In 2007, 1.2 million people in the United States were hospitalized with pneumonia, and more than 52 000 died from the disease. Community-acquired bacterial pneumonia (CABP) can be caused by a variety of organisms as a result of patient factors such as comorbidities, epidemiologic conditions, or the setting in which the infection was contracted. Treatment of CABP differs depending on the types of bacteria that are suspected. In the last several years, due to the concern regarding multidrug-resistant organisms (MDROs), 2 new antibiotics have been developed and approved for use in CABP. Ceftaroline fosamil (Teflaro) was approved by the US Food and Drug Administration (FDA) in October 2010 and tigecycline (Tygacil) in March 2009. In clinical trials, both agents have been shown to be efficacious and are generally well tolerated. Although these agents have received approval as therapy for CABP, it is the responsibility of physicians and pharmacists to prudently use these antimicrobials where they are truly needed. Until these agents show superiority over conventional therapy for selected patient populations, given the wide variety of pharmacotherapy that can prove efficacious for pneumonia, the new agents should be reserved for patients who have known risk factors for MDROs. Further studies are warranted for these agents in the setting of CABP.

Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient's nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient's dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

Currently, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world and is predicted to be the third leading cause by the year 2020. The purpose of this manuscript is to review the expanding role of community pharmacists in the detection and management of patients with COPD. Pharmacists in the community setting can improve outcomes in patients with COPD by minimizing risk factors through smoking cessation interventions, prevention of disease by evaluating immunization history and early detection by providing spirometry. In addition, these pharmacists are well‐positioned for initiating medication therapy management (MTM) services, reducing noncompliance by counseling on proper medication use to ensure adherence and correct inhalation technique, as well as participating in transition of care. There is evidence that pharmacists can support other health care professionals with appropriate treatment recommendations, reducing overall direct and indirect health care costs. In summary, medications are an important tool in managing COPD, with adherence being critically important for these patients, and community pharmacists are an accessible health care professional able to perform needed medication and wellness related interventions that can improve patient outcomes.

Diabetic nephropathy, also referred to as diabetic kidney disease, is a multifaceted complication of one of the largest epidemics in the United States. Diabetic patients currently represent approximately 8% of the US population. Aggressive screening and control of diabetes, hypertension, and dyslipidemia as well as dietary protein restriction are vital to the prevention and management of diabetic kidney disease. Because there are no direct pharmacologic options for diabetic kidney disease, treatment is focused on controlling comorbidities that exacerbate the development and progression of diabetic kidney disease. This article will provide an overview of structural renal alterations during the progression of diabetic kidney disease as well as a concise review of current diabetic kidney disease management guidelines with a focus on agents that affect the renin-angiotensin-aldosterone system. At this point in time, the mainstays of therapy are angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. More research is currently needed to determine if renin inhibitors will have an active role in the management of diabetic kidney disease.

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