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The administration of Hange-shashin-to is effective in preventing diarrhea caused by irinotecan hydrochloride (CPT-11)when they are coadministered but a high incidence of constipation has been reported when CPT-11 is used in combination with anti-diarrhea drugs.As many aspects of the occurrence of constipation with the combined use of Hange-shashin-to and CPT-11 were unclear,we decided to clarify the occurrence of constipation and its relationship with the CPT-11 dosage.To do this,we retrospectively compared two treatment groups in which Hange-shashin-to had been coadministered with CPT11 at 60 mg/m2 and 48 mg/m2,respectively.The incidence of constipation was significantly higher in the group treated with CPT-11 at 60 mg/m2 and Hange-shashin-to than that treated with CPT-11 at 48 mg/m2.These results indicate that the occurrence of constipation in such combined use is correlated not only with the CPT-11 dose but also Hange-shashin-to activity.The results also suggest that interaction between Hange-shashin-to and CPT-11 is strongly associated with the occurrence of constipation.

To investigate the cause of an outbreak of epidemic keratoconjunctivitis (EKC) that occurred in the Department of Ophthalmology of our hospital,we conducted an environmental PCR test which produced adenovirus-positive reactions.The positive environmental factors included eye drops for treatment purposes that were shared by some patients,suggesting that eye drop contamination was a possible cause of the outbreak of EKC.Following this,our Department of Pharmacy started distributing small volumes of eye drops all of which were used by individual patients (none left to share with other patients).In view of this,we conducted a questionnaire survey regarding the present status of the small-volume transfer of eye drops at 45 health care institutions.Replies were obtained from 37 institutions (78%).The methods of usage of eye drops for treatment purposes and those administered after surgery varied among institutions and there was also a difference in the way that they were used between inpatients and outpatients.Seven institutions distributed small volumes of eye drops for the treatment of individual patients.As for the desires of institutions concerning eye drops for treatment purposes and those for use after surgery,25 said that eye drop products should be standardized to contain a small volume just sufficient for administration to 1 patient.In conclusion,to prevent nosocomial infections,pharmaceutical companies should supply eye drops in small-volumes to prevent cross-contamination.