Faculty of Pharmacy

Co-op Faculty of Pharmacy Siam University

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1. Insight in the Pathophysiology and treatment of schizophrenia

2. Essential Psychopharmacology of Psychotropic drugs

3. Porous poly matrix film with antimicrobial activities for wound dressing application

4. Antioxidant and anti-inflammatory activities of Clerodendrum leaf extracts collected in Thailand

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1. Effects of Zine Contents on Physical Properties and Drug Release form Matrix Tables

2. Pharmacotherapy of Anxiety Disorders

3. Pharmacotherapy of Depression

4. Evaluation of ϒ-cyclodextrin effect on permeation of lipophilic drugs-application of cellophone/fused octanol membrane .pdf

5. Cyclodextrin based telmisartan ophthalmic suspension-formulation development for water insoluble drugs

6. 3D-QSAR-studies-on-lipid-peroxidation-inhibitory-activity-of-chromone-derivatives

7. Underdose-antibiotics-in-patients-on-CRRT

8. In silico trails using Monte Carlo simulation to evaluate ciprofloxacin and levofloxacin dosing in critically ill patients receiving prolonged intermittent renal replacement therapy

9. Using imgSeek to support Pharmacy students of Pill identification

10. Role of Valproic Acid in Bipolar Disorder

11. FtsZ Protein – Novel antibacterial target

12. Glucokinase – The new promising target for hypoglycemic drugs

13. Development of Questionnaire measuring attitude towards the Pharm. D. Curriculum, Faculty of Pharmacy, Siam University

14. Clinical outcomes of Pharmaceutical Care at Warfarin outpatient clinic Bangplama Hospital, Suphanburi

15. Characterization of poly lactic acid nano fiber from electrospinning technique

16. Formulation of skin infections micro emulsions prepared from modified coconut oil

17. Narumol110360 Biological activity evaluation and molecular docking study of chromone derivatives as cyclooxygenase-2 inhibitors 

18. Ex vivo Ceftolozane/Tazobactam clearance during continuous renal replacement therapy.

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[fruitful_tab title=”1. Drug Dosing in Patients with CRRT Foculing on Antimicrobial agent”]
[ct_button id=”button_47″ size=”small” solid=”20″ link=”http://www.inter.siam.edu/wp-content/uploads/2017/09/Drug Dosing in Patients with CRRT Focusing on Antimicrobial agents.pdf” icon=”” arrow=”1″ color=”#179bd7″ css_animation=”” animation_delay=”1500″] Full Text : pdf[/ct_button]
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[fruitful_tab title=”2. Thermal Properties and Rheological Behaviors of the Anesthetic Gel Containing Lidocaine and Prilocaine”]
Thai Pharmaceutical and Health Science Journal – วารสารไทยเภสัชศาสตร์และวิทยาการสุขภาพ
ISSN: 1905-3460
Journal click here –> http://ejournals.swu.ac.th/index.php/pharm/article/view/9313/7994
[ct_button id=”button_47″ size=”small” solid=”15″ link=”http://www.inter.siam.edu/wp-content/uploads/2017/09/Thermal Properties and Rheological Behaviors of the Anesthetic Gel Containing Lidocaine and Prilocaine.pdf” icon=”” arrow=”1″ color=”#179bd7″ css_animation=”” animation_delay=”1500″] Full Text : pdf[/ct_button]
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[fruitful_tab title=”3. Pharmacotherapy of Depression in Patients with Chronic Medical Illness”]
Isan Journal of Pharmaceutical Sciences, IJPS – วารสารเภสัชศาสตร์อีสาน
Journal click here –> https://www.tci-thaijo.org/index.php/IJPS/article/view/90340/78267
[ct_button id=”button_47″ size=”small” solid=”15″ link=”http://www.inter.siam.edu/wp-content/uploads/2017/09/Pharmacotherapy of Depression in Patients with Chronic Medical Illness.pdf” icon=”” arrow=”1″ color=”#179bd7″ css_animation=”” animation_delay=”1500″]Full Text : pdf[/ct_button]
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[fruitful_tab title=”4. Anti-oxidative Effects and Toxicity of Bauhinia penicilliloba Ethanolic Leaf Extracts “]

Abstract

This study aimed to investigate the anti-oxidative effect and toxicity of Bauhinia penicilliloba ethanolic leaf extracts (EEBP). The EEBP was 23.45% from dried weight which yielded active purified fraction (AFBP) at 1.84%. The AFBP was phytochemical screened and found to be flavonoid which identified as rutin, quercetin and kaempferol by using HPLC. The scavenging activity of EEBP and AFBP was examined by DPPH (IC50=12.91±0.11 and 5.55±0.23 μg/mL) and ABTS assays (TEAC=0.60±0.02 and 4.93±0.15 mM). The reducing power of EEBP and AFBP which were conducted by FRAP assay, was 0.61±0.09 and 8.68±0.15 mM/mg. The EEBP and AFBP also inhibited TBARS formation in brain tissue (IC50=13.58±3.25 and 6.07±0.74 μg/mL). The phenolic contents of EEBP and AFBP were 77.71±1.43 and 4,162.59±81.90 μg/mg of gallic acid equivalents. LD50 values for acute toxicity of a single intra-gastric (i.g.) route administered to adult male and female mice were >6.00 g/kg BW, whereas, LD50 values of intra-peritoneal (i.p.) route were >4.00 g/kg BW and 2.77 g/kg BW. Sub-chronic toxicity was conducted by given orally of the EEBP for 8 weeks. The body weight, organ weight, AST, ALT, ALP, Cr and BUN serum levels were not altered. Our study suggests that B. penicilliloba may have a considerable potential for further development as a new anti-oxidative agent.
Keywords : Bauhinia penicilliloba, anti-oxidative activity, acute toxicity, sub-chronic toxicity
Faculty of Pharmaceutical Sciences, Ubon Ratchathani University | Faculty of Pharmacy, Siam University, Bangkok
Journal click here –> http://phar.ubu.ac.th/page?mlv1=7&mlv2=7&mlv3=1&publishid=754
[ct_button id=”button_47″ size=”small” solid=”15″ link=”http://www.inter.siam.edu/wp-content/uploads/2017/08/Anti-oxidative-Effects-and-Toxicity-of-Bauhinia-penicilliloba-Ethanolic-Leaf-Extracts.pdf” icon=”” arrow=”1″ color=”#179bd7″ css_animation=”” animation_delay=”1500″]Full Text : pdf[/ct_button]
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[fruitful_tab title=”5. Cyclodextrin-Based Formulations: A Non-Invasive Platform for Targeted Drug Delivery”]

Abstract

Cyclodextrins (CDs) are recognized as promising pharmaceutical excipients due to their unique ability to form water-soluble inclusion complexes with various poorly soluble compounds. The numerous investigations on CDs and their use in nanomedicine have received considerable attention in the last three decades, leading to the rapid development of new CD-containing formulations that significantly facilitate targeted drug delivery and controlled drug release, with consequent improvements in drug bioavailability. This MiniReview highlights the efficacy and recent uses of CDs for non-invasive drug delivery. Using ophthalmic and nasal drug delivery as examples, an overview of chemical properties, mechanisms of CDs on drug solubilization, stabilization and permeation, along with their toxicological profiles relevant to nasal and ocular administration, are provided and discussed. The recent development and application of CD-based nanocarrier systems for targeted drug delivery are summarized.
Authors: Chutimon Muankaew, Thorsteinn Loftsson
Publishing link: https://www.ncbi.nlm.nih.gov/pubmed/29024354
Fulltext: http://onlinelibrary.wiley.com/doi/10.1111/bcpt.12917/full
Siam University : http://www.research-system.siam.edu/images/Essential/Cyclodextrin-Based_2.pdf
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[fruitful_tab title=”6. Update on Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)”]
Publishing link : http://www.research-system.siam.edu/images/Essential/update41260-M.pdf
By : ผศ.ดร.ภก.วีรชัย ไชยsจามร
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[fruitful_tab title=”7. Strategies to optimize antimicrobial dosing regimens in patients receiving renal replacement therapy”]
Publishing link : http://www.research-system.siam.edu/images/Essential/strategies41260-M.pdf
By : ผศ.ดร.ภก.วีรชัย ไชยsจามร
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[fruitful_tab title=”8. Antimicrobial Dosing Adjustment in Patients with Reduced Renal Function”]
Publishing link : http://www.research-system.siam.edu/2013-12-20-04-26-42/4957-antimicrobial-dosing-adjustment-in-patients-with-reduced-renal-function
By : ผศ.ดร.ภก.วีรชัย ไชยsจามร
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[fruitful_tab title=”9. Antibiotics in the pipeline”]
Publishing link : http://www.research-system.siam.edu/2013-12-20-04-26-42/5040-antibiotics-in-the-pipeline-2
By : จันทนา ห่วงสายทอง, แสง อุษยาพร, อภิโชติ โซ่เงิน
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[fruitful_tab title=”10. Dyslipidemia Among Thai HIV-Infected Adults Receiving Antiretroviral Therapy: A Hospital-Based Report”]
Authors: Apichot So-Ngern, Buddharat Khan-asa, Preecha Montakantikul and Weerawat Manosuthi / Faculty of Pharmacy, Siam University, Bangkok; Siriraj Hospital, / Faculty of Medicine Siriraj Hospital, Mahidol University; /
Faculty of Pharmacy, Mahidol University, Bangkok; / Ministry of Public Health, Nonthaburi, Thailand

Download Abstract : http://www.research-system.siam.edu/2013-12-20-04-26-42/5128-dyslipidemia-among-thai-hiv-infected-adults-receiving-antiretroviral-therapy-a-hospital-based-report
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[fruitful_tab title=”11. Design of Experiment Approach for Fabrication Process of Electrospun Shellac Nanofibers Using Factorial Designs”]
NAWINDA Chinatanqkul, SIRIKARN Pengon, CHUTIMA Llmrnatvaplrat and SONTAYA Limmatvapirat
Faculty of Pharmacy, Siam University, Thailand / Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Silpakorn University, Thailand / Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Thailand / Pharmaceutical Biopolymer Group (PBiG), Faculty of Pharmacy, Silpakorn University, Thailand.

Abstract

Electrospun shellac nanofibers might be potentially used for wound dressing application due to its natural origin and excellent protective properties. In this study, a full factorial design with three replicated center points was performed in order to investigate the main and interaction effects of shellac content (35-40% w/w), applied voltage (9-27 kV) and flow rate (0.4-1.2 mL/hr) on the morphology of shellac nanofibers. A total of 11 experiments were conducted. The response variables were the diameter of nanofibers, the distribution of diameter and the amount of beads. The results showed that the concentration of shellac was the most significant impact on shellac nanofiber diameter, while applied voltage, interaction between shellac content and voltage, and feed rate were minor factors, respectively. Shellac content and applied voltage had negative relationships with bead amount. When reducing the concentration of shellac and voltage, the amount of beads was increased. However, the influence of these parameters on diameter distribution seemed to be not significant. Based on response surface plot, nanofibers with thinner diameter (-493 nm) and less number of beads (-0.47) could be obtained at the optimum conditions; the shellac content of 38.5% w/w, the voltage of 21 kV and the feed rate of0.4 mL/hr.

Keywords: shellac, electrospun nanofibers, factorial design, wound dressing

Download Abstract : http://www.research-system.siam.edu/2013-12-20-04-26-42/5130-dyslipidemia-among-thai-hiv-infected-adults-receiving-antiretroviral-therapy-a-hospital-based-report-3
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[fruitful_tab title=”12. Development of bilayer zein-based matrix tablets for multiphasic drug release kinetics”]

Abstract

Zein has been widely used as a film coating material for controlling the release of drug. However, the role as a matrix forming agent in tablets, especially the extended release dosage forms, was not clearly studied. The objectives of this study were to develop the bilayer tablets with multiple drug release kinetics, and to explore the effect of different zein contents on the mechanism of drug release from matrix tablets. Chlorpheniramine maleate was selected as a model drug. Matrix tablets with various amounts of zein were prepared as bilayer formulations by direct compression method. The first layer was designed for immediate release, and the second layer was aimed to provide a sustained release characteristic. Tableting properties including weight, thickness, diameter, friability, hardness and disintegration were evaluated. The dissolution assay was carried out in 0.1 N HC1 (pH 1.2), phosphate buffer solutions with pH of 5.5 and 7.0, respectively. The kinetics of drug release were analyzed using various mathematical models. The results suggested that weight, thickness, diameter, hardness and friability were not significantly different among formulations and well-controlled within the desired range indicating excellent tableting properties. An increase in the amount of zein led to the increased disintegration time exhibiting extended drug release. The first layer without zein component was completely disintegrated and dissolved within 10 min while the second layer consisting of several zein concentrations was not disintegrated. When 60%w/w or more of zein was used, the drug release profile seemed to be sustained over a period of 8 h as influencing by the gel barrier formation of zein after contacting with the aqueous media. The kinetics of drug release in 0.1 N HC1 and phosphate buffer solution pH 5.5 were fitted with Higuchi model, whereas the drug
release profile in pH 7.0 phosphate buffer solution was followed Hixson-Crowell model. Therefore, the main mechanisms of drug release in acid and basic media were Fickian’s diffusion and tablet erosion.

Keywords: Zein, Chlorpheniramine maleate, Bilayer tablet, Sustained release, Kinetic

By: Noppadol Chongcherdsak1, Danuch Panchapornpon1, Nawinda Chinatangkul1, Chutima Limmatvapirat2, Sontaya Limmatvapirat

Department of Pharmaceutical Care, Faculty ofPharmacy, Siam University, Bangkok, Thailand, email: j-noppadon@hotmail.com, damch.pan@yahoo.com, nawindac@yahoo.com 2Department of Pharmaceutical Chemistry, Faculty ofPharmacy, Silpakorn University, Nakhon Pathom, Thailand, email: limmatvapirat_c@su.ac.th 3 Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand, email: limmatvapirat_s @su. ac.th
Clik PDF: http://www.research-system.siam.edu/images/Essential/Development_of_bilayer.pdf
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[fruitful_tab title=”13. Topoisomerase I Inhibitory Activity and 3D QSAR Studies of Chromone Derivatives.”]

Abstract

Topoisomerase I (Top I) is the molecular target for a diverse set of anticancer agents. This study was a continuation of previous work examining the Top I inhibitory activity of a series of chromone derivatives. Nine chromones were evaluated using eukaryotic DNA TOP I drug screening kit. The most potent inhibitor, chromone 20 showed greater inhibitory activity (IC50 = 0.83 mM) than the previously reported chromone compounds as well as the known Top I inhibitor, camptothecin. To develop the structure-Top I inhibitory activity relationship, the 3 dimensional quantitative structure-activity relationship (3D QSAR) were performed using comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA). The best CoMFA model gave cross-validated r2 (q2) = 0.578 and non cross-validated r2 = 0.995 while CoMSIA gave q2 = 0.632, r2 = 0.996. The contour maps provide the fruitful structural features which are useful for designing new compounds with higher activity.

Keyword : chromone derivatives, topoisomerase I inhibitory activity, CoMFA, CoMSIA,

Paper Type : Contributed Paper
Title : Topoisomerase I Inhibitory Activity and 3D QSAR Studies of Chromone Derivatives
Author : Chirattikan Maicheen, Narumol Phosrithong, Jiraphun Jittikoon and Jiraporn Ungwitayatorn*
Email : jiraporn.ung@mahidol.ac.th
Chiang Mai Joutnal of Science / Volume : Vol.45 No.2 (March 2018)
Download Fulltext : http://epg.science.cmu.ac.th/ejournal/journalDetail.php?journal_id=8985
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[fruitful_tab title=”1. Solubility of Cyclodextrins and Drug/Cyclodextrin Complexes”]

Abstract

Cyclodextrins (CDs), a group of oligosaccharides formed by glucose units bound together in a ring, show a promising ability to form complexes with drug molecules and improve their physicochemical properties without molecular modifications. The stoichiometry of drug/CD complexes is most frequently 1:1. However, natural CDs have a tendency to self-assemble and form aggregates in aqueous media. CD aggregation can limit their solubility. Through derivative formation, it is possible to enhance their solubility and complexation capacity, but this depends on the type of substituent and degree of substitution. Formation of water-soluble drug/CD complexes can increase drug permeation through biological membranes. To maximize drug permeation the amount of added CD into pharmaceutical preparation has to be optimized. However, solubility of CDs, especially that of natural CDs, is affected by the complex formation. The presence of pharmaceutical excipients, such as water-soluble polymers, preservatives, and surfactants, can influence the solubilizing abilities of CDs, but this depends on the excipients’ physicochemical properties. The competitive CD complexation of drugs and excipients has to be considered during formulation studies.

KEYWORDS: complex; cyclodextrin; poorly soluble drug; solubility
Author :
1. Faculty of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand. phennapha.s@rsu.ac.th.
2.* Chutimon Muankaew Faculty of Pharmacy, Siam University, 38 Petchkasem Road, Phasi Charoen District, Bangkok 10160, Thailand. chutimon.mua@siam.edu.
3. Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phyathai Road, Pathumwan, Bangkok 10330, Thailand. phatsawee.j@chula.ac.th.
4. Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, 107 Reykjavik, Iceland. thorstlo@hi.is.

Link to Abstract
Link to Article

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[fruitful_tab title=”2. Education on Antimicrobials, Antimicrobial Resistance, and Infectious Diseases in Pharmacy Curricula, Thailand”]

Abstract

To compare the number and percentage of subjects, credits, and learning hours with regard to antimicrobials, antimicrobial resistance, and infectious diseases in pharmacy curricula of Faculty of Pharmacy in Thailand. This was a survey study that defined keywords in regard with antimicrobials, antimicrobial resistance, and infectious diseases by physician and clinical pharmacist. The keywords were used to search from course descriptions, and course syllabi in Thai pharmacy curricula in each university. There were19 universities providing pharmacy curricula in Thailand, which data were completed by 13 out of 19 universities. All universities provided the subjects related to antimicrobials, antimicrobials resistance and infectious diseases. Khon Kaen University had the highest number (36 credits) and percentage of credits (15.79%). Siam University had the highest percentage of lecture hours (57.33%). Mahasarakam University had the highest percentage of laboratory hours (86.67%). In addition, there were 6 out of 19 universities with the infectious diseases clerkship. All 19 universities provided the subjects related to antimicrobials, bacterial resistance and infectious diseases in various types of learning (i.e. lecture, laboratory and clerkship). These could provide pharmacy graduates in promoting appropriate use of antimicrobial agents.

Keyword: Antimicrobials; Antimicrobial resistance; Infectious diseases; Pharmacy curricula; Thailand
Author:
T. 1. Paiboonvong, C. Pummangura, P. Tedtaisong, V. Thamlikitkul, P. Tragulpiankit, T. Suansanae, S. Sukkha, P. Montakantikul

1 Faculty of Pharmacy, Siam University, Bangkok, Thailand
2 Department of Pharmacy, Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University
3 Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
4 Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
Link to Abstract
Link to Article

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[fruitful_tab title=”3. Development of the Instructional Model to Enhance Communication Skills for Pharmacy Students based on Transformative Learning Theory.”]

Abstract

The purposes of this research were 1) to develop the instructional model to enhance Communication Skills for Pharmacy students (CSP) based on transformative learning theory and 2) to evaluate the effectiveness of this model. The study was conducted under a research and development process dividing into 4 phases as follows: 1) developing the instructional model 2) Creating the research instruments 3) Establishing a pilot study to evaluate the feasibility of the model. 4) Implementing the instructional model to assess the effectiveness of the model. 38 people of fifth-year pharmacy students who were studying in the second semester of academic year 2016, Siam University were intentionally chosen to be the research sample by purposive sampling method. The research instruments were the learning management plan, communication skills in pharmacy practice testand critical reflection worksheet.The data were analyzedbyusing repeated measures ANOVA and content analysis. The results show that 1) the components of CSP are patient-centered communication skills and nonverbal communication skills. 2) The Instructional modelconsisted of principle, objectives and process divided into 6 phases:experiential learning, critical reflection, dialogue, repeated experiential learning, lesson learned discussion and presentation. 3) The result of the instructional model effectiveness assessment showed that CSP average posttest scores were higher statistical significantly than those obtained from pretest (p < .05). Regarding to learning process efficiency, the journal writing was able to establish critical reflective thinking of the students, and improved their analytical thinking and applying knowledge for practical utilization. The dialogue, could also develop active listening skills of the students brought about lesson learned discussion and share ideas which are major components of transformative learning. Keywords:communication skills in pharmacy practice, transformative learning, instructional model, pharmacy students. Archives: Vol 11 No 1 (2561): ฉบับภาษาไทย มนุษยศาสตร์ สังคมศาสตร์ และศิลปะ ( มกราคม - เมษายน 2561 ) Author: Sathian Phunpon, Khanittha Saleemad, Chalermsri Pummangura, Jitra Dudsdeemaytha Link to Abstract
Link to Article

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[fruitful_tab title=”4. คลินิคชะลอไตเสื่อม”]
Link: http://research-system.siam.edu/2013-12-20-04-26-42/3248-2013-12-20-05-58-197
By : Asst.Prof.Dr.Weerachai Chaijamorn
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[fruitful_tab title=”5. Preparation times and costs for various solutions used for continuous renal replacement therapy”]
Link: http://research-system.siam.edu/images/Essential/weerachai_Chaijamorn_6-61_.pdf
By : Asst.Prof.Dr.Weerachai Chaijamorn
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[fruitful_tab title=”6. Investigation on the interactions between glucomannans and bifidobacterium protein by using molecular dynamics simulations”]

Abstract

Konjac glucomannan is a polysaccharide extracted from the Amorphophallus konjac K.Koch plant. It is often used as food additives due to their low toxicity, biodegradability and low calories. The unique properties of konjac glucomannan is its prebiotic activities. Konjac glucomannan which cannot be digested and absorbed in human stomachs and small intestines. Therefore, it is fermented in the large intestine and becomes food for the beneficial bacteria or probiotics especially bifidobacteria and lactobacilli in human colons. This study examined the effect of the size of konjac glucomannan on the prebiotic property. The interactions between the different degrees of polymerization of konjac glucomannan and Bifidobacterium protein were investigated in 0.15 M sodium chloride solution at 310 K by using molecular dynamics simulation. The results have shown that water molecules dramatically affect the alignment of konjac glucomannan in the system. The active site of Bifidobacterium protein that determined by the calculations are composed of ASP154, ARG49, ASN206, and ASN401. The lowest flexibility of GM5 structure shows strong interactions with Bifidobacterium protein. The most suitable size of konjac glucomannan that can bind with the protein has the degrees of polymerization no more than 8.

Keywords: Konjac glucomannan, Bifidobacterium, Molecular dynamics simulations

By : Dr.Warot Chotpatiwetchkul
Link: https://www.sciencedirect.com/science/article/pii/S2214785318300324

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[fruitful_tab title=”7. Outcomes of Clinical Practice Guideline for Sepsis Patients in Taksin Hospital”]

Abstract

Background: Sepsis is a serious disease with a high mortality rate.
Objective: To study the effect of a Clinical Practice Guideline [CPG] on mortality for sepsis patient management in Thailand.
Materials and Methods: The design was a retrospective study. The medical records of 472 severe sepsis or septic shock patients treated prior to and after the hospital sepsis CPG implementation in hospital were reviewed.

Results: Four hundred seventy-two patients were eligible for enrollment. The mortality rate was statistically significant different among studied patients in pre-implementation period (43.6%) and implementation period (13.1%) (p<0.001). There was statistically higher percentage of patients who received antibiotics within the first hours of being diagnosed with sepsis in implementation period (97.9%), compared with pre-implementation period (74.2%) (p<0.001). The significant higher numbers of patients in implementation period having enough volume replacement within the first six hours of severe sepsis or septic shock diagnosis compared with in pre-implementation period, as measured by an adequate urine output (≥0.5 ml/kg/hour) (84.6% versus 73.8%) (p = 0.018), and by an adequate central venous pressure (8 to 12 mmHg) (82.4% versus 43.3%) (p<0.001). In addition, there were significant difference in the percentages of patients having a reversal of septic shock in pre-implementation and implementation period (94.8% versus 88.4%) (p = 0.02). Conclusion: An implementation of the sepsis CPG in secondary-care hospital led to increase appropriate management and decrease mortality among the severe sepsis patients. Keywords: Severe sepsis, Septic shock, Clinical practice guideline for sepsis Link to article
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