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Rev Esp Quimioter 2022; 35(2):115-130

Pharmacological treatment of COVID-19: an opinion paper

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, ALEJANDRA GARCÍA-BOTELLA, EMILIO BOUZA

Published: 11 December 2021

http://www.doi.org/10.37201/req/158.2021

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.

Rev Esp Quimioter 2022; 35(2):115-130 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):100-102

Report of sexually transmitted infections prevalence in asymptomatic pregnant women under 25 years old in Lleida, Spain 

ALBA MUÑOZ SANTA, ALBA BELLÉS BELLÉS, ERIC LÓPEZ GONZÁLEZ, IVÁN PRATS SÁNCHEZ, SARAY MORMENEO BAYO, ALBERT BERNET SÁNCHEZ, JESÚS ARAMBURU ARNUELOS, MARIA FONT FONT, LUCÍA FRAILE GARCÍA, MERCÈ GARCIA GONZÁLEZ

Published: 10 December 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/100.2021

Rev Esp Quimioter 2022; 35(1):100-102 [Full-text PDF]

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Rev Esp Quimioter 2022; 35(1):63-70

Comorbidities of Primary Care patients with COVID-19 during the first wave of the SARS-CoV-2 pandemic in the Community of Madrid

JOSÉ-LUIS PUERTA, MACARENA TORREGO-ELLACURÍA, ÁNGEL DEL REY-MEJÍAS, CÉSAR BIÉNZOBAS LÓPEZ

Published: 10 December 2021

http://www.doi.org/10.37201/req/114.2021

Objectives. Recent publications on inpatients with COVID-19 describing their comorbidities and demographic profile exists, but data from large populations requiring only primary care (PC) are scarce. This paper aims to fill this gap and report the prevalence of eight comorbidities (high blood pressure, diabetes mellitus, cancer, cardiovascular disease, asthma, chronic kidney disease, chronic obstructive pulmonary disease, and chronic heart failure) among patients attending PC during the onset of the SARS-CoV-2 pandemic in the Community of Madrid (CoM), Spain.
Patients and methods. This is an observational retrospective study that collects data registered in the CoM between February 25th and May 31st, 2020. Data are divided in two groups: Group-1 (N=339,890) consist of all patients with suspected or proven SARS-CoV-2 infection; and Group-2 is the subgroup (N=48,556, 14.3% of Group-1) of individuals with COVID-19 confirmed by positive RT-PCR test.
Results. Comparing Group-1 with Group-2, 339,890/48,556 patients, respectively, the main results were as follows: average age (60.9/69.9 years), presence of at least one comorbidity (33.51%/47.69%), high blood pressure (19.74%/32.74%), diabetes mellitus (7.13%/13.75%), cancer (6.56%/10.6%), cardiovascular disease (4.52%/9.26%), asthma (7.98%/6.56%), chronic kidney disease (1.84%/4.41%), chronic obstructive pulmonary disease (2%/4.03%), and chronic heart failure (1.14%/2.77%). High blood pressure and diabetes mellitus were seen to be the most frequent (6.56%/8.38%) association.
Conclusions. Patients requiring PC attention during the first wave of the COVID-19 pandemic in the CoM presented with a very high rate of comorbidities, with marked differences
among those with or without a confirmed SARS-CoV-2 infection.

Rev Esp Quimioter 2022; 35(1):63-70 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):50-62

Prognostic power of soluble urokinase plasminogen activator receptor (suPAR) for short-term mortality in patients seen in Emergency Departments due to infections

RAFAEL RUBIO DÍAZ, ELENA DE RAFAEL GONZÁLEZ, ESTHER MARTÍN TORRES, ELENA VALERA NÚÑEZ, AURORA MARÍA LÓPEZ MARTOS, DAVID MELGUIZO MELGUIZO, MARÍA PIEDAD PICAZO PEREA, PEDRO JESÚS LÓPEZ GARCÍA, PATRICIA FUENTES BULLEJOS, MATILDE CHAFER RUDILLA, JULIÁN FABIÁN CARRETERO GÓMEZ, MARÍA CARMEN LORENZO LOZANO, AGUSTÍN JULIÁN-JIMÉNEZ

Published: 3 December 2021

http://www.doi.org/10.37201/req/108.2021

Objectives. To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate and suPAR) in patients seen in emergency departments (ED) due to infections. Secondly, if these could improve the accuracy of systemic inflammatory response syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA).
Methods. A prospective, observational and analytical study was carried out on patients who were treated in an ED of one of the eight participating hospitals. An assessment was made of 32 independent variables that could influence mortality at 30 days. They covered epidemiological, comorbidity, functional, clinical and analytical factors.
Results. The study included 347 consecutive patients, 54 (15.6%) of whom died within 30 days of visiting the ED. SUPAR has got the best biomarker area under the curve (AUC)-ROC to predict mortality at 30 days of 0.836 (95% CI: 0.765-0.907; P <.001) with a cut-off > 10 ng/mL who had a sensitivity of 70% and a specificity of 86%. The score qSOFA ≥ 2 had AUC-ROC of 0.707 (95% CI: 0.621-0.793; P < .001) with sensitivity of 53% and a specificity of 89%. The mixed model (suPAR > 10 ng/mL plus qSOFA ≥ 2) has improved the AUC-ROC to 0.853 [95% CI: 0.790-0.916; P < .001] with the best prognostic performance: sensitivity of 39% and a specificity of 97% with a negative predictive value of 90%.
Conclusions. suPAR showed better performance for 30-day mortality prognostic power from several biomarkers in the patients seen in ED due to infections. Score qSOFA has better performance that SRIS and the mixed model (qSOFA ≥ 2 plus suPAR > 10 ng/mL) increased the ability of qSOFA.

Rev Esp Quimioter 2022; 35(1):50-62 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(1):30-34

Adequacy to diagnostic recommendations in patients with Pneumocystis jirovecii pneumonia treated with intravenous pentamidine

LORENZO CANTARELLI, FERNANDO GUTIÉRREZ NICOLÁS, GLORIA JULIA NAZCO CASARIEGO, SARA GARCÍA GIL

Published: 1 December 2021

http://www.doi.org/10.37201/req/064.2021

Objectives. To determine the rate of microbiological confirmation in the diagnosis of Pneumocystis jirovecii pneumonia in patients treated with intravenous pentamidine and the potential correlation with treatment effectiveness and safety.
Material and methods. Single-centre retrospective study (2010-2020), which included those patients who received intravenous pentamidine treatment for at least 48 hours. The sample collection procedure and the microbiological analysis performed were recorded. Efficacy was determined by 14-day mortality rate and admission to the Intensive Care Unit (ICU), and disease control was determined by length of hospital stay and time from completion of treatment to discharge. The safety profile was assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Results. A total of 17 patients with P. jirovecii pneumonia were treated with pentamidine (76.5% male (n=13); mean age [standard deviation]: 58.6 [15.5]). Microbiological confirmation of the pathogen was established in 47.1% (n=8) of cases. Targeted use of pentamidine significantly reduced the time from treatment completion to hospital discharge (p=0.019). The safety profile was acceptable, with grade I toxicity occurring in one patient.
Conclusions. The study shows that more than 50% of patients receive treatment based on a presumptive diagnosis and without adhering to the established recommendations, with repercussions on the duration of admission and recovery of the patient. Future studies with a larger sample size will be necessary to consolidate the results obtained.

Rev Esp Quimioter 2022; 35(1):30-34 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(1):84-86

Manejo de afectación cutánea y sistémica por Candida auris 

CELIA ROIG MARTÍ, JOSÉ JAVIER JIMÉNEZ SIERRA, IGNACIO PÉREZ CATALÁN, BARBARÁ GOMILA SARD, ALEJANDRO CARDENAL ÁLVAREZ, MARÍA DOLORES BELLÉS MEDALL

Published: 30 November 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/072.2021

Rev Esp Quimioter 2022; 35(1):84-86 [Texto completo PDF]


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Rev Esp Quimioter 2022; 35(1):35-42

Infective endocarditis treated in a secondary hospital: epidemiological, clinical, microbiological characteristics and prognosis, with special reference to patients transferred to a third level hospital

ANA ISABEL PELÁEZ BALLESTA, ELISA GARCÍA VÁZQUEZ, JOAQUÍN GÓMEZ GÓMEZ

Published: 30 November 2021

http://www.doi.org/10.37201/req/092.2021

Introduction. To analyse the clinical and epidemiological characteristics and mortality-related factors of patients admitted to a secondary hospital with Infective Endocarditis (IE).
Methods. Observational study of a cohort of patients who have been diagnosed with IE in a secondary hospital and evaluated in accordance with a pre-established protocol.
Results. A total of 101 cases were evaluated (years 2000-2017), with an average age of 64 years and a male-to-female ratio of 2:1. 76% of the cases had an age-adjusted Charlson comorbidity index of >6, with 21% having had a dental procedure and 36% with a history of heart valve disease. The most common microorganism was methicillin-susceptible S. aureus (36%), with bacterial focus of unknown origin in 54%. The diagnostic delay time was 12 days in patients who were transferred, compared to 8 days in patients who were not transferred (p=0.07); the median surgery indication delay time was 5 days (IQR 13.5). The in-hospital mortality rate was 34.6% and the prognostic factors independently associated with mortality were: cerebrovascular events (OR 98.7%, 95% CI, 70.9–164.4); heart failure (OR 27.3, 95% CI, 10.2–149.1); and unsuitable antibiotic treatment (OR 7.2, 95% CI, 1.5–10.5). The mortality rate of the patients who were transferred and who therefore underwent surgery was 20% (5/25).
Conclusions. The onset of cerebrovascular events, heart failure and unsuitable antibiotic treatment are independently and significantly associated with in-hospital mortality. The mortality rate was higher than the published average (35%); the diagnostic delay was greater in patients for whom surgery was indicated.

Rev Esp Quimioter 2022; 35(1):35-42 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):95-96

Unusual isolation of Pseudoglutamicibacter cumminsii in urine culture 

LUCÍA CHAVES BLANCO, CRISTINA GÓMEZ-CAMARASA, MARTA ILLESCAS LÓPEZ, NATALIA CHUECA PORCUNA, LAURA L. ROJAS-GARCÍA

Published: 29 November 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/088.2021

Rev Esp Quimioter 2022; 35(1):95-96 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):91-94

A rare case of cardiac alveolar echinococcosis without any complications for eight years 

DIDEM ÇELIK, İLKER ÖDEMIŞ, METIN KORKMAZ, ŞÜKRAN KÖSE

Published: 26 November 2021

LETTER TO THE EDITOR

http://www.doi.org/10.37201/req/082.2021

Rev Esp Quimioter 2022; 35(1):91-94 [Full-text PDF]


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Rev Esp Quimioter 2022; 35(1):71-75

Impact of the COVID-19 pandemic: Community and hospital shared pharmaceutical care model. Satisfaction and acceptability of patients with HIV infection on antiretroviral treatment

MARÍA EMA MOLAS, HERNANDO KNOBEL, OLIVIA FERRÁNDEZ, MARTA DE ANTONIO CUSCÓ, NURIA CARBALLO MARTÍNEZ, CRISTINA RODRÍGUEZ CABA, SONIA LUQUE, ANA GUELAR, SILVIA CASTAÑEDA ESPINOSA, SANTIAGO GRAU

Published: 26 November 2021

http://www.doi.org/10.37201/req/055.2021

Background. The health crisis due to the COVID-19 pandemic is a challenge in the dispensing of outpatient hospital medication (OHM). Models of Antiretroviral Therapy (ART) based on community pharmacy support (ARTCP) have proven to be successful. The aim was to evaluate the degree of satisfaction, acceptability and limitations of the implementation of ARTCP, in the context of a pandemic, in our environment.
Methods. Descriptive cross-sectional study carried out in a Barcelona hospital, during the months of July-November 2020. A telephone survey was carried out via a questionnaire on the quality dimensions of the model (degree of satisfaction, acceptability) and associated inconveniences. Data collected: demographics, antiretroviral treatment (ART), concomitant medication, drug interactions (DDIs), CD4 lymphocyte count and plasma viraemia. Data analysis included descriptive statistics.
Results. A total of 533 (78.0%) HIV patients receiving ART were included. 71.9% (383/533) of these patients were very satisfied and 76.2% preferred attending the community pharmacy rather than the hospital. The mean satisfaction rating was 9.3 (DS: 1.4). The benefits reported were: 1) proximity to home (406: 76.1%); 2) lower risk of contagion of COVID-19 (318: 59.7%); 3) shorter waiting time (201: 37.1%); 4) time flexibility (104: 19.5%); 5) reduction of financial expenses (35: 6.57%). A total of 11 (2%) patients reported no benefit. Only 22.9% reported disadvantages associated with ARTCP: 1) lack of privacy (65: 12.2%); 2) lack of coordinationorganization (57: 10.7%).
Conclusion. The COVID-19 pandemic has had an impact on the provision of pharmaceutical care for HIV patients. The ARTPC model has proved efficient, with patients reporting a high degree of satisfaction.

Rev Esp Quimioter 2022; 35(1):71-75 [Full-text PDF] [Supplementary material PDF]


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