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Rev Esp Quimioter 2023; 36(1): 92-96

Fatal septic shock and Waterhouse-Friderichsen syndrome caused by serovar B Capnocytophaga canimorsus in an immunocompetent patient. Case report and review

DOMINGO FERNÁNDEZ VECILLA, ITZIAR ANGULO LÓPEZ, FELICITAS ELENA CALVO MURO, CRISTINA ASPICHUETA VIVANCO, FRANCESCO RENZI, MARÍA ESTHER PEREDA MARTÍNEZ, JAUME ROSSELLÓ SORIA, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 25 November 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/060.2022

Rev Esp Quimioter 2023; 36(1): 92-96  [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1): 52-58

Potentially inappropriate medications according to Marc, STOPP and PRISCUS criteria in a cohort of elderly HIV+ patients. The COMMPI project

PATRICIA GARCÍA-LLORET, YOLANDA BORREGO-IZQUIERDO, MERCEDES MANZANO-GARCÍA, MARÍA G. CANTILLANA-SUÁREZ, ANTONIO GUTIÉRREZ-PIZARRAYA, RAMÓN MORILLO-VERDUGO

Published: 23 November 2022

http://www.doi.org/10.37201/req/070.2022

Introduction. The objective is to determine the prevalence of potentially inappropriate drugs according to the Marc, STOPP, and PRISCUS lists in elderly HIV patients.
Patients and methods. It was an observational, retrospective, and multicenter study. People living with HIV 65 years or older who underwent chronic concomitant treatment were included. Descriptive and multivariate analyzes were performed to study the association between polypharmacy and potentially inappropriate medication compliance.
Results. A total of 55 patients were included, 81.8% men and a median age of 69 years (IQR: 67-73). The median number of comorbidities was 3 (IQR: 2-5) and the most frequent pattern of multimorbidity was cardiometabolic (62.9%). The predominant antiretroviral treatment was triple therapy (65.5%). Polypharmacy was present in 70.9% of the patients and 25.5% had major polypharmacy. The most frequent polypharmacy pattern was cardiovascular (69.2%). The percentage of potentially inappropriate medications according to the Marc, STOPP and PRISCUS lists was 65.5%, 30.9% and 14.5%, respectively (p<0.001). Adjusted for age and sex, polypharmacy was not independently associated with potentially inappropriate medication compliance in any of the lists.
Conclusion. Polypharmacy and potentially inappropriate medications have a high prevalence. There is great variability in the percentage according to the list applied. Age, sex, and presence of polypharmacy are not predisposing factors to the presence of potentially inappropriate medications.

Rev Esp Quimioter 2023; 36(1): 52-58 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):45-51

Cytomegalovirus reactivation in patients diagnosed with severe COVID-19: A point prevalence study in a general hospital

MARÍA JESÚS PÉREZ-GRANDA, PILAR CATALÁN, PATRICIA MUÑOZ, TERESA ALDÁMIZ, JUAN CAMILO BARRIOS, CARLOS RAMÍREZ, RITA GARCÍA-MARTÍNEZ, MARÍA VICTORIA VILLALBA, LUIS PUENTE, EMILIO BOUZA

Published: 22 November 2022

http://www.doi.org/10.37201/req/068.2022

Purpose. To determine the prevalence of CMV reactivation in a population admitted for severe COVID-19 to a general hospital.
Methods. Point prevalence study in all hospitalized patients with severe COVID-19 (admitted either to general wards or ICU). Determination of the presence of CMV DNA in circulating blood. COVID-19 was confirmed in patients with compatible clinical manifestations, usually with pneumonia and a positive nasopharyngeal PCR test.
Results. We included 140 hospitalized patients with COVID-19 who consented to participate. A total of 16 patients (11.42%), had circulating CMV-DNA in peripheral blood at the time of the study. Patients with positive CMV viral load were mainly ICU patients (11/37 -29,7%) and only 5/103 cases (4,85%) were hospitalized into general wards. The accumulated doses of corticosteroids (prednisone equivalents) in the study day were (median and IQR) 987.50 mg (396.87-2,454.68) and 187.50 mg (75.00-818.12) respectively in CMV positive and negative patients (p < 0.001). A significant proportion of CMV positive patients were discovered because of the study and were clinically unsuspected by their physicians. The coinfected COVID-CMV positive population had a higher risk of accumulated secondary nosocomially-acquired infections and a worse prognosis.
Conclusion. CMV reactivation should be systematically searched in patients in COVID-19 cases admitted to the ICU.

Rev Esp Quimioter 2023; 36(1):45-51 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):26-29

EDP-938, a new antiviral with inhibitory activity against the nucleoprotein of the respiratory syncytial virus

JORDI REINA, CARLA IGLESIAS

Published: 21 November 2022

http://www.doi.org/10.37201/req/096.2022

The absence of an effective vaccine against respiratory syncytial virus (RSV) has led to the development of various drugs with the ability to inhibit or block its replicative activity. The first generation, called fusion inhibitors, bind to the protein on the viral surface and prevent the virus from binding and entering the cell. However, its low efficacy has determined the start of studies with second-generation compounds capable of binding or blocking the nucleoprotein (N); most of these compounds are analogs of 1,4-benzodiazepines. EDP-938 has shown high efficacy against RSV. The first trials in humans have shown that this antiviral is rapidly absorbed after oral administration and has a half-life of between 11-18 hours Administration for seven days of multiple oral doses of up to 600 mg/day or 300 mg/day/twice a day, there were hardly any significant adverse effects and the viral load in the lower respiratory tract decreased significantly.

Rev Esp Quimioter 2023; 36(1):26-29 [Texto completo PDF]


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Rev Esp Quimioter 2023; 36(1):59-64

Impact and control of the COVID pandemic in an elite sports club: Real Madrid

NIKO MIHIC, JAIME ABASCAL, JOSÉ LÓPEZ CHICHARRO, FELIPE SEGURA, SUZANNE HUURMAN, BORJA NÚÑEZ DE AYSA, EMILIO BOUZAA

Published: 7 November 2022

http://www.doi.org/10.37201/req/072.2022

The incidence and risk factors for poor outcome in patients with COVID are well known, as are the protective measures in high-risk populations. In contrast, the epidemiological and clinical behavior of this disease in the population of elite athletes who are the paradigm of good health is poorly understood. Data on COVID in athletes are scarce and have focused preferentially on the consequences on sports performance of confinement measures and on the pathophysiological risks of infected athletes.
Real Madrid is a large elite sports institution with facilities in the City of Madrid where 600 athletes train daily. The incidence of COVID during a study period of 671 days of observation in athletes, professional or amateur, working in the institution has been 0,74 per 1,000 days of exposure. The disease has been asymptomatic or oligosymptomatic in all athletes and did not require any hospital admissions.
The different teams did not have to suspend any of its sportive commitments for COVID during the study period and there was no evidence of outbreaks of internal transmission between members of the different teams.

Rev Esp Quimioter 2023; 36(1):59-64 [Full-text PDF]


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Rev Esp Quimioter 2023; 36(1):82-87

Time to decision in sepsis

RICARD FERRER, JUAN GONZÁLEZ DEL CASTILLO, MARÍA MARTÍNEZ-MARTÍNEZ, ERIKA P. PLATA-MENCHACA, M. NIEVES LARROSA

Published: 4 November 2022

http://www.doi.org/10.37201/req/083.2022

Introduction. This study aimed to identify the common barriers leading to delayed initial management, microbiological diagnosis, and appropriate empirical antimicrobial treatment in sepsis.
Patients and methods. A cross-sectional study was performed by the application of a population-based survey. Four different surveys were designed, targeting the healthcare personnel located in main hospital areas [emergency department (SEMES); infectious diseases and clinical microbiology-microbiological diagnosis (SEIMC-M); intensive care and infectious diseases, (SEMICYUC-GTEIS); and infectious diseases and clinical microbiology-clinical diagnosis, (SEIMC-C)].
Results. A total of 700 valid surveys were collected from June to November 2019: 380 (54.3%) of SEMES, 127 (18.1%) of SEIMC-M, 97 (13.9%) de SEMICYUC-GTEIS and 96 (13.7%) of SEIMC-C, in 270 hospitals of all levels of care. The qSOFA score was used as a screening tool. The most used biomarker was procalcitonin (n=92, 39.8%). The sepsis code was implemented in 157 of 235
participating centers (66.2%), particularly in tertiary level hospitals. The mean frequency of contaminated blood cultures was 8.9% (8.7). In 85 (78.7%) centers, positive results of blood cultures were available within the first 72 hours and were communicated to the treating physician effectively by phone or e-mail in 76 (81.7%) cases. The main reason for escalating treatment was clinical deterioration, and the reason for de-escalating antimicrobials was significantly different between the specialties. Quality indicators were not frequently monitored among the different participating centers.
Conclusion. There are significant barriers that hinder adequate management processes in sepsis in Spanish hospitals.

Rev Esp Quimioter 2023; 36(1):82-87 [Full-text PDF] [Supplementary-material PDF]



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Rev Esp Quimioter 2023; 36(1):1-25

Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper

EMILIO BOUZA, MIGUEL MARTIN, JOSÉ ENRIQUE ALÉS, NURIA ARAGONÉS, BEGOÑA BARRAGÁN, RAFAEL DE LA CÁMARA, JOSÉ LUIS DEL POZO, VALENTÍN GARCÍA-GUTIÉRREZ, RAMÓN GARCÍA-SANZ, DIEGO GRACIA, VICENTE GUILLEM, VÍCTOR JIMÉNEZ-YUSTE, MARI CRUZ MARTIN-DELGADO, JOAQUÍN MARTÍNEZ, RAFAEL LÓPEZ, ÁLVARO RODRÍGUEZ-LESCURE, JULIÁN RUIZ GALIANA, ANA MARÍA SUREDA, FRANCISCO TEJERINA-PICADO, ANTONI TRILLA, ANTONIO ZAPATERO, ESTEBAN PALOMO, JESÚS SAN-MIGUEL

Published: 2 November 2022

http://www.doi.org/10.37201/req/087.2022

We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration.
In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment.
Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.

Rev Esp Quimioter 2023; 36(1):1-25 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(6):587-588

Una vacuna inactivada para la inmunización primaria frente a varicela

JUAN RODRÍGUEZ-GARCÍA, MARÍA ÁNGELES ONIEVA-GARCÍA, MANUEL GARCÍA CENOZ, JOSÉ ANTONIO GARCÍA ERCE

Published: 25 October 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/071.2022

Rev Esp Quimioter 2022; 35(6):587-588  [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(6):570-571

Pacientes con inmunización frente a SARS-CoV-2 que han requerido ingreso hospitalario por neumonía COVID-19 en un hospital comarcal (Sierrallana-Cantabria)

PAULA HERNÁNDEZ MARTÍNEZ, PAULA GONZÁLEZ BORES, SONIA LÓPEZ GARRIDO, LUCÍA PAZ FAJARDO, ANDREA TEJERO FERNÁNDEZ, MARÍA EZQUERRA MARIGÓMEZ, JOAQUINA LÓPEZ- CASAS GINER, ANA MARÍA ARNÁIZ GARCÍA

Published: 24 October 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/042.2022

Rev Esp Quimioter 2022; 35(6):570-571  [Texto completo PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):102-107

Timing in antibiotic therapy: when and how to start, de-escalate and stop antibiotic therapy. Proposals from a stablished antimicrobial stewardship program

JUAN PASQUAU-LIAÑO, SVETLANA SADYRBAEVA-DOLGOVA, SERGIO SEQUERA-ARQUELLADA, CORAL GARCÍA-VALLECILLOS, CARMEN HIDALGO-TENORIO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.22.2022

The current morbimortality of serious infections is unacceptable and there is a need to promote the increase in the efficacy of empirical and targeted antibiotherapy. This could be achieved by initiatives coming from ASP teams aimed at promoting increased efficacy of antibiotic therapy .In the optimization of the antibiotic therapy there are several critical points in which an adequate timing could achieve benefits in the survival of patients with severe infections: prompt initiation of empirical treatment; de-escalation performance, appropriate targeted treatment; and finally, curtail antibiotic duration.

Rev Esp Quimioter 2022; 35(Suppl.3):102-107 [Full-text PDF]


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