These data from real-world observations demonstrate a higher risk for cardiovascular events in patients with a CYP2C19 loss-of-function allele if clopidogrel versus alternative therapy is prescribed. A future randomized study of genotype-guided antiplatelet therapy may be of value.

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Background and objectives Pharmacogenomics (PGx) is the use of human genomic information to avoid toxicity and optimize efficacy of drug therapy in an individual. Hospital pharmacists are the key persons to facilitate the incorporation of PGx into clinical practice. PGx is relatively new to Thai hospital pharmacists. Therefore, this study aimed to evaluate the knowledge, attitude, and practice of Thai hospital pharmacists towards PGx implementation. Materials and methods We conducted a cross-sectional questionnaire-based survey among 600 hospital pharmacists in 21 hospitals across Thailand. The questionnaire consisted of 35 questions using comment boxes, Likert scales, and multiple choice answers. Results The response rate was 20.5% (n = 123). Nearly half of the hospital pharmacists (46.3%) had low PGx knowledge score (<5 points), particularly for applied PGx knowledge in clinical situations. Concerns regarding PGx reimbursement, privacy issues, and discrimination were mentioned in this survey. However, most hospital pharmacists had positive attitude towards PGx service. Only 7% of hospital pharmacists had recommended or interpreted PGx tests in the past year. National PGx guidelines and government policies were considered the important factors for PGx implementation. Moreover, the most preferred learning format for PGx education was professional academic conferences. Conclusion Hospital pharmacists in Thailand had positive attitude towards PGx, despite limited experience and practice of PGx. PGx education to support an application of PGx knowledge in clinical situations is required. National PGx guidelines and government policies may need to be developed to address the concerns for reimbursement, privacy, and discrimination to ensure successful PGx implementation.

Summary What is Known and Objective Carbapenem‐resistant Enterobacteriaceae (CRE) are virulent gram‐negative bacilli and cause urgent healthcare problems worldwide. One of the main factors leading to the emergence of CRE is antimicrobial consumption. The objective of this study was to assess how closely the rate of antimicrobial consumption and the prevalences of carbapenem‐resistant Escherichia coli (CR‐EC) and carbapenem‐resistant Klebsiella pneumoniae (CR‐KP) are correlated. Methods A retrospective study was performed at a university hospital in Thailand from January 2013 to September 2016. The prevalence of E coli and K pneumoniae was represented as percentages per species per quarter. The antimicrobial consumption rate per quarter was expressed as the defined daily dose (DDD)/1000 patient‐days. Evaluation of the relationships between the rate of antimicrobial consumption and the prevalences of CR‐EC and CR‐KP was conducted via Pearson's or Spearman's correlation analyses. Results and Discussion During the study period, the prevalence of CR‐EC and CR‐KP was less than 6%; however, significantly increasing prevalences were reported for both CR‐EC (r = 0.55, P = 0.03) and CR‐KP (r = 0.87, P < 0.01). There was a significant increasing trend in the consumption of meropenem (r = 0.65, P = 0.01), levofloxacin (r = 0.63, P = 0.01), ceftriaxone (r = 0.55, P = 0.03), ertapenem (r = 0.52, P = 0.05) and the carbapenem group (r = 0.64, P = 0.01). A significant correlation was observed between CR‐KP prevalence and total carbapenem consumption (r = 0.55, P = 0.04). Moreover, levofloxacin consumption had a significant positive relationship with the prevalence of CR‐KP (r = 0.65, P = 0.01). No positive correlation was found with the prevalence of CR‐EC. What is New and Conclusion The rate of consumption of levofloxacin and carbapenems was the important key factor correlated with the rate of emergence of CR‐KP. This is the first report demonstrating the correlation between levofloxacin consumption and CR‐KP prevalence.

Pharmacogenomics (PGx) is increasingly being recognized as a potential tool for improving the efficacy and safety of drug therapy. Therefore, several efforts have been undertaken globally to facilitate the implementation process of PGx into routine clinical practice. Part of these efforts include the formation of PGx working groups working on PGx research, synthesis, and dissemination of PGx data and creation of PGx implementation strategies. In Asia, the Southeast Asian Pharmacogenomics Research Network (SEAPharm) is established to enable and strengthen PGx research among the various PGx communities within but not limited to countries in SEA; with the ultimate goal to support PGx implementation in the region. From the perspective of SEAPharm member countries, there are several key elements essential for PGx implementation at the national level. They include pharmacovigilance database, PGx research, health economics research, dedicated laboratory to support PGx testing for both research and clinical use, structured PGx education, and supportive national health policy. The status of these essential elements is presented here to provide a broad picture of the readiness for PGx implementation among the SEAPharm member countries, and to strengthen the PGx research network and practice in this region.