With a substantial number of women using herbal products to augment their milk production, this article will review available literature illustrating efficacy and adverse effects of using these products. Embase, PubMed, and EBSCO (all databases) were searched from inception to June 2011 using terms such as ‘‘galactagogue,’’ ‘‘galactogogue,’’ ‘‘herbal,’’ and ‘‘botanical’’ and the search was subsequently narrowed to specific herbals by name. Additional articles were obtained from article reference lists. Supplemental information was obtained with Natural Standard. All abstracts retrieved were evaluated for relevance and germane articles were included. Numerous lactation-stimulating herbals have been identified in the literature with varying degrees of evidence,mostly anecdotal. Use of torbangun, milk thistle, and fenugreek may correlate with increased milk supply. Evidence regarding adverse effects, pharmacodynamic properties, and pharmacokinetic effects remains scarce. Despite the fact that postpartum women may turn to herbal galactagogues, scant clinical evidence exists to justify their effectiveness. Further clinical trials are needed in order to substantiate these findings.

The RIPS elective was successful in improving residency candidate confidence at the ASHP Midyear Clinical Meeting. Students reported that the course was helpful and improved their confidence and ability to interview.

Students receiving additional preparation prior to interviews when seeking postdoctoral training were significantly more likely to obtain a residency position. In academic settings with limited resources, mock interviews may be preferred over comprehensive preparatory courses.

Purpose To examine the impact of a pharmacy-initiated antibiotic review service on the appropriateness of antibiotic therapy at a community hospital. Methods A retrospective review was conducted that assessed antibiotic prescribing before implementation of an antibiotic review service, followed by an interventional phase that assessed the impact of pharmacy-generated recommendations. Medical records were evaluated for appropriateness of antibiotic therapy. For records reviewed retrospectively, potential recommendations for improvement of antibiotic appropriateness were documented. Potential recommendations were based on evidence-based practice guidelines and pertained to organism susceptibilities, renal dosage adjustments, intravenous-to-oral conversion, duplication, duration, and indication for therapy. During the interventional phase, recommendations were directed to the prescribing physician via telephone or written communication. Patient charts were revisited regularly to assess for potential new recommendations and to determine acceptance of previous recommendations. Results At initial review, 95 (59%) orders reviewed retrospectively were considered appropriate. A total of 73 potential recommendations for improving appropriateness of retrospective orders were recorded. At completion of follow-up, overall appropriateness of retrospective orders decreased to 57%. Prospectively, 115 (57%) orders were considered appropriate at initial review. Physicians accepted 39 (71%) of the 55 recommendations generated for improving appropriateness of these orders. Pharmacy-generated recommendations were successful in improving the number of appropriate prospective orders by 13% (P = 0.004) and identified a cost savings of approximately $12,000. Conclusion The pharmacy-initiated antibiotic review service has been well accepted by physicians and appears to have a positive impact on the number of appropriately prescribed antibiotic orders. Complete implementation of this review service may demonstrate greater impact.