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With the revisions to the Japanese medical institutions law of April 2006, an improved medical care security system in a medical institution is indispensable. More and more medical institutions are now assigning full-time pharmacists to the task of medical safety. Hospital pharmacy sections are utilizing a valid evaluation system developed by the Japan Council for Quality Health Care. Pharmaceutical specialists who contribute to medical security, such as certified oncology pharmacists and certified infection control pharmacists (CICPha) are much awaited. In addition, the DPC (Diagnosis Procedure Combination) system has now become widespread in Japan, and the call is for pharmaceutical care that can decrease medical costs. It is imperative for health care systems to assure the appropriate use of drugs to decrease medical costs without reducing medical services. CICPha can contribute to the antimicrobial management program, and has also focused on medical care security. Several antimicrobial management programs of broad-spectrum agents, i.e., formulary restriction and prior approval, are gradually being enforced in Japan. The CICPha role is far-reaching, and it should make a concerted effort to prevent the injudicious use of antimicrobial agents resulting in the emergence of drug resistance; this must be handled by infection control doctors and nurses along with microbiological technicians. The CICPha must regulate the appropriate use of these agents, and perform surveillance of antimicrobial use and resistance (AUR). We describe the necessity and evaluation of AUR, and also underscore the necessity of training clinical pharmacists who will contribute to patient safety in days to come.

感染制御及び医療安全に貢献する薬剤師の必要性