Sepsis in older adults has many challenges that affect rate of septic diagnosis, treatment, and monitoring parameters. Numerous age-related changes and comorbidities contribute to increased risk of infections in older adults, but also atypical symptomatology that delays diagnosis. Due to various pharmacokinetic/pharmacodynamic changes in the older adult, medications are absorbed, metabolized, and eliminated at different rates as compared to younger adults, which increases risk of adverse drug reactions due to use of drug therapy needed for sepsis management. This review provides information to aid in diagnosis as well as offers recommendations for monitoring and treating sepsis in the older adult population.

With the continuing evolution of pharmacy as a clinical profession, the need to prepare well‐trained clinicians beyond the knowledge gained from a doctor of pharmacy degree program is magnified. Such training is afforded by pharmacy residency programs, which have expanded from hospital sites to practice settings as diverse as managed care organizations and public health departments. Although the resident benefits from the intensive training program, the sponsoring institution also derives many benefits from hosting the residency. Fundamentally, residents are licensed pharmacists who provide several contributions to the organization at generally a much‐reduced direct cost. Federal funding for graduate medical education, often referred to as Medicare pass‐through funds, is a common source of support for the conduct of postgraduate year one residency programs in health system settings; other sources of funding may be found in organizational and academic outlets. Residents may be integral in expanding the revenue of an organization by serving as patient care providers, developing or enhancing services, and billing for services delivered. By virtue of the roles they can assume, residents can facilitate the redeployment of existing pharmacists to other areas, tasks, or projects, thus expanding the capabilities of the department. Increasing the capacity to conduct experiential education for pharmacy students, and the compensation for such activity, can be an additional benefit. Practice sites that conduct residency training often experience a greater degree of employee satisfaction and higher employee retention rates. Engaging in quality improvement and assessment activities, assisting in staff development, and supporting innovative approaches to care are additional activities that pharmacy residents can support. This primer from the American College of Clinical Pharmacy was developed to highlight the value an organization can realize by conducting pharmacy residency training.

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Clinical pharmacy services in the critical care setting have expanded dramatically and include assisting physicians in pharmacotherapy decision making, providing pharmacokinetic consultations, monitoring patients for drug efficacy and safety, providing drug information, and offering medical education to physicians, nurses, and patients. Measurable clinical effects of these services include reduced drug errors and adverse drug events, decreased morbidity and mortality rates, and a positive pharmacoeconomic impact by decreasing overall health care costs.