperative of Puget Sound is a consumer-governed health maintenance organization with approximately 380,000 enrollees. The enrollees are provided pharmacy services at 3 hospital locations, 28 primary care clinics, and 4 specialty care clinics. A Pharmacy and Therapeutics Committee (P&T) oversees cooperative-wide formulary management of all medications used for inpatients and outpatients, thus decreasing the stock of medications in all the pharmacy locations while providing representative drugs from all therapeutic classes. A subcommittee of the P&T committee, the Antibiotic Usage Review Group, manages the antimicrobial formulary. It consists of staff members from infectious disease, nursing, pulmonary medicine, family practice medicine, and pharmacy departments. The group provides recommendations based on seven specific areas; reviewing requests from prescribers for the addition of new antimicrobial agents to the formulary; evaluating antimicrobial agents by drug class; reviewing potential drugs for therapeutic interchange; developing use criteria for specific antimicrobial agents or classes; developing treatment algorithms for specific infectious diseases; performing drug use evaluations for antimicrobial agents; and approving the use of nonformulary antimicrobial agents. This approach has limited the inappropriate prescribing of antimicrobials and has increased the medical staff's knowledge on appropriate use of these agents.
普吉特海湾健康合作组织是一家由消费者管理的健康维护组织，约有38万名参保人。参保人可在3个医院地点、28个初级保健诊所和4个专科护理诊所获得药学服务。药事与治疗学委员会（P&T）负责监督全合作组织范围内用于住院和门诊患者的所有药物的处方集管理，从而减少所有药房地点的药品库存，同时提供所有治疗类别的代表性药物。P&T委员会的一个小组委员会，即抗生素使用审查小组，负责管理抗菌药物处方集。它由传染病、护理、肺病学、家庭医学和药学部门的工作人员组成。该小组基于七个特定领域提供建议：审查开处方者提出的将新抗菌药物添加到处方集中的请求；按药物类别评估抗菌药物；审查潜在的治疗性互换药物；制定特定抗菌药物或类别的使用标准；制定特定传染病的治疗算法；对抗菌药物进行用药评估；以及批准使用非处方抗菌药物。这种方法限制了抗菌药物的不适当处方，并增加了医务人员对这些药物合理使用的知识。
