ALICIA GODOY HURTADO, CARMEN LIÉBANA MARTOS, PATRICK BARTSCHI, RAJAB AL-GHANEM, JOSÉ MANUEL GALICIA BULNES, JAZMÍN SALDÍVAR GÓMEZ
Published: 23 November 2020
http://www.doi.org/10.37201/req/069.2020
Rev Esp Quimioter 2021; 34(1): 61-63 [Texto completo PDF]
CRISTIAN ROSAS ESPINOZA, JOSÉ MANUEL CARO TELLER, GUILLERMO MAESTRO DE LA CALLE, MARÍA ARRIETA LOITEGUI, JOSÉ MIGUEL FERRARI PIQUERO
Published: 19 November 2020
http://www.doi.org/10.37201/req/082.2020
Objectives. The increase in infections with multidrug resistant bacteria has forced to return to the use of colistin, antibiotic with known nephrotoxicity. The aim of the study is to determine the incidence of colistin nephrotoxicity nowadays.
Material and methods. Retrospective-observational-unicentric study was collected hospitalized patients in intravenous colistin treatment during the years 2018-2019. Nephrotoxicity was defined according to the RIFLE scale. The variables to determine it were serum creatinine (sCr) and glomerular filtration (GF). The variables analyzed were age, sex, treatment duration, loading and cumulative dose, empirical/targeted treatment, chronic kidney disease, concomitant use of intravenous contrast and nephrotoxic drugs.
Results. A total of 90 patients (60% men) were included, with an average age of 58.2±18.1 years. The mean duration of treatment was 9±8.3 days, with an average cumulative dose of 69.8±71MU. There were no differences between sCr and GF at the beginning and end of treatment. The incidence of nephrotoxicity was 1.73 cases/100 days of treatment (prevalence of 15.56%).
Conclusions. Colistin nephrotoxicity has an important incidence, without developing severe illness.
Rev Esp Quimioter 2021; 34(1): 12-17 [Texto completo PDF]
RAÚL ORTIZ DE LEJARAZU, FEDERICO MARTINÓN TORRES, ÁNGEL GIL DE MIGUEL, JAVIER DÍEZ DOMINGO, ESTHER REDONDO MARGUELLO
Published: 19 November 2020
http://www.doi.org/10.37201/req/110.2020
Adults aged 65 years or older suffer the most severe health effects of seasonal flu. Although the influenza vaccine is effective in preventing influenza virus infection and its complications, it is not as effective in the elderly due to
age-associated immunosenescence phenomenon. Since 2009, a high-dose trivalent influenza vaccine has been approved in the United States for the immunization of people ≥ 65 years with an antigen concentration four times higher than the standard vaccine. Multiple clinical trials carried out over different seasons, and using different methodologies, have shown that the high-dose trivalent influenza vaccine is not only more effective, but it also has a similar safety profile and is more immunogenic than the standard dose vaccine in the prevention of flu and its complications in the elderly. This document reviews the current scientific evidence on the safety and immunogenicity of high-dose influenza vaccine in people aged 65 years and over, and includes information from randomized clinical trials, observational studies with data from real clinical practice, and systematic reviews, and meta-analysis.
Rev Esp Quimioter 2021; 34(1): 1-11 [Texto completo PDF]
REYES SERRANO GIMÉNEZ, JARA GALLARDO ANCIANO, MARÍA AGUAS ROBUSTILLO CORTÉS, JOSÉ RAMÓN BLANCO RAMOS, ANTONIO GUTIÉRREZ PIZARRAYA, RAMÓN MORILLO VERDUGO
Published: 16 November 2020
http://www.doi.org/10.37201/req/084.2020
Objectives. HIV population is aging at an earlier age than those uninfected, requiring more non-HIV medications to treat noncommunicable diseases. In the context of chronic HIV infection, the next therapeutic change would be the polymedication control. This paper has the purpose of explore the attitudes of older people living with HIV toward deprescribing.
Material and methods. This was an observational, prospective and multicenter study conducted from March-April, 2018. People living with HIV (PLWH) on highly active antiretroviral therapy and older than 65 years were included. In addition to demographic and pharmacotherapeutic data, attitudes regarding deprescribing were collected through the “Revised Patients’ Attitudes Towards Deprescribing Questionnaire”.
Results. A total of 42 patients were included in this study. Regarding their attitudes in relation to deprescription, there were three statements with the most consensuses. The first (“I have a good understanding of the reasons I was prescribed each of my medicines”) had 91.9% consensus. The second and third questions showed 89.2% consensus in both cases; “Overall, I am satisfied with my current medicines” and “I like to be involved in making decisions about my medicines with my doctors”.
Conclusions. This study is the first to explore the beliefs and attitudes of older PLWH in relation to deprescription process. There are positive attitudes regarding medication knowledge but there also is a percentage of patients who had a negative opinion regarding deprescription. We must study and go deeper in our knowledge of techniques that could help us to better understand their preferences, in order to establish effective and successful deprescription strategies.
Rev Esp Quimioter 2021; 34(1): 18-27 [Full-text PDF]
MARÍA JOSÉ GONZÁLEZ-ABAD, MERCEDES ALONSO SANZ
Published: 3 November 2020
http://www.doi.org/10.37201/req/094.2020
Rev Esp Quimioter 2020; 33(6): 464-465 [Texto completo PDF]
INÉS OLAYA GARCÍA RODRÍGUEZ, ANA MADUEÑO ALONSO, VANESSA FELIPE DÍAZ, MARÍA LECUONA FERNÁNDEZ
Published: 28 October 2020
http://www.doi.org/10.37201/req/083.2020
Rev Esp Quimioter 2020; 33(6): 462-463 [Texto completo PDF]
EDUARDO GUTIÉRREZ-ABEJÓN, FRANCISCO HERRERA-GÓMEZ, IGNACIO J. AYESTARÁN-MARTÍNEZ, FRANCISCO JAVIER ÁLVAREZ
Published: 26 October 2020
http://www.doi.org/10.37201/req/096.2020
Objectives. This study presents the use and trends of use of topical ocular anti-infectives into a European population in the current decade (2015 to 2019) with an analysis of concomitant use with other ocular drugs, considering distribution by age and gender.
Patients and Methods. A population-based registry study was carried out to assess the ocular anti-infectives use from 2015 to 2019. All dispensations of these medicines at pharmacies in the largest region of Spain, Castile and León, was accessed. The number of packages dispensed, the percentage of the population under treatment, diagnosis, and the concomitant use with other ocular medicines was observed. For all analyses, the population distribution by age and gender was considered.
Results. An average of 198,000 packages of topical ocular anti-infectives were dispensed annually to 5.38% of the population, and more commonly for women than for men (5.83% vs. 4.91%). Children and the elderly used more these medicines. Tobramycin, alone or in combination, accounted for more than 68% of the total consumption (135,000 packages per year), and was the most widely used anti-infective in almost all identified diagnoses. Conjunctivitis (50.12%), and stye (11.51%) were the most frequent diagnoses. The consumption of ocular anti-infectives increased by 8.23% from 2015 to 2019, and more among men than in women.
Conclusions. Our findings show that the most used topical ocular anti-infective was tobramycin, in accordance with the clinical practice guidelines recommendations. However, ocular infections are sometimes treated empirically, especially conjunctivitis.
Rev Esp Quimioter 2020; 33(6): 453-458 [Full-text PDF]
FRANCISCO JAVIER CANDEL, PABLO BARREIRO, JESÚS SAN ROMÁN, JUAN CARLOS ABANADES, RAQUEL BARBA, JOSÉ BARBERÁN, CARLOS BIBIANO, JESÚS CANORA, RAFAEL CANTÓN, CRISTINA CALVO, MAR CARRETERO, FERNANDO CAVA, RAFAEL DELGADO, JULIO GARCÍA-RODRÍGUEZ, JUAN GONZÁLEZ DEL CASTILLO, CRISTINA GONZÁLEZ DE VILLAUMBROSIA, MONTSERRAT HERNÁNDEZ, JUAN EMILIO LOSA, FRANCISCO JAVIER MARTÍNEZ-PEROMINGO, JOSÉ MARÍA MOLERO, PATRICIA MUÑOZ, ELENA ONECHA, MAMIKO ONODA, JUAN RODRÍGUEZ, MARTA SÁNCHEZ-CELAYA, JOSÉ ANTONIO SERRA, ANTONIO ZAPATERO
Published: 19 October 2020
http://www.doi.org/10.37201/req/120.2020
The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the “gold standard” for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very “pointof-care”. Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19.
Rev Esp Quimioter 2020; 33(6): 466-484 [Full-text PDF ENGLISH] [Texto completo PDF – ESPAÑOL]
ISMAEL MORA-GUZMÁN, INÉS RUBIO-PÉREZ, DIEGO DOMINGO-GARCIA, ELENA MARTÍN-PÉREZ
Published: 16 October 2020
http://www.doi.org/10.37201/req/081.2020
Objective. To assess antibiotic consumption, susceptibility patterns and targeted treatment for OXA-48 carbapenemase-producing Enterobacteriaceae (CPE) related infections in surgical patients in a General Surgery Department.
Material and methods. Retrospective review of patients with a positive culture for OXA-48 and associated clinical data of infection, while hospitalized in a General Surgery Department from January 2013 to December 2018.
Results. Sixty-five patients with 66 isolations (OXA-48) were included: Klebsiella pneumoniae, 57 (86.5%); Enterobacter cloacae, 5 (7.6%); Escherichia coli, 3 (4.5%); Morganella morganii, 1 (1.5%). The most frequent source was intra-abdominal infection (n=39, 60%), and previous antibiotic consumption was: piperacillin-tazobactam (48%), meropenem (45%), ciprofloxacin (25.5%), ertapenem (16.5%), imipenem (12%), amikacin (12%), tigecycline (12%). Temporal trends (2013/14, 2015/16 and 2017/18) in susceptibility patterns were (percentages): ceftazidime-avibactam X-X-100; amikacin 100- 96-84 (p=0.518); tigecycline 100-92-80 (p=0.437); colistin 100-67-66 (p<0.001); meropenem 37-64-72 (p=0.214); imipenem 51-41-77 (p=0.109); gentamicin 13-19-18 (p=0.879); ertapenem 35-0-0 (p<0.001). Median duration of the targeted antibiotic therapy was 14 [IQR 9-20] days; antibiotics used were: tigecycline (57%); meropenem (40.5%); amikacin (37.5%); ceftazidime-avibactam (9%); imipenem (7.5%); colistin (7.5%). Global mortality rate at 30 days was 12% (8 patients). Targeted treatment was appropriate (antibiogram) in 87.7%, and targeted combination scheme was administered in 76.9%, which included a carbapenem in 49.2%.
Conclusions. OXA-48-related-intra-abdominal infection is significant in surgical patients, with substantial broad-spectrum antibiotic consumption. Useful targeted therapy includes ceftazidime-avibactam, amikacin, tigecycline, meropenem, and imipenem.
Rev Esp Quimioter 2020; 33(6): 448-452 [Texto completo PDF]
ROSA ESCUDERO-SÁNCHEZ, S. SCARLETH MENDOZA, LIZARDO, ELENA BATLLE LÓPEZ, CAROLINA CAMPELO GUTIERREZ, JUAN EMILIO LOSA GARCÍA, MARÍA VELASCO ARRIBAS
Published: 13 October 2020
http://www.doi.org/10.37201/req/005.2020
Background. Infective endocarditis has a high morbidity and mortality and requires a coordinated medical-surgical management. The objective was to analyse the impact of surgery on mortality in a hospital without cardiac surgery.
Material and methods. Evaluation of a prospective cohort of patients with infective endocarditis diagnosed between August 2011 and January 2016 according to modified Duke’s criteria.
Results. Sixty-four patients were included, of whom seventeen patients were operated (26.6%). Mortality was 32.8% and it was associated with chronic obstructive pulmonary disease history, staphylococci coagulase-negative and the appearance of complications, as valvular insufficiency and embolisms in the central nervous system; cardiac surgery was not associated with mortality. Four patients (6,6%) were not operated despite indication of cardiac surgery. The main reason for not been intervened was the poor presurgical prognosis (44.7%).
Conclusions. Mortality due to infective endocarditis in a hospital without cardiac surgery is high. The need for interhospital teams is strengthened.
Rev Esp Quimioter 2020; 33(6): 436-443 [Texto completo PDF]
