A clinical nutrition support pharmacist training program, in collaboration with the Spanish Foundation of Hospital Pharmacy, Spanish Society of Clinical Nutrition, Abbott Nutrition International, University of Tennessee, College of Pharmacy and Regional One Health, is described. Nutrition support pharmacists from Spain were selected to participate in a one-month training program with an experienced board-certified nutrition support pharmacist faculty member within an interdisciplinary nutrition support team environment in the U.S. Participants were expected to actively engage in an advanced clinical practice role with supervision. Clinical activities included daily intensive patient monitoring, physical assessment, critical evaluation of the patient and development of an appropriate treatment plan for patients receiving either enteral or parenteral nutrition therapy. Upon successful completion of the training program, participants were anticipated to incorporate these techniques into their current practice in Spain and to train other pharmacists to function in an advanced clinical role independently or within an interdisciplinary nutrition support team environment.

Background Administering treatment by the right route improves patient safety and reduces healthcare spending. Purpose To assess the medical acceptance of sequential treatment (ST) proposals made by the pharmacy in accordance with agreed guidelines and to evaluate the cost savings. Materials and methods For 2 months, the pharmacist twice a week, recorded patients continuing intravenous antibiotic treatment for more than 72 h. Following clinical and analytical standards previously accepted by the Drugs Committee, each patient was evaluated, and if they complied with all aspects necessary to make the transition to oral treatment, this was recommended to the doctor in the clinical record. The antibiotics that were analysed were those with high bioavailability. Results Over two months we noted 76 patients, but only 16 met the requirements for treatment change. Number of patients recruited: 76 Candidates for ST after 72 h: 16 (21%) Not candidates: 60 (79%) Pharmaceutical recommendation: 13 (17%) Change made by the physician 3 (3.9%) Accepted:10 (76.9%) Not accepted:3 (23.1%) The rest of the patients, 60 (79%), were not candidates for oral treatment due to: Fasting treatment (35%) Discharge of patients from hospital (31.6%) Altered lab test results (23.3%) Palliative care (5%) Death of patient (1.7%) To ensure patient compliance (1.7%) Diagnosis did not favour a change of treatment (1.7%) Conclusions The level of medical acceptance of the ST was high (76.9%), but the percentage of patient candidates was low (21%) because the average hospital stay is short (5.9 days) and the majority of patients had altered gastrointestinal absorption. Amoxicillin/clavulanic acid was the antibiotic most often administered orally, but more money was saved (275.26 €) by changing to oral treatment with fluoroquinolones. No conflict of interest.