DOMINGO FERNÁNDEZ VECILLA, CRISTINA ASPICHUETA VIVANCO, ESTÍBALIZ UGALDE ZÁRRAGA, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 29 September 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/035.2023
Rev Esp Quimioter 2023; 36(6): 635-637 [Full-text PDF]
MARINA AROZA-ESPINAR, ALEJANDRO MERLÁN-HERMIDA, LAURA SUÁREZ-HORMIGA, JOSÉ-LUIS PÉREZ-ARELLANO
Published: 29 September 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/027.2023
Rev Esp Quimioter 2023; 36(6): 632-634 [Full-text PDF]
DOMINGO FERNÁNDEZ VECILLA, MARY PAZ ROCHE MATHEUS, FELICITAS ELENA CALVO MURO, GOTZON IGLESIAS HIDALGO, JOSÉ LUIS DÍAZ DE TUESTA DEL ARCO
Published: 28 September 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/026.2023
Rev Esp Quimioter 2023; 36(6): 629-631 [Full-text PDF]
PABLO VIDAL-CORTÉS, JORGE NIETO DEL OLMO, ANA ISABEL TIZÓN VARELA, ESTRELLA SEOANE FERNÁNDEZ, FERNANDO EIRAS ABALDE, JORGE BLANCO CHAPELA, LUCÍA LARRAÑAGA SIGWALD, DANIEL ERNESTO SUÁREZ FERNÁNDEZ, PAULA FERNÁNDEZ UGIDOS, LORENA DEL RÍO CARBAJO
Published: 25 September 2023
http://www.doi.org/10.37201/req/060.2023
Objectives. To assess the frequency of bacterial coinfection upon ICU admission in SARS-CoV-2 pneumonia patients, its microbiology, and impact on prognosis.The secondary objective was to identify risk factors for coinfection on admission.
Methods. Retrospective study, including patients with SARS-CoV-2 pneumonia admitted to the ICU.We defined bacterial coinfection by respiratory symptoms, radiological data, positive and clinically significant microbiological results in samples obtained in the first 48 h of admission and/or a determination of procalcitonin ≥ 0.5 ng/mL in the first 48 h.We evaluated demographic variables, comorbidities, SARS-CoV-2 infection data, severity scores, treatments received, need for respiratory support and outcomes (ICU and hospital mortality).
Results. A total of 182 patients were analyzed, 62 (34.1%) with bacterial coinfection.The most frequent microbiology was S. pneumoniae and M. pneumoniae. 96.1% of the patients received antibiotic therapy on admission, 98.9% corticosteroids, 27.5% tocilizumab, and 7.7% remdesivir.85.7% required invasive mechanical ventilation.The SOFA score (OR: 1.315, 95% CI1.116-1.548) and the delay in ICU admission (OR: 0.899, 95% CI 0.831-0.972) were related to the risk of coinfection. Bacterial coinfection increases the risk of death in hospital (OR 2.283; 95% CI 1.011.5.151; p=0.047).
Conclusions. Bacterial coinfection is common in COVID patients admitted to the ICU and increases the risk of death. It is not possible to identify with certainty, at the time of admission, which patients do not benefit from antibiotic treatment.
Rev Esp Quimioter 2023; 36(6): 612-620 [Texto completo PDF]
ELENA HERRANZ-BAYO, HERMINIA NAVARRO-AZNÁREZ, ANDREA PINILLA-RELLO, CARLOS IGNACIO DÍAZ-CALDERÓN-HORCADA
Published: 21 September 2023
http://www.doi.org/10.37201/req/047.2023
Objectives. To analyze the modifications of antiretroviral therapy (ART) and their economic impact on daily clinical practice.
Material and methods. Observational, retrospective study of patients who started ART between 01/2017-12/2021 (follow-up until 12/2022). Variables collected: prescribed ART, duration, the reason for the change, and treatment costs.
Results. A total of 280 patients initiated ART therapy. The median durability of 1st line was: 19.9 months in 2017 (95%CI 13.9-25.9), 12.2 months in 2018 (95%CI 4.7-19.7), 27.4 months in 2019 (95%CI 6.8-48.1) and the median was not reached for the years 2020 and 2021 (p<0.001). Triple therapy with protease inhibitors was changed in 63.8% (81/127) of cases, followed by integrase inhibitors 52.1% (159/305), while dual therapy (DTG/3TC) only in 8.3% (7/84). The main cause of discontinuation was simplification/optimization 47.5% (124/261), followed by adverse effects 21.8% (57/261), with 2017 being the only year where simplification/optimization was at the same level as adverse effects. The economic impact of ART changes resulted in an average cost reduction of 34.0€ [-391.4 to +431.4] per month per patient. The year 2019 stands out as the only year where these changes were associated with an increase in mean additional cost (23.4€ [-358.3 to +431.4]).
Conclusions. Optimization/simplification accounts for almost half of the reasons for TAR change, with an economic impact that, despite the inflection point of 2019, each year manages to exceed the previous one, achieving a progressive cost reduction maintained over time.
Rev Esp Quimioter 2023; 36(6): 604-611 [Texto completo PDF]
ELENA SÁNCHEZ-YÁÑEZ, MARÍA JOSÉ HUERTAS-FERNÁNDEZ, MARÍA DE LAS AGUAS ROBUSTILLO-CORTES, ROSA RAMOS-GUERRERO, SERGIO FERNÁNDEZ-ESPÍNOLA, ROCÍO DIAZ-ACEDO, VIOLETA MONTERO-MARTIN,RAMÓN MORILLO-VERDUGO
Published: 19 September 2023
http://www.doi.org/10.37201/req/021.2023
Objective. To determine the effectiveness of a pharmaceutical intervention, based on the CMO methodology (capacity, motivation and opportunity), to decrease the prevalence of the PIMDINAC concept (potentially inappropriate medication+drug interactions+non-adherence to concomitant medication) in people living with HIV infection.
Material and methods. Longitudinal prospective multicenter study, conducted between October 2021 and October 2022. Patients living with HIV older than 65 years, on antiretroviral treatment and concomitant drug prescription were included. Demographic, clinical, and pharmacotherapeutic variables were collected. Pharmaceutical care was provided for6 months according to the CMO model in each patient. The main variable was the percentage of patients who simultaneously fulfilled the PIMDINAC concept, comparing the baseline value with the same value at the end of the study. In addition, the percentage of patient’s adherent to concomitant and antiretroviral treatment and the percentage of patients meeting the pharmacotherapeutic targets established for the prescribed medicationat 24 weeks of follow-up were compared.
Results. Sixty-eight patients were included. Seventy-two percent were men, with a median age of 68 years. The median number of concomitant drugs was 7. A 60.6% of the patients had polypharmacy. The prevalence of the presence of the PIMDINAC concept decreased significantly (10.3 vs. 0%). In isolation, each of the aspects also decreased significantly (p<0.031). The percentage of patients who met the objectives improved significantly from 48,5 at baseline to 88.2 (p<0.001).
Conclusions. The pharmaceutical intervention based onarmaceutical intervention based on the CMO methodology significantly decreased the prevalence of the PIMDINAC concept and increased the number of patients who achieved the objectives, optimising their pharmacotherapy.
Rev Esp Quimioter 2023; 36(6): 584-591 [Full-text PDF]
ALFREDO MALDONADO-BARRUECO, CLAUDIA SANZ-GONZÁLEZ, IKER FALCES-ROMERO, PALOMA GARCÍA-CLEMENTE, JUANA CACHO-CALVO, INMACULADA QUILES-MELERO
Published: 18 September 2023
http://www.doi.org/10.37201/req/058.2023
Background. The prevalence of drug-resistant Neisseria gonorrhoeae (NG) infections is increasing. Studies report the prevalence of NG strains presenting A2059G/C2611T (rRNA 23S) and S91F (parC) mutations conferring resistance to azithromycin and ciprofloxacin.
Material and methods. We conducted a prospective cohort study evaluating first void-urine urines, rectal, and oropharyngeal swabs collected from a cohort of patients in a tertiary hospital in Madrid between October 2022 and January 2023. Samples were screened by Allplex™ 7-STI Essential Assay (Seegene®). Drug resistances were performed by Allplex™ NG&DR Assay (Seegene®).
Results. A total of 1,415 patients were included, of which 112 had a positive sample for NG infection. One patient had a C2611T mutation (0.9%) and neither patient showed A2059G mutation. We found 67 (59.8%) S91F-positive patients. Forty-four patients (39.3%) not had any mutations.
Conclusions. We report a low-prevalence of mutations A2059G/C2611T to macrolides and a high-prevalence to S91F in NG infections. Molecular methods for the detection of NG resistance could be useful in direct non-culturable samples.
Rev Esp Quimioter 2023; 36(6): 625-628 [Full-text PDF]
CRISTINA BORRALLERAS, JAVIER CASTRODEZA SANZ, PILAR ARRAZOLA, CARMEN CÁMARA HIJÓN, JOSÉ Mª EIROS, MARÍA FERNÁNDEZ-PRADA, ÁNGEL GIL DE MIGUEL, GLORIA MIRADA MASIP, FERNANDO MORAGA-LLOP, DANIEL OCAÑA RODRÍGUEZ, JOAN PUIG-BARBERÀ, JORGE VÁZQUEZ, JÚLIA VERGARA-ALERT, SALOMÉ DE CAMBRA
Published: 8 September 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/085.2023
Rev Esp Quimioter 2023; 36(6): 658-660 [Full-text PDF]
SALVADOR URQUÍA-CUTILLAS, MARÍA LUISA GÓMEZ-LUS, DAVID SEVILLANO, NATALIA GONZÁLEZ, LUIS ALOU
Published: 7 September 2023
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/082.2023
Rev Esp Quimioter 2023; 36(5): 549-551 [Full-text PDF]
ADRIÁN TÉLLEZ SANTOYO, CARLOS LOPERA, ANDREA LADINO VÁSQUEZ, FERRAN SEGUÍ FERNÁNDEZ, IGNACIO GRAFIÁ PÉREZ, MARIANA CHUMBITA, TOMASSO FRANCESCO AIELLO, PATRICIA MONZÓ, OLIVIER PEYRONY, PEDRO PUERTA-ALCALDE, CELIA CARDOZO, NICOLE GARCIA-POUTON, PEDRO CASTRO, SARA FERNÁNDEZ MÉNDEZ, JOSÉ MARÍA NICOLAS ARFELIS, ALEX SORIANO VILADOMIU, CAROLINA GARCIA-VIDAL
Published: 12 August 2023
http://www.doi.org/10.37201/req/032.2023
Objectives. Clinical data on which artificial intelligence (AI) algorithms are trained and tested provide the basis to improve diagnosis or treatment of infectious diseases (ID). We aimed to identify important data for ID research to prioritise efforts being undertaken in AI programmes.
Material and methods. We searched for 1,000 articlesfrom high-impact ID journals on PubMed, selecting 288 of the latest articles from 10 top journals. We classified them into structured or unstructured data. Variables were homogenised and grouped into the following categories: epidemiology, admission, demographics, comorbidities, clinical manifestations, laboratory, microbiology, other diagnoses, treatment, outcomes and other non-categorizable variables.
Results. 4,488 individual variables were collected, from the 288 articles. 3,670 (81.8%) variables were classified as structured data whilst 818 (18.2%) as unstructured data. From the structured data, 2,319 (63.2%) variables were classified as direct—retrievable from electronic health records—whilst 1,351 (36.8%) were indirect. The most frequent unstructured data were related to clinical manifestations and were repeated across articles. Data on demographics, comorbidities and microbiology constituted the most frequent group of variables.
Conclusions. This article identified that structured variables have comprised the most important data in research to generate knowledge in the field of ID. Extracting these data should be a priority when a medical centre intends to start an AI programme for ID. We also documented that the most important unstructured data in this field are those related to clinical manifestations. Such data could easily undergo some structuring with the use of semi-structured medical records focusing on a few symptoms.
Rev Esp Quimioter 2023; 36(6): 592-596 [Full-text PDF] [Supplementary material PDF]
