Kerry Empey

Publications (2)4.37 Total impact

• Source

  Available from: man.ac.uk

  Article: Results of an antimicrobial control program at a university hospital.

  Craig Martin, Ighovwerha Ofotokun, Robert Rapp, Kerry Empey, John Armitstead, Claire Pomeroy, Ardis Hoven, Martin Evans
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  ABSTRACT: The results of the first five years of an ongoing antimicrobial control program are reported. In 1998, a multidisciplinary antimicrobial subcommittee of the pharmacy and therapeutics committee of a university hospital was formed and charged with making formulary interventions in an effort to reduce rising antimicrobial resistance rates and drug expenditures. In 1999, a number of measures were implemented for controlling antimicrobial use. Selected antimicrobials with the potential for inappropriate use or whose inappropriate use had been documented were placed in the control of physicians in the infectious diseases (ID) division. Prior approval by an ID physician was required before the pharmacy could dispense these agents. Other key interventions included removal of ceftazidime and cefotaxime from the formulary, restriction of vancomycin and carbapenem use, and replacement of ciprofloxacin with levofloxacin as the sole fluoroquinolone on the formulary. Data regarding antimicrobial use and expenditures between 1998 and 2002 were compared and analyzed. Antimicrobial use was reduced by 80% for third-generation cephalosporins and 15% for vancomycin following the implementation of the new antimicrobial policies. Antimicrobial-resistance patterns for many important gram-negative pathogens, including Pseudomonas aeruginosa, demonstrated a reversal of previous increases. In addition, the rate of methicillin-resistant Staphylococcus aureus decreased by an average of 3% each year from 1999 to 2002. Pharmacy expenditures for all antimicrobials, including antiviral, antifungal, and antibacterial agents, decreased 24.7%, with a cumulative cost saving of 1,401,126 US dollars, without inflation assumptions. The implementation of an antimicrobial control program decreased the use of selected antimicrobial agents and resulted in substantial reduction of expenditures for antimicrobials.
  American Journal of Health-System Pharmacy 05/2005; 62(7):732-8. · 1.96 Impact Factor
• Article: Macrocytosis as an indicator of medication (zidovudine) adherence in patients with HIV infection.

  Frank Romanelli, Kerry Empey, Claire Pomeroy
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  ABSTRACT: This retrospective chart review was conducted in an outpatient human immunodeficiency virus (HIV) clinic to determine if macrocytosis can be used as a clinical indicator of zidovudine adherence in HIV-infected outpatients. This study included 71 HIV-positive patients who were taking zidovudine and 93 HIV-positive controls who were not taking zidovudine, for 8 weeks or longer. One control and 16 subjects were excluded secondary to insufficient laboratory data or preexistence of other macrocytosis-inducing etiologies. The incidence of macrocytosis (mean corpuscular volume [MCV] >/= 100 fL) was significantly different among subjects and controls: 78% versus 32.6% (p < 0.001), respectively. Adherence (determined by documentation from a physician/pharmacist) was assessed among subjects for whom zidovudine was prescribed, comparing those with and without macrocytosis. Adherence was observed in 77% and 18% of the macrocytosis-positive and macrocytosis-negative subjects, respectively (p < 0.001). Macrocytosis was also observed in patients receiving stavudine (another thymidine analogue, in the class of nucleoside reverse transcriptase inhibitors). Twenty-seven of the 41 patients for whom stavudine was prescribed developed macrocytosis (65.8%). These results indicate that macrocytosis may be useful in assessing adherence to zidovudine-containing antiretroviral regimens and may also have a role in assessing stavudine adherence.
  AIDS PATIENT CARE and STDs 09/2002; 16(9):405-11. · 2.41 Impact Factor