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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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Rev Esp Quimioter 2022;35(Suppl.3):97-101

Treatment of Clostridioides difficile infection: from guidelines to clinical practice

ESPERANZA MERINO, MIGUEL SALAVERT

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.21.2022

The Clostridioides difficile Infection (CDI) treatment guidelines were published in 2021; however, the incorporation of these recommendations into clinical practice was rather irregular and inconsistent. The differences in the implementation of these new guidelines were due, in part, to the variety in the different professionals who provided patient care, as well as to the issues involved in either their accessibility or availability or both. The main requirements for implementation include appropriate reflection on patient stratification, drug positioning, accessibility to drugs, as well as the organization of structured clinical pathways that can facilitate the functionality and evaluation of the management of CDI.

Rev Esp Quimioter 2022; 35(Suppl.3):97-101 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):94-96

Latent tuberculosis infection: approach and therapeutic schemes

JESÚS FORTÚN, ENRIQUE NAVAS

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.20.2022

Tuberculosis continues to be a major public health problem. A priority objective is the implementation of early diagnosis, contact investigation and latent tuberculosis infection (LTBI) testing. World Health Organization (WHO) concludes that there is no gold standard for the diagnosis of LTBI; both the tuberculin test and IGRA (interferon gamma release assays) indirectly identify tuberculosis infection; both tests are considered acceptable but imperfect. WHO recommends that regimens that include rifamycins are equally effective but less toxic and more adherent than long regimens with isoniazid.

Rev Esp Quimioter 2022; 35(Suppl.3):94-96 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):89-93

Models for bacteraemia risk prediction. Clinical implications

CARLOTA CLEMENTE-CALLEJO, AGUSTÍN JULIÁN-JIMÉNEZ, FRANCISCO JAVIER CANDEL GONZÁLEZ, JUAN GONZÁLEZ DEL CASTILLO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.19.2022

Bacteraemia has important consequences for the patient, as it is associated with worse clinical outcomes. On the other hand, unnecessarily obtaining samples for blood cultures increases costs and the workload in the microbiology laboratory. Its diagnosis implies a time delay, but decisions about start antibiotic treatment, discharge, or admits the patient must be taken during the first attention and, therefore, before known the blood cultures results. This manuscript reviews the different strategies based on clinical scores and biomarkers that are useful for predicting bacteraemia and improving initial decision-making.

Rev Esp Quimioter 2022; 35(Suppl.3):89-93 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):84-88

New definitions of susceptibility categories EUCAST 2019: clinic application

SANDRA G. NABAL DÍAZ, OLGA ALGARA ROBLES, JUAN M. GARCÍA-LECHUZ MOYA

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.18.2022

In January 2019, the European Committee for the Study of Antimicrobial Susceptibility (EUCAST) introduced some changes in the definitions of clinical categories for antibiotic susceptibility. The objective of these changes was to improve the credibility of category “I”, optimizing and lengthening the survival and use of available antibiotics in the face of increasing antimicrobial resistance. This article aims to describe and explain these changes in the EUCAST criteria as well as make a short review about the factors on which the antibiotic susceptibility criteria depend.

Rev Esp Quimioter 2022; 35(Suppl.3):84-88 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):80-83

Rapid techniques for therapeutic optimization. Diagnostic stewardship

EMILIA CERCENADO

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.17.2022

Rapid microbiologic methods provide clinicians with information regarding the causative organisms of infections and their resistance to antimicrobials to optimize patient outcomes and antimicrobial use. Diagnostic stewardship requires that appropriate tests are requested and information is translated into appropriate management. The implementation of rapid techniques also provides collaborative opportunities between antimicrobial stewardship and diagnostic stewardship programs contributing to limiting the spread of antimicrobial resistance, and decreasing mortality, hospital length of stay, and healthcare costs

Rev Esp Quimioter 2022; 35(Suppl.3):80-83 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.3):74-79

Current management of CMV infection in cancer patients (solid tumors). Epidemiology and therapeutic strategies

VÍCTOR GARCÍA-BUSTOS, MIGUEL SALAVERT, ROSA BLANES, DAFNE CABAÑERO, MARINO BLANES

Published: 24 October 2022

http://www.doi.org/10.37201/req/s03.16.2022

Little evidence is available regarding the incidence of CMV disease in patients with solid cancers. Latest data show that approximately 50 % of these patients with CMV PCR positivity developed clinically relevant CMV-viremia, and would require specific therapy. In the clinical arena, CMV reactivation is an important differential diagnosis in the infectological work up of these patients, but guidelines of management on this subject are not yet available. CMV reactivation should be considered during differential diagnosis for patients with a severe decline in lymphocyte counts when receiving chemoradiotherapy or immunochemotherapy with lymphocyte-depleting or blocking agents. Monitoring of CMV reactivation followed by the implementation of preemptive strategies or the establishment of early antiviral treatment improves the prognosis and reduces the morbidity and mortality of these patients.

Rev Esp Quimioter 2022; 35(Suppl.3):74-79 [Full-text PDF]


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