ALICIA SERRERA ÁLVAREZ, MARTA GARCÍA COCA
Published: 3 June 2021
http://www.doi.org/10.37201/req/011.2021
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(4): 390-392 [Texto completo PDF]
RAFAEL CANTÓN, PILAR DE LUCAS RAMOS, 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, EMILIO BOUZA
Published: 2 June 2021
http://www.doi.org/10.37201/req/071.2021
The emergence and spread of new variants of SARS-CoV-2 has produced enormous interest due to their possible implication in the improved transmissibility of the virus, their consequences in the individual evolution of the infection, as well as in the possible escape from the immunity generated by the current vaccines. The variants that attract most attention are those of public health concern, including B.1.1.7 (UK), P.1 (Brazilian) and B.1.351 (South African). This list is extended by the variants of interest that emerge and are expanding in certain countries but are found sporadically in others, such as B.1.427 and B.1.429 (Californians) or B.1.617 (Indian). Whole genome sequencing or strategies specifically targeting the spicule gene are used in the microbiology laboratories for characterization and detection. The number of infected individuals, the sanitary situation of each country, epidemiological measures and vaccination strategies influence its dispersion and new variants are expected to emerge. This emergence can only be avoided today by increasing the vaccinated population in all countries and by not relaxing epidemiological containment measures. It is not excluded that in the future it will be necessary to revaccinate against new variants.
Rev Esp Quimioter 2021;34(5):419-428 [Full-text PDF]
ÒSCAR MIRÓ, EMÍLIA MIRÓ, ERIC JORGE GARCÍA-LAMBERECHTS, ALBERTO VILLAMOR ORDOZGOITI, JUAN GONZÁLEZ DEL CASTILLO
Published: 1 June 2021
http://www.doi.org/10.37201/req/051.2021
Objective. To determine the approaches used in Spanish emergency departments (EDs) in patients suspected of having sexually transmitted diseases (STD) analysed according to the size of the hospital, ED census and autonomous community.
Material and methods. Questionnaire to the heads of 282 public EDs (7/24) related to emergency routines for patients with suspected STD. Results compared using odds-ratio (OR) and 95% confidence interval (95%CI) according to hospital size (large vs medium-small: ≥500 vs. <500 beds) and ED census (high vs. medium-low: ≥200 vs. <200 patients/day), by autonomous community.
Results. A total of 250 EDs responded (89%). With protocol for STD 36% of EDs [>60% Catalonia, Vasque Country, more in large hospitals (LH), (OR=2.65, 95%CI=1.46-4.82) and high census (HCEN) EDs, (OR=3.49, 95%CI=2.03-5.98)]. 70% obtained exudate sampling (>80% Catalonia, Madrid, Castilla-La Mancha, Aragón, Navarra, Vasque Country), 44% STD serology (>60% Madrid) and 35% HIV serology [(>60% Navarra, Baleares; more in LH (OR=2.43, 95%CI=1.34-4.42) and HCEN EDs (OR=1.94, 95%CI=1.15-3.29)]. At discharge, follow-up in hospital outpatients clinics 53% of EDs [>60% Catalonia, Comunidad Valenciana, Murcia, Castilla-La Mancha, Vasque Country, Asturias; more in LH (OR=2.45, 95%CI=1.31-4.57) and HCEN EDs (OR=2.25, 95%CI=1.35-3.76)] and by primary care 28% (>80% Cantabria). In 55% of EDs, patients are discharged with a scheduled follow-up (>80% Extremadura, La Rioja, Navarra) and 32% visit next workday [>60% Vasque Country; more in LH (OR=3.43, 95%CI=1.87-6.30) and HCEN EDs (OR=3.63, 95%CI=2.08-6.37)].
Conclusion. The care of patients with suspected STD is not homogeneous in Spanish EDs. Areas of improvement were detected, especially the need for specific diagnostic and follow-up protocols.
Rev Esp Quimioter 2021; 34(4): 353-364 [Texto completo PDF]
MACARENA HORMANSTORFER, HÉCTOR BORODOWSKI, KEVIN NELSON, MARÍA JAZMÍN PATROSSO, INGRID KOLLAND, LUCA ITALIANO, VERÓNICA INÉS CASALI, PALOMA VICTORIA BARRIOS, LUIS FELIPE HERNÁNDEZ SEPULVEDA, MARÍA EUGENIA TANARO, CYNTHIA ALDANA PETRAGLIA, ALEXIA DENISSE AGUZEZKO, CECILIA LUNA, CARLOS MOUSE, IGNACIO GANDINO, JOSE LUIS PRESAS, FRANCISCO PAULIN
Published: 31 May 2021
http://www.doi.org/10.37201/req/141.2020
Objective. The aim of this study was to analyze in a prospective cohort of hospitalized COVID-19 patients the relationship between biomarkers levels and their variation within the first 4 days since admission, and prognosis.
Material and methods. Prospective cohort study. Individuals with confirmed diagnosis of covid-19 admitted in our hospital were included. Blood samples were obtained systematically on days 1 and 4 of hospitalization. Levels of RCP, LDH, Ferritin and D-dimer, together with platelets, lymphocytes and neutrophils counts were measured. A combined outcome that included ICU admission and death was considered the primary outcome. Logistic regression analysis was performed.
Results. We included 335 patients with confirmed COVID-19. During their hospitalization, 23 (6.8%) needed ICU admission, and 10 (2.9%) died. In the multivariate analysis, a value of RCP greater than 10 mg/dl (OR 8.69, CI95% 1.45-52), an increase in RCP greater than 20% (OR 26.08, CI 95% 3.21-211.3), an increase in LDH greater than 20% (OR 6.29, CI 95% 1.84-21.44), a count of lymphocytes lower than 1500/mm3 (OR 2.74, CI 95% 1.04-7.23), a D-dimer value greater than 550 ng/ml (OR 9.8, CI 95% 1.78-53.9) and a neutrophil/lymphocyte index greater than 3(OR 4.5, CI 95% 1.43-14.19) were all associated with the primary outcome.
Conclusion. Our study shows that the utilization of static and dynamic biomarkers may represent an important tool to assess prognosis of COVID-19 patients.
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Rev Esp Quimioter 2021; 34(4): 308-314 [Full-text PDF] [Supplementary material PDF]
DAVID SÁNCHEZ RAMOS, CAROLINA PINTO PLÁ, ANA DE GRACIA LEÓN, JAVIER COLOMINA RODRÍGUEZ
Published: 29 May 2021
http://www.doi.org/10.37201/req/024.2021
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(4): 393-395 [Texto completo PDF]
AGUSTÍN JULIÁN-JIMÉNEZ, JUAN GONZÁLEZ DEL CASTILLO, ERIC JORGE GARCÍA-LAMBERECHTS, RAFAEL RUBIO DÍAZ, ITZIAR HUARTE SANZ, CARMEN NAVARRO BUSTOS, FRANCISCO JAVIER MARTÍN-SÁNCHEZ, FRANCISCO JAVIER CANDEL GONZÁLEZ, EN NOMBRE DEL GRUPO INFURG-SEMES
Published: 25 May 2021
http://www.doi.org/10.37201/req/043.2021
Objective. To analyse a new risk score to predict bacteremia in the patients with Community-acquired Pneumonia (CAP) in the emergency departments.
Patients and methods. Prospective and multicenter observational cohort study of the blood cultures ordered in 74 Spanish emergency departments for patients with CAP seen from November 1, 2019, to March 31, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the chosen cut-off for getting the sensitivity, specificity, positive predictive value and negative predictive value.
Results. A total of 1,020 blood samples wered cultured. True cases of bacteremia were confirmed in 162 (15.9%). The remaining 858 cultures (84.1%) wered negative. And, 59 (5.8%) were judged to be contaminated. The model´s area under the receiver operating characteristic curve was 0.915 (95% CI, 0.898-0.933). The prognostic performance with a model´s cut-off value of ≥ 5 points achieved 97.5% (95% CI, 95.1-99.9) sensitivity, 73.2% (95% CI, 70.2-76.2) specificity, 40.9% (95% CI, 36.4-45.1) positive predictive value and 99.4% (95% CI, 99.1-99.8) negative predictive value.
Conclusion. The 5MPB-Toledo score is useful for predicting bacteremia in the patients with CAP seen in the emergency departments.
Rev Esp Quimioter 2021; 34(4): 376-382 [Texto completo PDF]
MARTA GUTIÉRREZ-LORENZO, DANIEL RUBIO-CALVO, JOAQUÍN URDA-ROMACHO
Published: 25 May 2021
http://www.doi.org/10.37201/req/148.2020
Introduction. Among the new antiretroviral treatment (ART) regimens, bictegravir (BIC) stands out, a recently incorporated integrase inhibitor. BIC conjugated with emtricitabine (FTC) and tenofovir alafenamide (TAF) has been shown to be non-inferior in efficacy as initiation therapy in a single daily dose regimen compared to other initiation ART. The objective of our study is to evaluate the impact of the inclusion of this new ART scheme in real clinical practice.
Material and methods. Observational, retrospective and descriptive study that included all adult HIV patients (age ≥18 years) who had been treated with BIC/FTC/TAF for at least 24 consecutive weeks for 1.5 year to evaluate effectiveness, safety and economic impact.
Results. A total of 115 patients were included. There were 28 patients without previous treatment, naive, (24.3%). The pretreated patients had a mean of 42±9 months of prior ART. The percentage of patients at week 24 after switching to BIC/FTC/TAF with suppressed plasma viral load was 88% in the naive group and 94.1% in the pretreated group. Adverse events were reported in 8 (7%) patients. The economic impact of the change to BIC/FTC/TAF for these patients was €1,202.63/patient/year, representing an increase of 9.3%.
Conclusions. Our results correlate with the results of two phase 3 non-inferiority clinical trials in naive patients (88% and 84%) and those of a phase 3 non-inferiority clinical trial in pretreated patients (86%). However, we found a large difference between the high percentages of patients reporting an adverse event in three phase 3 clinical trials and our results.
Rev Esp Quimioter 2021; 34(4): 315-319 [Texto completo PDF]
MARTA DAFNE CABAÑERO-NAVALÓN, VÍCTOR GARCÍA-BUSTOS, MIGUEL SALAVERT LLETÍ
Published: 24 May 2021
http://www.doi.org/10.37201/req/063.2021
Cefditoren pivoxil is a third-generation oral cephalosporin with extended spectrum against Gram-negative, Gram-positive, and several anaerobic microorganisms, including those frequently implicated in skin and soft tissue infections (SSTI). Despite the fact that there are no approved breakpoint criteria for cefditoren susceptibility, many pharmacokinetic and pharmacodynamic studies reassert cefditoren as a good oral antibiotic for the treatment of SSTI. Regarding patients with SSTI, including those infections caused by Staphylococcus aureus y Streptococcus pyogenes, cefditoren showed high cure rates when compared to other oral cephalosporins.
Rev Esp Quimioter 2021; 34(3):185-192 [Full-text PDF]
PABLO CARDINAL-FERNÁNDEZ, ESTEBAN GARCIA CUESTA, JOSÉ BARBERÁN, JOSÉ F. VARONA, ALBERTO ESTIRADO, ALBERTO MORENO, JULIO VILLANUEVA, MERCEDES VILLAREAL, ORVILLE BAEZ-PRAVIA, JUSTO MENÉNDEZ, PAULA VILLARES, ALEJANDRO LÓPEZ ESCOBAR, JESÚS RODRÍGUEZ-PASCUAL, CRISTINA ALMIRALL, EDUARDO DOMÍNGUEZ, CARLOS PEY, ANTONIO FERREIRO, MANUEL REVILLA AMORES, NIKE SÁNCHEZ, SANTIAGO RUIZ DE AGUIAR, JOSÉ M. CASTELLANO
Published: 19 May 2021
http://www.doi.org/10.37201/req/050.2021
Background. Spain is one of the European countries most affected by the COVID-19 pandemic. Epidemiologic studies are warranted to improve the disease understanding, evaluate the care procedure and prepare for futures waves. The aim of the study was to describe epidemiologic characteristics associated with hospitalized patients with COVID-19.
Methods. This real-world, observational, multicenter and retrospective study screened all consecutive patients admitted to 8 Spanish private hospitals. Inclusion criteria: hospitalized adults (age≥18 years old) with clinically and radiologically findings compatible with COVID-19 disease from March 1st to April 5th, 2020. Exclusion criteria: patients presenting negative PCR for SARS-CoV-2 during the first 7 days from hospital admission, transfer to a hospital not belonging to the HM consortium, lack of data and discharge against medical advice in
emergency departments.
Results. One thousand and three hundred thirty-one COVID-19 patients (medium age 66.9 years old; males n= 841, medium length of hospital stayed 8 days, non-survivors n=233) were analyzed. One hundred and fifteen were admitted to intensive care unit (medium length of stay 16 days, invasive mechanical ventilation n= 95, septic shock n= 37 and renal replacement therapy n= 17). Age, male gender, leukocytes, platelets, oxygen saturation, chronic therapy with steroids and treatment with hydroxychloroquine/azithromycin were independent factors associated with mortality. The proportion of patients that survive and received tocilizumab and steroids were lesser and higher respectively than those that die, but their association was not significant.
Conclusions. Overall crude mortality rate was 17.5%, rising up to 36.5% in the subgroup of patients that were admitted to the intensive care unit. Seven factors impact in hospital mortality. No immunomodulatory intervention were associated with in-hospital mortality.
Rev Esp Quimioter 2021; 34(4): 342-352 [Full-text PDF] [Supplementary material PDF]
FERNANDA MEIRA, LAIA ALBIACH, CRISTINA CARBONELL, JOSÉ-ÁNGEL MARTÍN-OTERINO, MERCEDES MARTÍN-ORDIALES, LAURA LINARES, IRENE MACAYA, DAIANA AGÜERO, JUAN AMBROSIONI, MARTA BODRO, CELIA CARDOZO, MARIANA CHUMBITA, LORENA DE LA MORA, NICOLE GARCÍA-POUTON, CAROLINA GARCIA-VIDAL, ANA GONZÁLEZ-CORDÓN, MARTA HERNÁNDEZ-MENESES, ALEXY INCIARTE, MONTSERRAT LAGUNO, LORNA LEAL, LAURA MORATA, PEDRO PUERTA-ALCALDE, VERÓNICA RICO, LAURA LETONA, ALBERTO CÓZAR-LLISTÓ, GERARD DUEÑAS, MONTSERRAT SOLÁ, BERTA TORRES, JHON ROJAS, ANTONIO MORENO, ESTELA MORENO-GARCÍA, MANUEL TORRES, JOSÉ A MARTÍNEZ, ALEX SORIANO, FELIPE GARCÍA
Published: 13 May 2021
http://www.doi.org/10.37201/req/045.2021
Objectives. The study aims to describe characteristics and clinical outcome of patients with SARS-CoV-2 infection that received siltuximab according to a protocol that aimed to early block the activity of IL-6 to avoid the progression of the inflammatory flare.
Patients and methods. Retrospective review of the first 31 patients with SARS-CoV-2 treated with siltuximab, in Hospital Clinic of Barcelona or Hospital Universitario Salamanca, from March to April 2020 with positive polymerase-chain reaction (PCR) from a nasopharyngeal swab.
Results. The cohort included 31 cases that received siltuximab with a median (IQR) age of 62 (56-71) and 71% were males. The most frequent comorbidity was hypertension (48%). The median dose of siltuximab was 800 mg ranging between 785 and 900 mg. 7 patients received siltuximab as a salvage therapy after one dose of tocilizumab. At the end of the study, a total of 26 (83.9) patients had been discharged alive and the mortality rate was 16.1% but only 1 out of 24 that received siltuximab as a first line option (4%).
Conclusions. Siltuximab is a well-tolerated alternative to tocilizumab when administered as a first line option in patients with COVID-19 pneumonia within the first 10 days from symptoms onset and high C-reactive protein.
Rev Esp Quimioter 2021; 34(4): 337-341 [Full-text PDF]
