INÉS OLAYA GARCÍA RODRÍGUEZ, LAURA SANTE FERNÁNDEZ, ANA MADUEÑO ALONSO, MARÍA DEL MAR ALONSO SOCAS, MARÍA LECUONA FERNÁNDEZ
Published: 16 March 2021
http://www.doi.org/10.37201/req/122.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(3):256-258 [Texto completo PDF]
MARTA GARCÍA-QUEIRUGA, BEGOÑA FEAL CORTIZAS, FERNANDO LAMELO ALFONSÍN, SONIA PERTEGA DIAZ, ISABEL MARTÍN-HERRANZ
Published: 16 March 2021
http://www.doi.org/10.37201/req/122.2020
Introduction. To describe the avoided costs and to analyze the effectiveness of intravenous antibiotic treatment in continuous perfusion in patients at Hospital at Home Units (HHU) administered using elastomeric infusion pumps (EIP) prepared in a Hospital Pharmacy Service (HPS).
Materials and methods. Retrospective observational study of the number and type of EIP prepared in the HPS and of the treated patients. Study period: January 2017-December2018. Analyzed data: demographic data of patients, location of infection, responsible microorganism, medication and type of EIP, dose and duration of treatment and its effectiveness in terms of cure or non-cure or patient’s death. Economic valuation considering: costs of EIP, nursing time needed for preparation and cost of HHU care.
Results. A total of 1,688 EIP to treat 102 patients resulted in 106 episodes of outpatient treatment of parenteral antibiotic therapy (OPAT) for 1,409 days, thereby avoiding 1,409 days of hospital admission. A total of 59.8% of the patients were men and the mean age was 70.5 ± 17 years. A 31.1% and 68.9% of the cases were empirical and pathogen-directed treatments, respectively. The most used antimicrobials were piperacillin/tazobactam (42.7%), ceftazidime (24.5%), meropenem (19.8%), ceftolozane/tazobactam (2.8%), and cloxacillin (1.9%). Mean duration of treatment was 13.29 ± 8.60 days. Location of infection: respiratory (42.5%), urinary (17.9%), skin and soft tissue (12.3%), bacteraemia (11.3%), osteomyelitis (7.5%), abdominal (3.8%) and 4.7% in other locations. The cure rate was 84%. Total avoided cost: 580,788.28€ in the 24 months studied.
Conclusion. This program represents very important economic savings for the health system, and the effectiveness of the antibiotic treatment has not been compromised.
Rev Esp Quimioter 2021; 34(3):200-206 [Full-text PDF]
JOSÉ MANUEL MENDEZ-LEGAZA, IRENE LÓPEZ-RAMOS, MOISÉS GARCÍA BRAVO, ALMUDENA TINAJAS PUERTAS, MARÍA ANTONIA GARCÍA CASTRO
Published: 15 March 2021
http://www.doi.org/10.37201/req/144.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(3):264-266 [Texto completo PDF]
ANA CASTELLANO-MARTÍNEZ, MOISÉS RODRÍGUEZ-GONZÁLEZ
Published: 12 March 2021
http://www.doi.org/10.37201/req/138.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(3):261-263 [Texto completo PDF]
CAROLINA GARCIA-VIDAL, FERNANDA MEIRA, ALBERTO CÓZAR-LLISTÓ, GERARD DUEÑAS, PEDRO PUERTA-ALCALDE, NICOLE GARCIA-POUTON, MARIANA CHUMBITA, CELIA CARDOZO, MARTA HERNANDEZ-MENESES, RODRIGO ALONSO-NAVARRO, VERÓNICA RICO, DAIANA AGÜERO, MARTA BODRO, LAURA MORATA, CARLOTA JORDAN, CARLOS LOPERA, JUAN AMBROSIONI, FERRAN SEGUI, NACHO GRAFIA, PEDRO CASTRO, FELIPE GARCÍA, JOSEP MENSA, JOSÉ ANTONIO MARTÍNEZ, GEMMA SANJUAN, ALEX SORIANO, AND COVID19-RESEARCHER GROUP
Published: 6 March 2021
http://www.doi.org/10.37201/req/018.2021
Objective. Controversial results on remdesivir efficacy have been reported. We aimed to report our real-life experience with the use of remdesivir from its availability in Spain.
Methods. We performed a descriptive study of all patients admitted for ≥48 hours with confirmed COVID-19 who received remdesivir between the 1st of July and the 30th of September 2020.
Results. A total of 123 patients out of 242 admitted with COVID-19 at our hospital (50.8%) received remdesivir. Median age was 58 years, 61% were males and 56.9 % received at least one anti-inflammatory treatment. No adverse events requiring remdesivir discontinuation were reported. The need of intensive care unit admission, mechanical ventilation and 30-days mortality were 19.5%, 7.3% and 4.1%, respectively.
Conclusion. In our real-life experience, the use of remdesivir in hospitalized patients with COVID-19 was associated with a low mortality rate and good safety profile.
Rev Esp Quimioter 2021; 34(2): 136-140 [Full-text PDF]
MARÍA DOLORES ORTEGA RECIO, GUILLERMO GONZALO OJEDA BURGOS, ROSARIO PALACIOS MUÑOZ, CRISTINA GÓMEZ AYERBE
Published: 4 March 2021
http://www.doi.org/10.37201/req/139.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 167-168 [Texto completo PDF]
RAFAEL CANTÓN, ELENA LOZA, RICARDO M. ARCAY, EMILIA CERCENADO, FRANCISCO JAVIER CASTILLO, RAMÓN CISTERNA, LIDIA GÁLVEZ-BENÍTEZ, FERNANDO GONZÁLEZ ROMO, ALICIA HERNÁNDEZ-CABEZAS, JESÚS RODRÍGUEZ-LOZANO, ANA ISABEL SUÁREZ-BARRENECHEA, FE TUBAU, JAZMÍN DÍAZ-REGAÑÓN, DIEGO LÓPEZ-MENDOZA, AND THE SMART-SPAIN WORKING GROUP
Published: 1 March 2021
http://www.doi.org/10.37201/req/019.2021
Objective. To analyse the susceptibility to ceftolozane-tazobactam and comparators in Enterobacterales and Pseudomonas aeruginosa isolates recovered from intraabdominal (IAI), urinary (UTI), respiratory (RTI) and bloodstream infection (BSI) in the SMART (Study for Monitoring Antimicrobial Resistance Trends) study.
Methods. The susceptibility of 5,351 isolates collected in 11 Spanish hospitals (2016-2018) were analysed (EUCAST-2020 criteria) by broth microdilution and were phenotypically studied for the presence of extended-spectrum beta-lactamases (ESBL). Ceftolozane-tazobactam and/or carbapenem resistant isolates were genetically characterized for ESBL and carbapenemases.
Results. Escherichia coli was the most frequent pathogen (49.3% IAI, 54.9% UTI, 16.7% RTI and 50% BSI), followed by Klebsiella pneumoniae (11.9%, 19.1%, 13.1% and 15.4%, respectively). P. aeruginosa was isolated in 9.3%, 5.6%, 32% and 9%, respectively. The frequency of isolates with ESBLs (2016-2017) was: 30.5% K. pneumoniae, 8.6% E. coli, 2.3% Klebsiella oxytoca and 0.7% Proteus mirabilis. Ceftolozane-tazobactam was very active against non-ESBL-(99.3% susceptible) and ESBL-(95.2%) producing E. coli being less active against K. pneumoniae (98% and 43.1%, respectively) isolates. CTX-M-15 was the most prevalent ESBL in E. coli (27.5%) and K. pneumoniae (51.9%) frequently associated with OXA-48-like carbapenemase. Overall, 93% of P. aeruginosa isolates were susceptible to ceftolozane-tazobactam, preserving this activity (>75%) in isolates resistant to other beta-lactams except in those resistant to meropenen or ceftazidime-avibactam. GES-5, PER-1, VIM-1/2 were the most prevalent enzymes in isolates resistant to ceftolozane-tazobactam.
Conclusions. Ceftolozane-tazobactam showed high activity rates against isolates recovered in the SMART study although it was affected in K. pneumoniae and P. aeruginosa isolates with ESBL and/or carbapenemases.
Rev Esp Quimioter 2021; 34(3):228-237 [Full-text PDF] [Supplentary material PDF]
MARIA DOLORES ROJO-MARTIN, INMACULADA DE TORO PEINADO, JUAN DIEGO RUIZ MESA, BEGOÑA PALOP BORRÁS
Published: 28 February 2021
http://www.doi.org/10.37201/req/123.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 158-161 [Full-text PDF]
IRATI ARREGUI GARCIA, MATILDE ELÍA LOPEZ, AITZIBER AGUINAGA PÉREZ, JOAQUÍN MANRIQUE ESCOLA, CARMEN EZPELETA BAQUEDANO
Published: 26 February 2021
http://www.doi.org/10.37201/req/136.2020
LETTER TO THE EDITOR
Rev Esp Quimioter 2021; 34(2): 164-166 [Texto completo PDF]
EMILIO BOUZA, JAVIER COBO, Mª JESÚS RODRÍGUEZ-HERNÁNDEZ, MIGUEL SALAVERT, JUAN P HORCAJADA, JOSÉ ANTONIO IRIBARREN, ENGELS OBI, VIRGINIA LOZANO, STEFANO MARATIA, MARIBEL CUESTA, ESTEFANY URÍA, ENRIC LIMÓN
Published: 23 February 2021
http://www.doi.org/10.37201/req/135.2020
Introduction. Clostridioides difficile infection (CDI) is associated with increased hospital stays and mortality and a high likelihood of rehospitalization, leading to increased health resource use and costs. The objective was to estimate the economic burden of recurrent CDI (rCDI).
Material and methods. Observational, retrospective study carried out in six hospitals. Adults aged ≥18 years with ≥1 confirmed diagnosis (primary or secondary) of rCDI between January 2010 and May 2018 were included. rCDI-related resource use included days of hospital stay (emergency room, ward, isolation and ICU), tests and treatments. For patients with primary diagnosis of rCDI, the complete hospital stay was attributed to rCDI. When diagnosis of rCDI was secondary, hospital stay attributed to rCDI was estimated using 1:1 propensity score matching as the difference in hospital stay compared to controls. Controls were hospitalizations without CDI recorded in the Spanish National Hospital Discharge Database. The cost was calculated by multiplying the natural resource units by the unit cost. Costs (euros) were updated to 2019.
Results. We included 282 rCDI episodes (188 as primary diagnosis): 66.31% of patients were aged ≥65 years and 57.80% were female. The mean hospital stay (SD) was 17.18 (23.27) days: 86.17% of rCDI episodes were isolated for a mean (SD) of 10.30 (9.97) days. The total mean cost (95%-CI) per episode was €10,877 (9,499-12,777), of which the hospital stay accounted for 92.56%.
Conclusions. There is high cost and resource use associated with rCDI, highlighting the importance of preventing rCDI to the Spanish National Health System.
Rev Esp Quimioter 2021; 34(2): 126-135 [Full-text PDF]
