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Rev Esp Quimioter 2022; 35(4):370-377

Efficacy and safety of outpatient parenteral antibiotic therapy in patients with infective endocarditis: a meta-analysis

WEN WEN, HONG LI, CHUNYI WANG, CHEN CHEN, JIAKE TANG, MENGYUN ZHOU, XUWEI HONG, YONGRAN CHENG, QI WU, XINGWEI ZHANG, ZHANHUI FENG, MINGWEI WANG

Published: 2 June 2022

http://www.doi.org/10.37201/req/011.2022

Background. To investigate the clinical outcome of patients with infective endocarditis (IE) during and after outpatient parenteral antimicrobial treatment (OPAT), and to further clarify the safety and efficacy of OPAT for IE patients.
Methods. Through December 20, 2021, a total of 331 articles were preliminarily searched in Pubmed, Web of Science, Cochrane Library and Embase, and 9 articles were eventually included in this study.
Results. A total of 9 articles comprising 1,116 patients were included in this study. The overall mortality rate of patients treated with OPAT was 0.04 (95% CI, 0.02-0.07), that means 4 deaths per 100 patients treated with OPAT. Separately, mortality was low during the follow-up period after OPAT treatment, with an effect size (ES) of 0.03 (95%CI, 0.02-0.07) and the mortality of patients during OPAT treatment was 0.04 (95% CI, 0.01-0.12). In addition, the readmission rate was found to be 0.14 (95% CI, 0.09-0.22) during the follow-up and 0.18 (95% CI, 0.08-0.39) during treatment, and 0.16 (95% CI, 0.10-0.24) for patients treated with OPAT in general. Regarding the relapse of IE in patients, our results showed a low overall relapse rate, with an ES of 0.03 (95% CI, 0.01-0.05). In addition, we found that the incidence of adverse events was low, with an ES of 0.26 (95% CI, 0.19-0.33).
Conclusion. In general, the incidence of adverse events and mortality, readmission, and relapse rates in IE patients treated with OPAT are low both during treatment and follow-up period after discharge, indicating that OPAT is safe and effective for IE patients. However, our study did not compare routine hospitalization as a control group, so conclusions should be drawn with caution. In order to obtain more scientific and rigorous conclusions and reduce clinical risks, it is still necessary to conduct more research in this field and improve the patient selection criteria for OPAT treatment, especially for IE patients. Finally, clinical monitoring and follow-up of OPAT-treated patients should be strengthened.

Rev Esp Quimioter 2022; 35(4):370-377 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(4):406-407

The importance of an early gastroenteritis diagnosis to discard MIS-C during SARS-CoV-2 pandemic  

MARÍA FERNÁNDEZ MIAJA, ANA VIVANCO ALLENDE, SARA DELGADO-NICOLÁS, MA EUGENIA LLANEZA-VELASCO, JAVIER FERNÁNDEZ DOMÍNGUEZ

Published: 31 May 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/170.2021

Rev Esp Quimioter 2022; 35(4):406-407  [Full-text PDF]


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Rev Esp Quimioter 2022; 35(4):408-410

Erratic enteric absorption of dolutegravir in a critically ill patient  

MARTA DE ANTONIO-CUSCÓ, FRANCISCO JOSÉ PARRILLA, HERNANDO KNOBEL FREUD, DANIEL ECHEVERRÍA-ESNAL, ANDREA CASTELLVÍ FONT, ANTONIA VÁZQUEZ, JOAN RAMON MASCLANS, OLIVIA FERRÁNDEZ, SANTIAGO GRAU

Published: 30 May 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/004.2022

Rev Esp Quimioter 2022; 35(4):408-410  [Full-text PDF]


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Rev Esp Quimioter 2022; 35(4):378-381

Real-world efficacy of switching to bictegravir/ emtricitabine/tenofovir alafenamide in pretreated patients with triple therapy containing rilpivirine

ALEJANDRO DE GEA GRELA, LUZ MARTÍN CARBONERO, RAFAEL MICÁN, JOSÉ IGNACIO BERNARDINO, LUIS RAMOS, Mª EULALIA VALENCIA

Published: 24 May 2022

http://www.doi.org/10.37201/req/013.2022

Objective. To analyze the efficacy and tolerability of the strategy to change from rilpivirine (RPV) based regimens to bictegravir / emtricitabine / tenofovir alafenamide (B/F/TAF).
Methods. Single-center, observational and retrospective study. Patients who made the change to B/F/TAF before February 2020 were selected, analyzing the results after 24 and 48 weeks. The percentage that remained with an undetectable viral load was determined, as well as the changes in CD4 + lymphocytes, metabolic parameters and renal function.
Results. A total of 42 patients were included. Thirty-two of the 35 patients (91.4%) who completed the 48 weeks of follow-up had an undetectable viral load. The CD4 + lymphocyte count remained stable at 24 and 48 weeks. The response to B/F/TAF was not influenced by the two analogs previously received.
Conclusion. Switching from triple therapy with RPV to B/F/TAF is a safe and effective strategy in real life.

Rev Esp Quimioter 2022; 35(4):378-381 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(4):362-369

Optimized identification of microorganisms directly from positive blood cultures by MALDI-TOF to improve antimicrobial treatment

PALOMA GARCÍA CLEMENTE, MARÍA PILAR ROMERO-GÓMEZ, JULIO GARCÍA-RODRÍGUEZ, EMILIO CENDEJAS-BUENO

Published: 23 May 2022

http://www.doi.org/10.37201/req/135.2021

Introduction. Bacteriemia is a major cause of morbidity and mortality among hospitalized patients worldwide. Early identification of microorganisms from blood culture can lead to improvement of treatment and outcomes.
Methods. The study was divided into two phases. The first phase when a comparison of the methods was made to check the concordance between them, using as a reference the standard method implemented in the laboratory. In a second phase, both methods are combined. We used the rapid identification method and when it could not identify we used the standard method. The microorganisms that were not identified by either of the two methods were identified from colony at 24 hours
Results. A total of 589 microbial positive blood cultures have been included in the present study. With the rapid method we obtained 96% and 88% identification results for Gram-negative bacilli (GNB) and Gram-positive cocci (GPC) respectively. In this study we observed that the combination of the rapid and standard method achieved identifications of 98% and 97% for GNB and GPC respectively.
Conclusions. The data analysed shows that both methods combined perform better than individually. We achieved an optimization of the identification of microorganisms directly from positive blood cultures by MALDI-TOF. This combination identified 98% of the microorganisms in between ten minutes to one hour and a half since the blood culture flagged positive.

Rev Esp Quimioter 2022; 35(4):362-369 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(3): 301-303

Mycoplasma y Ureaplasma spp. en la práctica clínica de las infecciones ano-genitales

MIGUEL FERNÁNDEZ-HUERTA, OSCAR Q. PICH, MATEU ESPASA

Published: 29 April 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/005.2022

Rev Esp Quimioter 2022; 35(3): 301-303  [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(3): 304-306

Sepsis por Capnocytophaga canimorsus en un paciente inmunocompetente  

DOMINGO FERNÁNDEZ VECILLA, FELICITAS ELENA CALVO MURO, FRANCESCO RENZI, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO

Published: 26 April 2022

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/006.2022

Rev Esp Quimioter 2022; 35(3): 304-306  [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(5):421-434

COVID-19: Some unresolved issues

JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, MARI CRUZ MARTÍN-DELGADO, FRANCISCO JAVIER MARTÍN-SÁNCHEZ, MANUEL MARTÍNEZ-SELLÉS, JOSÉ MARÍA MOLERO GARCÍA, SANTIAGO MORENO GUILLÉN, FERNANDO RODRÍGUEZ-ARTALEJO, JULIÁN RUIZ-GALIANA, RAFAEL CANTÓN, PILAR DE LUCAS RAMOS, ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, TERESA HERNÁNDEZ-SAMPELAYO, EMILIO BOUZA

Published: 21 April 2022

http://www.doi.org/10.37201/req/028.2022

Two years after the COVID-19 pandemic, many uncertainties persist about the causal agent, the disease and its future. This document contains the reflection of the COVID-19 working group of the Official College of Physicians of Madrid (ICOMEM) in relation to some questions that remain unresolved. The document includes considerations on the origin of the virus, the current indication for diagnostic tests, the value of severity scores in the onset of the disease and the added risk posed by hypertension or dementia. We also discuss the possibility of deducing viral behavior from the examination of the structure of the complete viral genome, the future of some drug associations and the current role of therapeutic resources such as corticosteroids or extracorporeal oxygenation (ECMO). We review the scarce existing information on the reality of COVID 19 in Africa, the uncertainties about the future of the pandemic and the status of vaccines, and the data and uncertainties about the long-term pulmonary sequelae of those who suffered severe pneumonia.

Rev Esp Quimioter 2022; 35(5):421-434 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(3): 273-278

Real-life experience of hepatitis C treatment in a Spanish prison

ROSA JUANA TEJERA-PÉREZ, ALICIA IGLESIAS-GÓMEZ, ANTONIA OLIVA-OLIVA, BEATRIZ RODRÍGUEZ-ALONSO, MONTSERRAT ALONSO-SARDÓN, MARÍA SÁNCHEZ LEDESMA, AMPARO LÓPEZ-BERNUS, CRISTINA CARBONELL-MUÑOZ, JOSUÉ PENDONES ULERIO, JUAN LUIS MUÑOZ-BELLIDO, MONCEF BELHASSEN-GARCÍA

Published: 20 April 2022

http://www.doi.org/10.37201/req/001.2022

Background. Hepatitis C virus (HCV) infection is a major public health problem that causes multiple comorbidities. People in prisons who inject intravenous drugs are at increased risk of HCV infection, and HCV infection is 15-fold more prevalent among prisoners compared with the community. The objective of this study was to analyse the clinical and epidemiological characteristics of residents of a Spanish prison with HCV infection who received antiviral treatment.
Material and methods. An observational, descriptive and retrospective study was performed. All patients with HCV infection diagnosed or followed up in an Infectious Diseases attached to a penitentiary were included in this study.
Results. Of 81 patients analysed, sixty-nine (83.1%) patients were male. The mean age was 50.1 (SD8.8) years, and 70% of the inmates had a history of injection drug use. Coinfection with HIV was detected in 30%. In up to 25% of the sample, there were data on chronic liver disease in the degree of liver cirrhosis. The diagnosis of HCV infection had been made more than 15 years earlier in 28% of those studied. Decompensations from liver disease, hepatocellular carcinoma, or hospital admissions were exceptional. Most of the inmates with HCV accepted treatment, and approximately 94% of the patients who completed treatment achieved a sustained virological response without interactions or complications of interest.
Conclusions. The availability of direct-acting antivirals and their exceptional side effects constitute an opportunity to reduce the burden of HCV infection in Spain, particularly in these high-risk populations.

Rev Esp Quimioter 2022; 35(3): 273-278 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):120-122

Mechanical ventilation associated pneumonia during ECMO therapy. A challenge for the Intensive Care physician

JOSÉ RICARDO GIMENO COSTA

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.26.2022

Rev Esp Quimioter 2022; 35(Suppl. 1):120-122 [Full-text PDF]


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