FARMACIA HOSPITALARIA最新文献

{"title":"Medication Safety Officers: A pillar of patient safety in hospital pharmacy.","authors":"Elizabeth Hess Ford, Christina Michalek","doi":"10.1016/j.farma.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.farma.2025.09.001","url":null,"abstract":"<p><p>The role of a Medication Safety Officer has emerged as a critical element in hospital pharmacy, addressing the persistent issue of medication errors. These errors, which can cause significant patient harm, have been documented for decades, prompting the establishment of formal roles dedicated to medication safety. Organizations such as the Institute for Safe Medication Practices (ISMP), the American Society of Health System Pharmacists (ASHP) as well as the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) and National Health Service (NHS) have been instrumental in supporting the Medication Safety Officer role. Medication errors can result in severe consequences, including patient harm and death. Landmark publications like the Institute of Medicine's \"To Err is Human\" and \"Crossing the Quality Chasm\" have highlighted the prevalence and impact of these errors, advocating for system improvements and the necessity of dedicated safety roles. Medication Safety Officers lead strategies and processes related to medication safety, develop strategic plans, and implement error prevention strategies. They analyze medication error reports, collaborate with healthcare staff, and optimize medication safety technologies. Medication Safety Officers play a key role in fostering a culture of safety within organizations, influencing practices to minimize harm and support second victim programs. Studies have shown that employing a Medication Safety Officer can significantly improve hospital safety scores, demonstrating the effectiveness of this role in enhancing patient safety. The daily responsibilities of a Medication Safety Officer include reviewing medication errors, assessing harm, attending meetings, and collaborating with healthcare practitioners. Overall, the role of a Medication Safety Officer is essential in identifying and mitigating medication risks, making hospitals safer, and ensuring the delivery of high-quality patient care.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical characteristics of inhaled antibiotics related to tolerability.","authors":"Manuel Vélez-Díaz-Pallarés, María Ángeles Parro-Martín, Hilario Martínez-Barros, Beatriz Montero-Llorente, Miriam Menacho-Román, Ana Gómez-Lozano, Rosa Nieto Royo, Luis Máiz Carro, Ana Álvarez-Díaz","doi":"10.1016/j.farma.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.007","url":null,"abstract":"<p><strong>Introduction: </strong>Inhaled antibiotics are used in the treatment of various respiratory diseases, including cystic fibrosis (CF), non-CF bronchiectasis, and ventilator-associated pneumonia. While some of these drugs are marketed as ready-to-use formulations, others require prior manipulation, such as dilution or reconstitution procedures that are often not standardized. Furthermore, certain antibiotics are only approved for intravenous administration, making it necessary to develop specific protocols for their preparation and use via the inhaled route. Their biochemical properties may also compromise patient safety and tolerability. The aim of this study was to assess how frequently preparation methods and biochemical parameters of inhaled antibiotic solutions are described in the scientific literature. Additionally, we explored their prevalence of use in our country and evaluated their biochemical characteristics to assess tolerability.</p><p><strong>Methods: </strong>A literature review was conducted using the MEDLINE database to identify studies describing the dilutions used for the administration of inhaled antibiotics. In addition, a nationwide survey was carried out to assess the dilutions currently used in hospital clinical practice. Biochemical analyses were performed in parallel to determine the pH, osmolality, and sodium and chloride ion concentrations of the solutions employed. Excipients present in each formulation were recorded based on information from the product's summary of characteristics.</p><p><strong>Results: </strong>The literature review identified 533 full-text publications describing 737 different inhaled antibiotic mixtures. Of these, 476 were not standardized. Only 190 mixtures included precise dilution instructions, while just 31 provided data on pH and 28 on osmolality. The national survey revealed a high prevalence of inhaled antibiotic use among participating hospitals, with 22 centres (64.7%) reporting the use of intravenous formulations administered via inhalation. Laboratory analyses showed that some of the evaluated dilutions fell outside the acceptable tolerability range, particularly those involving reconstitution of dry powders or dilution of concentrated intravenous solutions.</p><p><strong>Conclusion: </strong>There is limited information in the scientific literature regarding preparation methods and the biochemical characteristics of inhaled antibiotic solutions. Off-label use of intravenous formulations for inhalation is widespread, and some of the dilutions used exhibit biochemical parameters outside the recommended tolerability range, which may compromise both the safety and effectiveness of treatment.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Therapeutic drug monitoring of dalbavancin: A systematic review of strategies and clinical applications in the treatment of complex infections.","authors":"Laura Moñino-Dominguez, Alicia Aguado-Paredes, Jaime Cordero-Ramos","doi":"10.1016/j.farma.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.003","url":null,"abstract":"<p><strong>Introduction: </strong>dalbavancin is approved for treating acute bacterial skin and soft tissue infections, but its off-label use for treating complex chronic infections has become increasingly common. Currently, there is no established dosing regimen for such infections. Given the need for prolonged treatments, a dosing adjustment strategy based on therapeutic drug monitoring may optimize its use and allow for individualized regimens. This systematic review analyzes dalbavancin dosing in complex infections and TDM-based strategies to optimize treatment.</p><p><strong>Materials and methods: </strong>A search was conducted in PubMed, Embase, Scopus, and the Cochrane Library (2014-2024) using the following keywords: \"dalbavancin\", \"pharmacokinetics\", \"pharmacodynamics\", \"therapeutic drug monitoring\", and \"TDM\". Three independent reviewers selected and evaluated the studies. Clinical studies related to the pharmacokinetics of dalbavancin and the use of TDM in complex infections requiring prolonged regimens were included. Due to the heterogeneity among the studies, a qualitative analysis of the data was performed.</p><p><strong>Results: </strong>A total of 241 articles were identified. After removing duplicates and applying the inclusion and exclusion criteria, 10 studies were included. These studies exhibited heterogeneity in design (6 retrospective and 4 prospective) and sample size, encompassing 457 patients and 1.298 samples. Most studies focused on osteoarticular infections treated with dalbavancin using an initial two-dose regimen of 1,500 mg administered one week apart, followed by dose adjustments based on plasma level monitoring. The most commonly targeted pharmacokinetic/pharmacodynamic parameters were a trough concentration above 8 μg/ml and an area under the curve/minimum inhibitory concentration ratio greater than 111.1. Therapeutic Drug Monitoring-Guided strategies were found to optimize dosing and maintain adequate plasma levels. Significant interindividual variability in plasma concentrations was observed, influenced by factors such as renal function and body surface area.</p><p><strong>Discussion: </strong>The use of Therapeutic Drug Monitoring in dalbavancin dosing optimizes the treatment of complex chronic infections by adjusting dosing intervals and maintaining adequate therapeutic levels over extended periods. However, further validation and definition of specific pharmacokinetic/pharmacodynamic targets is required.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Influence of SARS-CoV-2 infection on the use of ceftazidime-avibactam in the critical patient.","authors":"Fátima Mayo Olveira, José Manuel Caro Teller, María Dolores Canales Siguero, Sara Ortiz Pérez, María Del Carmen Jiménez León, José Miguel Ferrari Piquero","doi":"10.1016/j.farma.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.farma.2025.03.016","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study was to analyse possible changes in antibiotic policy with ceftazidime-avibactam during the SARS-CoV-2 pandemic in an Intensive Care Unit (ICU) to determine patient mortality 28 days after initiation of antimicrobial therapy and to describe the microorganisms that most frequently colonise critically ill patients.</p><p><strong>Material and method: </strong>Observational, single-centre, cohort study that included patients on treatment with ceftazidime-avibactam in ICU between March 2020 and September 2021. Demographic (age, sex), microbiological (colonisation, microorganisms isolated in blood cultures), pharmacotherapeutic (duration of treatment with ceftazidime-avibactam, antimicrobials used in synergy with ceftazidime-avibactam) and clinical (mortality, length of hospital stay and comorbidities) variables were collected. As associated comorbidities, we identified how many of the patients included in the study had diabetes mellitus (DM), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD) or obesity.</p><p><strong>Results: </strong>Eighty-nine patients were included, 85.39% of whom were male. Forty-nine patients were infected with Sars-CoV-2. Median ICU stay was 46 days (RIQ = 58-27) in SARS-CoV-2 infected and 34 days (RIQ = 51-24) in non-infected patients. Patients were on ceftazidime-avibactam treatment for a median of 8 days (RIQ = 13-4), being 7 days (RIQ = 11-2) in COVID-19 positive patients and 11 days (RIQ = 14-6) in COVID-19 negative patients (p > 0.05). Empirical treatment with ceftazidime-avibactam was started empirically in 41.57% (n = 37) of the patients. The percentage of empiric initiations in SARS-CoV-2 infected patients was 43% and in non-infected patients 40%, with no statistically significant difference between empiric initiation according to SARS-CoV-2 diagnostic status (p > 0.05). A total of 43.8% (n = 39) of the patients were colonised by a multidrug-resistant (MDR) bacterium. Regarding on the microorganisms that colonised patients had, the most frequent was Klebsiella pneumoniae, present in 66.6% of patients (n = 26 patients). Overall mortality was 41.6%, with no statistically significant differences between SARS-CoV-2 infected and non-infected patients (42.9% and 40%, respectively; p > 0.05).</p><p><strong>Conclusion: </strong>The SARS-CoV-2 pandemic did not lead to a change in the criteria for the use of ceftazidime-avibactam in the critically ill patient.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, perception, and willingness to implement the CMO (Capability- Motivation-Opportunity) methodology among specialist physicians caring for patients with HIV in Spain.","authors":"Enrique Contreras Macías, Pilar Taberner Bonastre, Anaïs Corma Gómez, José Ramón Blanco Ramos, Ramón Morillo Verdugo","doi":"10.1016/j.farma.2025.08.009","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.009","url":null,"abstract":"<p><strong>Introduction: </strong>The CMO (Capability-Motivation-Opportunity) methodology is an innovative pharmaceutical care model designed to improve the quality of care for people living with HIV/AIDS (PLWHA). This approach evaluates the knowledge, perception, and willingness to implement the methodology among specialist physicians in Spain.</p><p><strong>Methods: </strong>This observational and descriptive study utilized a validated questionnaire distributed among clinicians involved in the care of PLWHA. The survey assessed their knowledge and perception of the methodology. Associations between variables were analyzed using bivariate tests.</p><p><strong>Results: </strong>Thirty physicians participated. Sixty percent reported moderate-to-high knowledge of the methodology, correlating with a positive perception of its clinical relevance (p = 0.02). Motivational interviewing and remote follow-up were identified as key tools.</p><p><strong>Conclusion: </strong>Knowledge of the CMO methodology is limited but positively valued. Its association with improved quality of health care underscores the importance of strategies to enhance its dissemination and adoption in clinical practice.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surface disinfectants used in healthcare environments.","authors":"Isabel Romero Crespo, Maria Luisa Gaspar Carreño, Maria Cristina Muñoz Contreras","doi":"10.1016/j.farma.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.farma.2025.03.011","url":null,"abstract":"<p><strong>Objective: </strong>Review the most relevant aspects to consider when selecting the optimal surface disinfectant for use in healthcare settings.</p><p><strong>Method: </strong>The review was conducted over a three-month period (January to March 2024) based on the list of healthcare surface disinfectants authorized by the Spanish Agency of Medicines and Medical Devices and those in a transitional period, with marketing allowed until their registration in the Official Biocide Register. Biocidal agents belonging to the categories of skin antiseptics and insect repellents were excluded. A total of 100 biocidal agents were selected and evenly distributed among four researchers. The review strategy involved consulting the marketing representatives of these products via email or by reviewing their technical datasheets on their respective websites. The reviewed aspects of each disinfectant included marketed presentations, declared efficacy, composition, indication, dosage, and usage instructions.</p><p><strong>Results: </strong>The total number of biocidal agents included in the study was 85. A total of 29 suppliers were consulted, covering 141 marketed presentations, 25 (29.41%) of which were sterile. Regarding the efficacy declared by suppliers, 100% (85 products) showed bactericidal activity, 81.18% (69) fungicidal activity, 78.82% (67) virucidal activity, 50.59% (43) yeasticidal activity, 20% (17) mycobactericidal/tuberculocidal activity, and 17.65% (15) sporicidal activity. In terms of usage instructions, 40 of the 85 biocides (47.06%) were presented in a ready-to-use dosage format, and 34 (40%) allowed for cleaning and disinfection in a single step. A total of 14 biocides (16.47%) included airborne disinfection options.</p><p><strong>Conclusions: </strong>Selecting the most appropriate surface disinfectant is not straightforward, given the wide range of marketed products, the number of factors to consider, and the fact that not all products meet every criterion. For this reason, the selection process must be accompanied by the implementation of optimized programs aimed at reducing the transmission of pathogens from surfaces to patients and healthcare personnel.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] New Alzheimer disease's treatments: Hope or disappointment.","authors":"Daniel Sevilla-Sánchez, Alejandro J Garza-Martínez","doi":"10.1016/j.farma.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.008","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute esophageal necrosis in a patient with lung cancer under treatment with osimertinib: Case report.","authors":"Alicia Aguado-Paredes, Laura Moñino-Dominguez, Maria Del Carmen Damas-Fuentes","doi":"10.1016/j.farma.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.farma.2025.07.004","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence of optimal and suboptimal response in chronic immune-mediated inflammatory diseases.","authors":"Joaquín Borrás-Blasco, Vicente Merino-Bohorquez, Esther Ramírez-Herráiz, Andrés Navarro-Ruiz","doi":"10.1016/j.farma.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.006","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standarization and characterization of intravenous drug dilutions in critically ill pediatric patients.","authors":"Laura Torralba-Fernández, Marta García-Palomo, Miguel López de Abechuco-Ruiz, Natalia Ramos-Sánchez, Clara Jiménez-Méndez, Rocío Prieto-Galindo, María Carmen Lorenzo-Lozano, Pablo Aguado-Barroso","doi":"10.1016/j.farma.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.farma.2025.08.005","url":null,"abstract":"<p><strong>Objective: </strong>To standardize the drug dilutions administered intravenously in a Pediatric Intensive Care Unit and to characterize these dilutions based on their pH, osmolarity, and vesicant nature. This aims to guide the selection of the most appropriate vascular access device, minimizing associated complications, and preserving the patient's venous capital.</p><p><strong>Methods: </strong>Through a consensus between Pharmacy and Pediatric Services, the most frequently administered intravenous drugs in the Pediatric Intensive Care Unit were selected. Two different dilutions were established for each drug, followed by the determination of their respective osmolarity and pH values. The vesicant nature of each drug was assessed according to the classification proposed by Clark et al. Additionally, vascular access device selection was guided by the algorithm proposed by Manrique et al., which considers the drug's properties, the duration of intravenous therapy, and the patient's venous capital status.</p><p><strong>Results: </strong>A total of 60 dilutions corresponding to 30 drugs from the following therapeutic groups were analyzed: antimicrobials (56%), antiepileptics (13%), sedatives (7%), diuretics (7%), anti-inflammatory and analgesics (7%), and others (10%). Twenty-five percent of the dilutions exhibited at least one high-risk factor for phlebitis (osmolarity >600 mOsm/L or pH < 4 or > 9), while 35% were classified as intermediate risk (osmolarity 450-600 mOsm/L or pH 4-5 or > 7.5-9). Only 10% of the analyzed drugs were classified as vesicants (acyclovir, phenytoin, and vancomycin). Seventeen dilutions of nine different drugs were identified that should not be administered through a peripheral venous catheter, even in short-term treatments. Of these, 15 had a high risk of causing phlebitis, while 2 had an intermediate risk.</p><p><strong>Conclusions: </strong>The physicochemical properties (osmolarity and pH) and vesicant nature of drugs are key factors contributing to the development of phlebitis in critically ill pediatric patients. Standardizing and characterizing drug dilutions will facilitate the selection of the most appropriate vascular access device, improving the safety and effectiveness of intravenous therapy.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}