AMPARO BUFORN PASCUAL, ADRIANA HERNÁNDEZ BELMONTE
Published: 20 June 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/139.2023
Rev Esp Quimioter 2024; 37(4): 360-361 [Texto completo PDF]
DAVID BRANDARIZ-NÚÑEZ, ANDREA LUANCES-RODRÍGUEZ, PABLO FEIJOO-VILANOVA, JOSÉ MARÍA GUTIÉRREZ-URBÓN, LUIS RAMUDO-CELA, MARÍA ISABEL MARTÍN-HERRANZ, LUIS MARGUSINO-FRAMIÑÁN
Published: 17 June 2024
http://www.doi.org/10.37201/req/012.2024
Introduction. Infective endocarditis (IE) is a potentially life-threatening infection, the incidence of which has in creased in recent decades, particularly among elderly patients with comorbidity. The primary objective of this study was to evaluate the effectiveness of dalbavancin in the consolidation therapy of IE in patients with comorbidity six months after the end of treatment (EOT).
Material and methods. An observational and retrospective study was conducted on patients with a Charlson Comorbidity Index (CCI) ≥ 3 who were diagnosed with IE and received consolidation therapy with dalbavancin.
Results. Forty-eight patients were included, 58.3% were male, mean age of 76.2 years (IQR: 66-88), and a mean age adjusted CCI of 6.5 (IQR: 5-7.5). Definite IE was diagnosed in 77% of cases. The most frequently isolated microorganisms were Staphylococcus aureus (45.8%) followed by Enterococcus spp. (31.3%). Complications of IE were observed in 67.7% of cases, and cardiac surgery was performed in 27% of patients. The primary reason for using dalbavancin was outpatient parenteral antibiotic therapy in 85.4% of cases. The effectiveness at EOT was 93.8%. At six months, six IE-related deaths, four unrelated deaths, and two IE relapses were observed. The effectiveness was 77%. Adverse effects related to DBV were reported in 4.2% of cases, of which 2% were considered serious.
Conclusion. Dalbavancin has proven to be an effective alternative as consolidation antibiotherapy for IE in elderly patients with comorbidity. Moreover, a very favorable safety profile with few associated adverse effects has been observed in this population.
Rev Esp Quimioter 2024; 37(4): 334-340 [Full-text PDF] [Supplementary material PDF]
LUIS ALOU, ELENA GÓMEZ-RUBIO, MARÍA-JOSÉ GIMÉNEZ MESTRE, FRANCISCO-JAVIER ALVARO-AFONSO, PILAR CORONEL, DAVID SEVILLANO
Published: 13 June 2024
http://www.doi.org/10.37201/req/028.2024
Skin and soft tissue infections (SSTIs), and particularly diabetic-related foot infections (DFI), present diagnostic and therapeutic complexities, often leading to severe complications. This study aims to evaluate the in vitro efficacy of cefditoren and amoxicillin/clavulanic acid against typical DFI pathogens. Clinical samples from 40 patients with mild SSTIs were analyzed, revealing a predominance of Staphylococcus spp. and Streptococcus spp. species. Cefditoren exhibited activity against 90% of isolates, with superior potency over amoxicillin/clavulanic acid. These findings underscore the utility of cefditoren in empirical treatment of DFI, although a larger sample size would be desirable for further validation.
Rev Esp Quimioter 2024; 37(4): 356-359 [Full-text PDF]
ARNAU TORRENT RODRÍGUEZ, AINA FONT I BARCELÓ, MELISSA BARRANTES GONZÁLEZ, DANIEL ECHEVERRIA ESNAL, DOLORS SOY MUNER, JOSÉ ANTONIO MARTÍNEZ, MONTSERRAT TUSET CREUS
Published: 5 June 2024
http://www.doi.org/10.37201/req/037.2024
Antimicrobial agents are widely used, and drug interactions are challenging due to increased risk of adverse effects or reduced efficacy. Among the interactions, the most important are those affecting metabolism, although those involving drug transporters are becoming increasingly known. To make clinical decisions, it is key to know the intensity of the interaction, as well as its duration and time-dependent recovery after discontinuation of the causative agents. It is not only important to be aware of all patient treatments, but also of supplements and natural medications that may also interact. Although they can have serious consequences, most interactions can be adequately managed with a good understanding of them. Especially in patients with polipharmacy it is compulsory to check them with an electronic clinical decision support database. This article aims to conduct a narrative review focusing on the major clinically significant pharmacokinetic drug-drug interactions that can be seen in patients receiving treatment for bacterial infections.
Rev Esp Quimioter 2024; 37(4): 299-322 [Full-text PDF]
ELENA MEDINA GARCÍA, ARANTXA BERZOSA, MARTA ILLÁN RAMOS, VICTORIA CURSACH PEDROSA, CRISTINA ARANDA CAZÓN, GLORIA HERRANZ CARRILLO, ENRIQUE CRIADO VEGA, JOSÉ TOMÁS RAMOS AMADOR
Published: 23 May 2024
http://www.doi.org/10.37201/req/117.2023
Introduction. Cytomegalovirus infection (CMV) is the most common congenital infection in developed countries. The aim of our study was to describe the features of the children that have congenital CMV infection at our hospital for the last 6 years.
Material and methods. A retrospective descriptive study was designed that included all the children with CMV congenital infection that were diagnosed at tertiary hospital of Madrid Community between 2017 and 2023.
Results. Twenty-two children were included. 54.5% have a prenatal diagnosis, 50% of them were in the third trimester, 25% at first trimester and 25% at the second. 22.7% were preterm. CMV was isolated in all the samples with CV more than 1000 copies/ml. When CMV was made in blood, 11/22 (50%) had a high CV. Only one newborn had a high CV at CRL. 44% have affectation at transfontanellar ultrasound evidenced by vasculopathy (62%), intraventricular hemorrhage (IVH) or periventricular calcifications (20%). 68% were asymptomatic, al though 20% had a retarded intrauterine growth (RIG) at birth or clinical features or analytical were objectified (neutropenia, thrombocytopenia, cholestasis). 33% got treatment with val ganciclovir and 33% had sequelae (hearing loss).
Conclusions. CMV congenital infection is still a severe public health issue in developed countries. Most of the cases are mild or asymptomatic even though we should have high clinical suspicion with compatible symptoms and consistent maternal history in order to make an early diagnosis and treatment to prevent or reduce sequelae.
Rev Esp Quimioter 2024; 37(4): 351-355 [Texto completo PDF]
MARÍA VALLET-REGÍ, ARÍSTIDES DE ALARCÓN, ENRIQUE GÓMEZ BARRENA, JOSEP A. PLANELL, JACOBO SILVA, EMILIO BOUZA
Published: 23 May 2024
http://www.doi.org/10.37201/req/039.2024
Prostheses or implantable medical devices (IMDs) are parts made of natural or artificial materials intended to replace a body structure and therefore must be well tolerated by living tissues. The types of IMDs currently available and usable are very varied and capable of replacing almost any human organ. A high but imprecise percentage of Spaniards are carriers of one or more IMDs to which they often owe their quality of life or survival. IMDs are constructed with different types of materials that are often combined in the same prosthesis. These materials must combine harmlessness to human tissues with high wear resistance. Their durability depends on many factors both on the host and the type of prosthesis, but the vast majority last for more than 10-15 years or remain in function for the lifetime of the patient. The most frequently implanted IMDs are placed in the heart or great vessels, joints, dental arches or breast and their most frequent complications are classified as non-infectious, particularly loosening or intolerance, and infectious. Complications, when they occur, lead to a significant increase in morbidity, their repair or replacement multiplies the health care cost and, on occasions, can cause the death of the patient. The fight against IMD complications is currently focused on the design of new materials that are more resistant to wear and infection and the use of antimicrobial substances that are released from these materials. Their production requires multidisciplinary technical teams, but also a willingness on the part of industry and health authorities that is not often found in Spain or in most European nations. Scientific production on prostheses and IMD in Spain is estimated to be less than 2% of the world total, and probably below what corresponds to our level of socio-economic development. The future of IMDs involves, among other factors, examining the potential role of Artificial Intelligence in their design, knowledge of tissue regeneration, greater efficiency in preventing infections and taking alternative treatments beyond antimicrobials, such as phage therapy. For these and other reasons, the Ramón Areces Foundation convened a series of experts in different fields related to prostheses and IMDs who answered and discussed a series of questions previously formulated by the Scientific Council. The following lines are the written testimony of these questions and the answers to them.
Rev Esp Quimioter 2024; 37(5): 369-386 [Full-text PDF]
Mª DOLORES TIRADO-BALAGUER, ALBERTO ARNEDO-PENA, SUSANA SABATER-VIDAL, ROSARIO MORENO-MUÑOZ
Published: 22 May 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/153.2023
Rev Esp Quimioter 2024; 37(4): 362-364 [Texto completo PDF]
JORDI REINA, ANE ITURBE
Published: 21 May 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/005.2024
Rev Esp Quimioter 2024; 37(4): 365-366 [Texto completo PDF]
FERNANDO COBO, VIRGINIA PÉREZ-CARRASCO, LETICIA CASTELLANO-SÁNCHEZ, JOSÉ A. GARCÍA-SALCEDO, JOSÉ MARÍA NAVARRO-MARÍ
Published: 17 May 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/025.2024
Rev Esp Quimioter 2024; 37(4): 367-368 [Texto completo PDF]
AGUSTÍN JULIÁN-JIMÉNEZ, ROCÍO LORENZO ÁLVAREZ, VICTORIA GUTIÉRREZ BUENO, MIRANDA SÁNCHEZ TRUJILLO, DARÍO EDUARDO GARCÍA
Published: 14 May 2024
http://www.doi.org/10.37201/req/027.2024
Introduction and objective. The term source (or focus) control encompasses all those physical measures that can be used to reduce the inoculum and modify those factors in the infectious medium that promote microbial growth or foreign antimicrobial defenses of the host. The main objective of this systematic review (SR) is to know and compare whether early detection and control of the focus (in less than 6 hours) in adult patients treated in the ED for severe infection or sepsis, compared to not controlling the focus or delayed focus control (more than 12 hours) is more effective and safer (improves clinical evolution, mortality, complications, hospital stay or need for ICU admission).
Method. A systematic review is carried out following the PRISMA regulations in the databases of PubMed, Web of Science, EMBASE, Lilacs, Cochrane, Epistemonikos, Tripdatabase and ClinicalTrials.gov from January 2000 to December 31, 2023 without language restrictions and using a combination of MESH terms: “Source Control”, “Early” “Infection OR Bacterial Infection OR Sepsis”, “Emergencies OR Emergency OR Emergency Department” and “Adults”. Observational cohort studies were included. No meta-analysis techniques were performed, but results were compared narratively.
Results. A total of 1,658 articles were identified, of which 2 that met the inclusion criteria and were classified as high quality were finally analyzed. The included studies represent a total of 2,404 patients with 678 cases in which an intervention was performed to control the focus (28.20%). In the first study, 28-day mortality was lower in patients who underwent an intervention to control the focus (12.3% vs. 22.5%; P <0.001), with an adjusted HR of 0.538 (95% CI: 0.389-0.744; P<0.001). In the second, it was demonstrated that the time elapsed from when the patient was evaluated for the first time and was hemodynamically stabilized, until the start of surgery was associated with his survival at 60 days with an OR of 0.31 (95% CI: 0.19-0.45; P <0.0001). In fact, for each hour of delay an adjusted OR of 0.29 (95% CI: 0.16-0.47; P<0.0001) is established. So if the intervention is performed before 2 hours at 60 days, 98% of the patients are still alive, if it is performed between 2-4 hours it is reduced to 78%, if it is between 4-6 hours it drops to 55%, but if it is done for more than 6 hours there will be no survivors at 60 days.
Conclusions. This review shows that source control carried out after the evaluation of patients attending the ED reduces short-term mortality (30-60 days) and that it would be advisable to implement any required source control intervention as soon as possible, ideally early (within 6 hours).
Rev Esp Quimioter 2024; 37(4): 323-333 [Texto completo PDF]
