EDWIN U. SUÁREZ, SILVIA CALPENA, BEATRIZ ÁLVAREZ, MIGUEL GÓRGOLAS, RAÚL CÓRDOBA
Published: 23 November 2021
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/098.2021
Rev Esp Quimioter 2022; 35(1):97-99 [Texto completo PDF]
ROSA MÉNDEZ, ANGELS FIGUEROLA, MARTA CHICOT, ANA BARRIOS, NATALIA PASCUAL, FERNANDO RAMASCO, DIEGO RODRÍGUEZ, ÍÑIGO GARCÍA, ANDRÉS VON WERNITZ, NELLY ZURITA, AUXILIADORA SEMIGLIA, DAVID JIMÉNEZ, SARA NAVARRO, MARÍA JOSÉ RUBIO, MERCEDES VINUESA, LOURDES DEL CAMPO, AZUCENA BAUTISTA, ALBERTO PIZARRO
Published: 23 November 2021
http://www.doi.org/10.37201/req/105.2021
Background. In the hospital of La Princesa, the “Sepsis Code” (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it.
Material and methods. A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05.
Results. We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines.
Conclusions. The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.
Rev Esp Quimioter 2022; 35(1):43-49 [Texto completo PDF]
RICARD FERRER, MARÍA CARMEN FARIÑAS, EMILIO MASEDA, MIGUEL SALAVERT, GERMAN BOU, JAZMÍN DÍAZ-REGAÑÓN, DIEGO LÓPEZ, VIRGINIA LOZANO, DAVID GÓMEZ-ULLOA, RAQUEL FENOLL, NURIA LARA, EILISH MCCANN
Published: 22 November 2021
http://www.doi.org/10.37201/req/096.2021
Introduction. Carbapenem-resistant Gram-negative (CRGN) infections are a major public health problem in Spain, often implicated in complicated, healthcare-associated infections that require the use of potentially toxic antibacterial agents of last resort. The objective of this study was to assess the clinical management of complicated infections caused by CRGN bacteria in Spanish hospitals.
Methods. The study included: 1) a survey assessing the GN infection and antibacterial susceptibility profile in five
participating Spanish hospitals and 2) a non-interventional, retrospective single cohort chart review of 100 patients with complicated urinary tract infection (cUTI), complicated intra-abdominal infection (cIAI), or hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia (HABP/VABP) attributable to CRGN pathogens.
Results. In the participating hospitals CRGN prevalence was 9.3% amongst complicated infections. In the retrospective cohort, 92% of infections were healthcare-associated, and Klebsiella pneumoniae and Pseudomonas aeruginosa were the most common pathogens. OXA was the most frequently detected carbapenemase type (71.4%). We found that carbapenems were frequently used to treat cUTI, cIAI, HABP/VABP caused by CRGN pathogens. Carbapenem use, particularly in combination with other agents, persisted after confirmation of carbapenem resistance. Clinical cure was 66.0%, mortality during hospitalization 35.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%.
Conclusion. Our results reflect the high burden and unmet needs associated with the management of complicated infections attributable to CRGN pathogens in Spain and highlight the urgent need for enhanced clinical management of these difficult-to-treat infections.
Rev Esp Quimioter 2021;34(6):639-650 [Full-text PDF]
MARÍA DEL PILAR AGUILAR JALDO, DAVID VINUESA GARCIA, EMILIO GUIRAO ARRABAL
Published: 21 November 2021
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/081.2021
Rev Esp Quimioter 2022; 35(1):89-90 [Texto completo PDF]
FERNANDO BERDUGO HURTADO, EMILIO GUIRAO ARRABAL, ANDRÉS BARRIENTOS DELGADO, ANTONIO JOSÉ RUIZ RODRÍGUEZ
Published: 19 November 2021
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/075.2021
Rev Esp Quimioter 2022; 35(1):87-88 [Full-text PDF]
ALEJANDRA GARCÍA-BOTELLA, ALBERTO GARCÍA-LLEDÓ, JAVIER GÓMEZ-PAVÓN, JUAN GONZÁLEZ DEL CASTILLO, TERESA HERNÁNDEZ-SAMPELAYO, 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, EMILIO BOUZA
Published: 15 November 2021
http://www.doi.org/10.37201/req/149.2021
Several health organizations, mainly in Western countries, have recently authorized the use of a booster dose of the COVID-19 vaccine for patients previously vaccinated with mRNA vaccines, with criteria that do not always coincide.
The COVID Scientific Committee of the Illustrious College of Physicians of Madrid (ICOMEM) has received and asked several questions about this situation, to which the group has tried to give answers, after deliberation and consensus.
The efficacy of the vaccines administered so far is beyond doubt and they have managed to reduce, fundamentally, the severe forms of the disease. The duration of this protection is not well known, is different in different individuals and for different variants of the virus and is not easily predictable with laboratory tests.
Data on the real impact of a supplementary or “booster” dose in the scientific literature are scarce for the moment and its application in large populations such as those in the state of Israel may be associated with a decrease in the risk of new and severe episodes in the short observation period available.
We also lack sufficient data on the safety and potential adverse effects of these supplementary doses and we do not know the ideal time to administer them in different situations.
In this state of affairs, it seems prudent to administer supplemental doses to those exposed to a higher risk, such as immunocompromised individuals and the elderly. On the other hand, we consider that this is not the time to accelerate, on the spur of the moment, a massive administration of a third dose to other population groups that are less exposed and at lower risk, without waiting for adequate scientific information, which will undoubtedly arrive gradually. We do not believe that this position is incompatible with the practical and ethical warnings made by the World Health Organization in this respect.
Rev Esp Quimioter 2022; 35(2):105-114 [Full-text PDF]
PEDRO MANUEL GARCÍA-CEBERINO, EMILIO GUIRAO-ARRABAL, FRANCISCO FERRER AMATE, JOSÉ HERNÁNDEZ-QUERO
Published: 10 November 2021
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/095.2021
Rev Esp Quimioter 2021;34(6):684-686 [Full-text PDF]
JUAN GONZÁLEZ DEL CASTILLO, AGUSTÍN JULIÁN JIMÉNEZ, FRANCISCO JAVIER CANDEL
Published: 29 October 2021
http://www.doi.org/10.37201/req/144.2021
Pneumonia is a major cause of global mortality in developed countries. The adequacy of the antibiotic treatment is essential for the good evolution of the patients. When selecting the antimicrobial, the severity of the patient, the characteristics of the antibiotics, and the profile of the patient to be treated should be considered. Recommendations for the selection of antibiotic treatment may differ between the patient who requires admission and the one who can be treated as outpatient. Beta-lactams, fluoroquinolones, and macrolides are the most widely used antimicrobials in this last circumstance. However, not all are the same in terms of efficacy, safety and ecological impact. This review delves into the aforementioned aspects to improve decision-making and offers concrete recommendations for the selection of antibiotic treatment. Likewise, it includes recommendations for performing sequential therapy. Finally, a brief review is made about the impact of SARS-CoV-2 infection on this pathology.
Rev Esp Quimioter 2021;34(6):599-609 [Texto completo PDF]
MARÍA ISABEL SÁNCHEZ-CÓDEZ, ESTRELLA PEROMINGO-MATUTE
Published: 28 October 2021
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/097.2021
Rev Esp Quimioter 2021;34(6):687-688 [Texto completo PDF]
JOSEP MENSA, JOSÉ BARBERÁN RICARD FERRER, MARCIO BORGES, PEDRO RASCADO, EMILIO MASEDA, ANTONIO OLIVER, FRANCESC MARCO, RAMÓN ADALIA, GERARDO AGUILAR, ÁNGEL ESTELLA, RAFAEL LEÓN LÓPEZ, MANUEL SANTIAGO ROBLES MARCOS, FRANCISCO JAVIER GONZÁLEZ DE MOLINA, RICARDO SERRANO GARCÍA, MIGUEL SALAVERT, JAVIER FERNÁNDEZ GÓMEZ, YULIYA POLIAKOVA, JUAN PASQUAU, JOSÉ RAMÓN AZANZA, GERMÁN BOU ARÉVALO, PEDRO LLINARES MONDÉJAR, PABLO CARDINAL-FERNÁNDEZ, ALEX SORIANO
Published: 25 October 2021
http://www.doi.org/10.37201/req/126.2021
Severe infection and its evolution to sepsis are becoming more prevalent every day and are among the leading causes of critical illness and mortality. Proper management is crucial to improve prognosis. This document addresses three essential points that have a significant impact on this objective: a) early recognition of patients with sepsis criteria, b) identification of those patients who suffer from an infection and have a high risk of progressing to sepsis, and c) adequate selection and optimization of the initial antimicrobial treatment.
Rev Esp Quimioter 2021;34(5):511-524 [Full-text PDF]
