,

Rev Esp Quimioter 2021; January 27

High level of medication regimen complexity index correlate with worse quality of life in people living with HIV

ENRIQUE CONTRERAS-MACÍAS, ANTONIO GUTIÉRREZ- PIZARRAYA, MARÍA AGUAS ROBUSTILLO-CORTÉS, RAMÓN MORILLO-VERDUGO

Published: 27 January 2021

http://www.doi.org/10.37201/req/097.2020

Objectives. People living with HIV (PLWHIV) have now a near-normal life expectancy and thus, a higher risk of polypharmacy. The main objective was to assess the correlation between medication regimen complexity index (MRCI) and quality of life (EQ-5D) and health utilities among PLWHIV patients on ART.
Patients and methods. Observational prospective single-center study including adult PLWHIV on ART from January to March-2020 attended at hospital pharmacy outpatient service according to a Capacity-Motivation-Opportunity (CMO) pharmaceutical care model.
Results. A total of 428 patients were included, mean age of 50 ± 10.9 years, 82.2% males. Negative correlation (r2=−0.147; p= 0.0002) between MRCI and EQ-5D was found. Relationship between the comorbidity pattern and quality of life, was also observed. Regarding MRCI, Anxiety/Depression, Pain/discomfort and Self-Care were the dimensions with the worst assessment.
Conclusions. A new multidimensional revised care plan for PLWHIV focussed on optimising overall patient care, not limited to viral load goal achievement alone but also in their pharmacotherapeutic complexity and quality of life is needed.

Rev Esp Quimioter 2021; January 27 [Full-text PDF]


,

Rev Esp Quimioter 2021; January 26

Variability between health areas in antibiotic consumption among pediatric outpatients of Principado de Asturias, Spain (2005-2018)

LAURA CALLE-MIGUEL, GRACIA MODROÑO RIAÑO, ANA ISABEL IGLESIAS CARBAJO, MARÍA AGUSTINA ALONSO ÁLVAREZ, CELIA VICENTE MARTÍNEZ, GONZALO SOLÍS SÁNCHEZ

Published: 26 January 2021

http://www.doi.org/10.37201/req/108.2020

Background. Antibiotics in Spain are mainly prescribed in the community sector, remarking a high variability between areas. The aim of this study is to describe the variability between health areas in the antibiotic consumption in the pediatric population of Asturias during 2005-2018 period.
Methods. Retrospective and comparative study using data about consumption of antibacterial agents for systemic use (J01C group in ATC, Anatomical Therapeutic Chemical, classification) in the pediatric outpatients of the eight health areas of Principado de Asturias between 2005 and 2018, based on defined daily dose (DDD) per 1000 inhabitants and day (DID).
Results. Mean antibiotic consumption in pediatric outpatients in Principado de Asturias (2005-2018) was 14 DID (CI95% 13.4 – 14.6). Consumption increased until 2009 (15.2 DID) and decreased from 2015 onwards (11.9 DID in 2018). β-lactam penicillins was the most consumed therapeutic group (10.7 DID). There were statistically significant differences among the areas with the highest and the lowest consumption rates (Avilés, 19 DID; Oviedo, 11.5 DID). A high variability between health areas was observed when analysing data temporally (difference of 11.8 DID in 2011) and therapeutic groups. The consumption of macrolides in Langreo health area and quinolones in Jarrio health area were 2.3 and 4.1 times higher, respectively, comparing to Gijón health area.
Conclusions. There is a wide quantitative and qualitative variability of antibiotic consumption in the pediatric outpatients among the different health areas of Asturias.

Rev Esp Quimioter 2021; January 26 [Texto completo PDF]


,

Rev Esp Quimioter 2021; January 25

Dalbavancina como tratamiento antibiótico supresor. A propósito de 1 caso

JOSÉ MARÍA BARBERO ALLENDE, MARTA GARCÍA SÁNCHEZ, ANA MARÍA CULEBRAS LÓPEZ, ROSA AGUDO ALONSO

Published: 25 Janurary 2021

http://www.doi.org/10.37201/req/105.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2021; January 25 [Texto completo PDF]


,

Rev Esp Quimioter 2021; January 25

Evolution of antimicrobial resistance and mortality in Staphylococcus aureus endocarditis during 15 years in a university hospital

MARCOS RODRÍGUEZ ESTEBAN, JESÚS ODE FEBLES, SARA ISABEL MIRANDA MONTERO, MARÍA RAMOS LÓPEZ, MARCOS FARRAIS VILLALBA, LUIS ÁLVAREZ ACOSTA, ALEJANDRO QUIJADA FUMERO, JULIO HERNÁNDEZ AFONSO, ANTONIO CABRERA LEÓN

Published: 25 January 2021

http://www.doi.org/10.37201/req/103.2020

Introduction. One of the most aggressive microorganisms in infective endocarditis (IE) is Staphylococcus aureus. We analyse the resistance of S. aureus to antibiotics and its impact on the clinical course of IE in a recent 15-year period.
Methods. Retrospective study of patients with IE in a university hospital from 2005 to 2019. Bivariate and multivariate analysis of severity at admission, comorbidities, minimum inhibitory concentrations (MIC) and mortality.
Results. Of the 293 IE cases, 66 (22.5%) were due to S. aureus, and 21 (7.2%) were methicillin-resistant S. aureus (MRSA). The prevalence of strains with a MIC to vancomycin ≥ 1mg/L increased from 4.8% to 63.6% (p <0.001) and the cases of MRSA from 38 to 27.3% (p = 0.045). Older age (p= 0.02), comorbidity (p <0.01) and nosohusial origin (p = 0.01), were factors associated with MRSA. But the antimicrobial resistance and severity on admission were not associated with exitus; predictive factors were the right-sided IE (OR = 0.08; 95% CI: 0.01-0.51), comorbidities (OR per Charlson index point = 1.30; 95% CI: 1.01-1.69) and creatinine on admission (OR per mg / dL = 1.56; 95% CI = 1.01- 2.35; p = 0.04).
Conclusion. We have experienced an increase in IE cases with MIC to vancomycin ≥ 1mg/L, without significant variation in infections due to MRSA. Antimicrobial resistance was not associated with mortality, but comorbidity and left involvement were predictive factors.

Rev Esp Quimioter 2021; January 25 [Texto completo PDF]


,

Rev Esp Quimioter 2020; January 2

Tuberculosis cases presenting with spontaneous hemopneumothorax and hypotension

AYSEGUL BAYSAK, DENIZ AKPINAR, KENAN CAN CEYLAN, GULFEM ECE, ELIF DUMAN, ADNAN TOLGA OZ, CEM ECE

Published: 2 Janurary 2021

http://www.doi.org/10.37201/req/070.2020

LETTER TO THE EDITOR

Rev Esp Quimioter 2020; January 2 [Full-text PDF]


,

Rev Esp Quimioter 2020; December 30

Prevalence of prescription of the Top-10 drug classes to avoid in elderly people living with HIV in a real practice cohort

ENRIQUE CONTRERAS MACÍAS, REYES SERRANO GIMÉNEZ, RAMÓN MORILLO VERDUGO

Published: 30 December 2020

http://www.doi.org/10.37201/req/087.2020

Objectives. We assessed the prevalence of potentially inappropriate prescriptions (PIP) among older (≥ 65 years) people living with HIV (PLWHIV). Additionally, the secondary objective was to analyse the relationship between pharmacotherapeutic complexity and compliance with STOPP-Beers criteria associated with Top-10 drugs classes to avoid (TOP-10-A) of European AIDS Clinical Society (EACS) guidelines.
Methods. This was a cross-sectional observational single-centre study. PLWHIV aged 65 years-old or over on ART attending at hospital pharmacy outpatient service from December-2019 to March-2020 were included. Patients were classified by age group: 65-69, 70-75 and more than 75 years. Moreover, was analysed the relationship between pharmacotherapeutic complexity and compliance with STOPP-Beers Criteria associated with Top-10-A drugs.
Results. A total of 19 individuals were included. Overall polypharmacy was observed in 16 PLWHIV (84.2%). A PIP included Top-10-A was identified in 9 (47.4%) PLWHIV. Benzodiazepines were the most prevalent group of prescribed drugs in 6 patients (30.0%). Complex patients were observed in 57.9% (MRCI index value greater than 11.25). Similarly, the sum of criteria STOPP-Beers was higher in older patients. Student’s t test showed the existence of a statistically significant relationship between pharmacotherapeutic complexity and sum of STOPP-Beers Criteria (p <0.05) in elderly PLWHIV.
Conclusions. Prescription of PIPs is highly prevalent in older PLWHIV. Consistent with data, presence of PIPs were associated a presence of higher pharmacotherapeutic complexity and sum of STOPP-Beers Criteria. The basis for a new revised care plan for PLWHIV focussed on optimising overall patient care pharmacotherapeutic complexity and its possible consequences.

Rev Esp Quimioter 2020; December 30 [Full-text PDF]


,

Rev Esp Quimioter 2020; December 18

Endocarditis infecciosa por Kytococcus schroeteri, a propósito de dos casos clínicos

HANSANEE FERNÁNDEZ MANANDU, NEREA ALCORTA LORENZO, XABIER CAMINO ORTIZ DE BARRÓN, JOSÉ IGNACIO BERASATEGUI CALDERÓN, FRANCISCO RODRÍGUEZ ARRONDO

Published: 18 December 2020

http://www.doi.org/10.37201/req/095.2020

CARTA AL DIRECTOR

Rev Esp Quimioter 2020; December 18 [Texto completo PDF]


,

Rev Esp Quimioter 2020; December 15

COVID-19 and Acute Respiratory Distress Syndrome. Impact of corticosteroid treatment and predictors of poor outcome

PABLO VIDAL-CORTÉS, LORENA DEL RÍO-CARBAJO, JORGE NIETO-DEL OLMO, ESTEFANÍA PROL-SILVA, ANA I. TIZÓN-VARELA, ANA RODRÍGUEZ-VÁZQUEZ, PILAR RODRÍGUEZ-RODRÍGUEZ, MARÍA D. DÍAZ-LÓPEZ, PAULA FERNÁNDEZ-UGIDOS, MARCOS A. PÉREZ-VELOSO

Published: 15 December 2020

http://www.doi.org/10.37201/req/091.2020

Objectives. To assess the impact of corticosteroids on inflammatory and respiratory parameters of patients with COVID-19 and acute respiratory distress syndrome (ARDS).
Methods. Longitudinal, retrospective, observational study conducted in an ICU of a second level hospital. Adult patients with COVID-19 were included. Baseline characteristics, data on SARS-CoV-2 infection, treatment received, evolution of respiratory and inflammatory parameters, and ICU and hospital stay and mortality were analyzed.
Results. A total of 27 patients were included, 63% men, median age: 68.4 (51.8, 72.2) years. All patients met ARDS criteria and received MV and corticosteroids. After corticosteroids treatment we observed a reduction in the O2 A-a gradient [day 0: 322 (249, 425); day 3: 169 (129.5, 239.5) p<0.001; day 5: 144 (127.5, 228.0) p<0.001; day 7: 192 (120, 261) p=0.002] and an increase in the pO2/FiO2 ratio on days 3 and 5, but not on day 7 [day 0: 129 (100, 168); day 3: 193 (140, 236) p=0.002; day 5: 183 (141, 255) p=0.004; day 7: 170 (116, 251) p=0.057]. CRP also decreased on days 3 and 5 and increased again on day 7 [day 0: 16 (8.6, 24); day 3: 3.4 (1.7, 10.2) p<0.001; day 5: 4.1 (1.4, 10.2) p<0.001; day 7: 13.5 (6.8, 17.3) p=0.063]. Persistence of moderate ARDS on day 7 was related to a greater risk of poor outcome (OR 6.417 [1.091-37.735], p=0.040).
Conclusion. Corticosteroids appears to reduce the inflammation and temporarily improve the oxygenation in COVID-19 and ARDS patients. Persistence of ARDS after 7 days treatment is a predictor of poor outcome.

Rev Esp Quimioter 2020; December 15 [Full-text PDF]


,

Rev Esp Quimioter 2020; December 11

Seroprevalence and Trends of HTLV-1/2 among Blood Donors of Santo Domingo, Dominican Republic, 2012-2017

EMILIANA EUSEBIO-PONCE, FRANCISCO JAVIER CANDEL, ROBERT PAULINO-RAMÍREZ, IRENE SERRANO-GARCÍA, EDUARDO ANGUITA

Published: 11 December 2020

http://www.doi.org/10.37201/req/117.2020

Objectives. Being a Caribbean country, the Dominican Republic is considered endemic for HTLV-1. Viral screening in blood banks is recommended for this blood borne infection. The purpose of this work is to analyze the seroprevalence and trends of HTLV-1/2 in the Dominican Republic blood donors; it is focused on Santo Domingo, the capital of the country, which has the largest blood donation activity. We also aim at comparing our findings with published data from neighboring countries.
Patients and methods. We performed a retrospective cross-sectional study of 10 blood centers of Santo Domingo, which reported HTLV and the other blood-transmitted infections in full. They represent more than 40% of the province’s blood donations. Annual seroprevalence of HTLV-1/2, period prevalence (2012-2017), and time trend were determined.
Results. A total of 352,960 blood donations were evaluated. The HTLV-1/2 period prevalence was 0.26% (929/352,960)(95% CI: 0.24–0.28%). We also found a marked predominance of replacement donation (90.4%) in comparison to voluntary contributions (9.6%). Therefore, this blood donor study may provide clues on the general prevalence of the infection.
Conclusions. Seroprevalence of HTLV-1/2 in blood donors of Santo Domingo, Dominican Republic, showed a relatively low and steady trend in the studied period.

Rev Esp Quimioter 2020; December 11 [Full-text PDF]


,

Rev Esp Quimioter 2020; December 9

Community-acquired pneumonia: similarities and differences between European and American guidelines – A narrative review –

JOSÉ BARBERÁN, RUBÉN RESTREPO, PABLO CARDINAL-FERNÁNDEZ

Published: 9 December 2020

http://www.doi.org/10.37201/req/114.2020

Community-acquired pneumonia (CAP) is severe disease. Early prescription of an adequate treatment has a positive impact in the CAP outcome. Despite the evidence of existing relevant differences between CAP across geographical areas, general guidelines can be designed to be applied everywhere. Eight years have passed between the publication of the European (EG) and American (AG) CAP guidelines, thus the aim of this narrative review is to compare both guidelines and summarize their recommendations. The main similarity between both guidelines is the antibiotics recommendation with the exception that AG mention new antimicrobials that were not available at the time of EG publication. Both guidelines recommend against routinely adding steroids as an adjuvant treatment. Finally, both guidelines acknowledge that the decision to hospitalize a patient is clinical and should be complemented with an objective tool for risk assessment. EG recommend the CRB-65 while AG recommend the Pneumonia Severity Index (PSI). EG and AG share a similar core of recommendations and only differ in minor issues such as new antibiotics. Likewise, both guidelines recommend against the routine prescription of steroids as an adjuvant therapy.

Rev Esp Quimioter 2020; December 9 [Full-text PDF]