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Rev Esp Quimioter 2021; 34(1): 28-32

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 2021; 34(1): 28-32 [Full-text PDF]


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Rev Esp Quimioter 2021; 34(1): 70-71

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 2021; 34(1): 70-71 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(1): 33-43

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 2021; 34(1): 33-43 [Full-text PDF]


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Rev Esp Quimioter 2021; 34(1): 44-50

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 2021; 34(1): 44-50 [Full-text PDF]


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Rev Esp Quimioter 2020; 34(2): 72-80

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; 34(2): 72-80 [Full-text PDF]


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Rev Esp Quimioter 2021; 34(1): 67-69

Serratia marcescens como causa de endoftalmitis tardía

DOMINGO FERNÁNDEZ VECILLA, PAULA BELÉN BLASCO PALACIO, MIREN JOSEBE UNZAGA BARAÑANO, JOSÉ LUIS DÍAZ DE TUESTA

Published: 3 December 2020

http://www.doi.org/10.37201/req/078.2020

CARTA AL DIRECTOR

Rev Esp Quimioter 2021; 34(1): 67-69 [Texto completo PDF]


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Rev Esp Quimioter 2021; 34(1): 56-60

Dual therapy with raltegravir plus a fixed dose combination of darunavir/ritonavir in people living with HIV in Argentina

FERNANDA ROMBINI, DIEGO M. CECCHINI, JAMILE BALLIVIAN, MARA HUBERMAN, ANALÍA URUEÑA, ISABEL CASSETTI

Published: 3 December 2020

http://www.doi.org/10.37201/req/090.2020

Objective. There are generic fixed-dose combinations (FDCs) of ritonavir-boosted darunavir (DRV/r) available in Argentina. Experiences with these FDCs in dual therapy remain limited in clinical practice. We aimed to describe clinical and virologic outcomes in patients exposed to FDC DRV/r + raltegravir (RAL) 400 mg every 12 h in a real-life setting.
Patients and methods. Retrospective analysis of electronic medical records of HIV-infected patients under FDC DRV/r + RAL in an HIV clinic in Argentina (2014-2018). Individuals were classified as “switch group” (SG, undetectable viral load [VL] with any toxicity/comorbidity) and “virologic group· (VG, detectable viremia and infection by multidrug-resistant HIV).
Results. Of 7,380 patients on ART, 116 (1.5%) received FDC DRV/r + RAL, being 58% in SG. Sixty percent received DRV/r 800/100 mg dose (rest, 600/100 mg). The median (IQR) age and CD4+ T-cell count were: 52 (42-58) years, and 373 cell/µL (202-642). Ninety-eight percent were ART-experienced with a median of 3 (IQR 2-5) prior treatments. Main reasons for switch (SG) were renal (57%), cardiovascular (54%) and bone (14%) comorbidities. Median exposure to DRV/r + RAL was 18 months. Among patients in SG, 98% and 96% had undetectable VL at 6 and 12 months; in the VG, 89% and 87% had undetectable VL at 6 and 12 months. No patient required suspension due to toxicity/ intolerance.
Conclusion. In this cohort of mostly experienced HIV-infected patients, FDC DRV/r + RAL was effective and safe. Such therapy may be considered an option for patients with comorbid conditions and/or with multidrug-resistant HIV.

Rev Esp Quimioter 2021; 34(1): 56-60 [Full-text PDF]


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Rev Esp Quimioter 2021; 34(1): 51-55

Clostridioides difficile infection in a long-term convalescence hospital: A real tale of pitfalls and outdated therapy

MARÍA ESTEBAN-RIHUETE, LUIS MORENO-BORRAZ, DIEGO RODRÍGUEZ-GASCÓN, JULIO CÉSAR GARCÍA-HERRERO, JUAN MANUEL GARCÍA-LECHUZ, ÁNGEL GARCÍA-FORCADA

Published: 1 December 2020

http://www.doi.org/10.37201/req/085.2020

Objective. The aim of the study was to know the characteristics and risk factors of Clostridioides difficile infection (CDI) in a long-term hospital is key to improve its management.
Material and methods. Retrospective study with 37 patients, along 43 months. We describe demographic variables, clinical data, time to diagnosis, treatment, and evolution.
Results. Analysis of 46 episodes (37 patients, mean age=82.2 years). 77.8% were absolutely dependent, 41.7% had chronic kidney disease, 64.9% had received antibiotics in the previous three months, 40.5% received antibiotics at diagnosis. It was the first episode in 78.4%, and first recurrence in 21.6%. Therapy was started in the first 24 hours after diagnosis in 89.2%, mostly metronidazole. 83.3% recovered, 3 patients died from CDI, diagnosis was registered in the discharge report in 91.1%.
Conclusions. Previous antibiotic therapy, high grade of dependency and renal failure were the main risk factors. There is room for improvement in CDI management at our hospital.

Rev Esp Quimioter 2021; 34(1): 51-55 [Full-text PDF]


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Rev Esp Quimioter 2020; 33(6): 430-435

Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase producing Enterobacterales in patients with diabetic foot infections requiring hospital admission

VICTORIA GARCÍA ZAFRA, ALICIA HERNÁNDEZ TORRES, ELISA GARCÍA VÁZQUEZ, TERESA SORIA COGOLLOS, MANUEL CANTERAS JORDANA, JOAQUÍN RUIZ GÓMEZ, JOAQUÍN GÓMEZ GÓMEZ, ANTONIO HERNÁNDEZ MARTÍNEZ, JOSÉ BARBERÁN

Published: 27 November 2020

http://www.doi.org/10.37201/req/101.2020

Purpose. Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) may complicate the treatment of diabetic foot infections (DFIs). The aim of this study was to determine the risk factors for these pathogens in DFIs.
Material and methods. This was a prospective observational study of 167 consecutive adult patients with DFIs. The diagnosis and severity of DFIs were based on the Infectious Disease Society of America (IDSA) classification system. Multivariate analyses were performed in order to identify risk factors for MRSA and ESBL-E infections.
Results. S. aureus was the most isolated pathogen (n=82, 37.9 %) followed by Escherichia coli (n= 40, 18.5%). MRSA accounted for 57.3% of all S. aureus and 70% of Klebsiella pneumoniae and 25% of E. coli were ESBL producers, respectively. Deep ulcer [OR 8,563; 95% CI (1,068-4,727)], previous use of fluoroquinolones [OR 2,78; 95% CI (1,156-6,685)] and peripheral vasculopathy [OR 2,47; 95% CI (1.068-4.727)] were the independent predictors for MRSA infections; and osteomyelitis [OR 6,351; 95% CI (1,609-25,068)] and previous use of cephalosporins [OR 5,824; 95% CI (1,517-22,361)] for ESBL-E infections.
Conclusions. MRSA and ESBL-E have adquired a great clinical relevance in DFIs. The availability of their risk factors is very convenient to choose the empirical treatment in severe forms.

Rev Esp Quimioter 2020; 33(6): 430-435 [Full-text PDF]


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Rev Esp Quimioter 2020; 33(6): 390-391

EDITORIAL

Utilización del test de detección de antígeno de SARS-CoV-2 en exudado nasofaríngeo para el control de la infección por COVID-19

M. DOLORES FOLGUEIRA LÓPEZ

Published: 24 November 2020

http://www.doi.org/10.37201/req/127.2020

Rev Esp Quimioter 2020; 33(6): 390-391 [Texto completo PDF]


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