Annals of Pharmacotherapy最新文献

{"title":"Safety of Different Weight-Based Dosing Strategies of Intravenous Acyclovir in Obese Patients: A Retrospective Cohort Study.","authors":"Mohamed Omar Saad, Safeya Omar Habib, Ahmed Mohammed Alhomosy, Islam Mohamed Salem, Ola Mohamad Hishari","doi":"10.1177/10600280251318017","DOIUrl":"10.1177/10600280251318017","url":null,"abstract":"<p><strong>Background: </strong>In obese patients receiving intravenous (IV) acyclovir, conflicting data exist regarding the risk of acute kidney injury (AKI) with different weight-based dosing strategies: total body weight (TBW), adjusted body weight (AdjBW), and ideal body weight (IBW).</p><p><strong>Objective: </strong>We aimed to compare the safety of the 3 dosing strategies in obese patients.</p><p><strong>Methods: </strong>A retrospective cohort study including obese patients who received IV acyclovir during their inpatient admissions. Patients were categorized into TBW, AdjBW, or IBW groups based on the received doses. The primary outcome was the incidence of AKI. Other outcomes included the need for renal replacement therapy (RRT), neurotoxicity, length of stay (LOS), and in-hospital mortality.</p><p><strong>Results: </strong>A total of 339 patients were included: 196 patients in TBW group, 86 patients in AdjBW group, and 57 patients in IBW group. The AKI developed in 17.3%, 11.6%, and 7% of TBW, AdjBW and IBW groups, respectively. After adjustment for confounders, reduced dosing (AdjBW or IBW) was associated with fewer AKI compared with TBW dosing (adjusted odds ratio (aOR) [95% CI] = 0.39 [0.19, 0.82]). Compared with TBW, IBW was associated with fewer AKI (aOR [95% CI] = 0.27 [0.08, 0.85]), but AdjBW was not (aOR [95% CI] = 0.48 [0.21, 1.09]). Median LOS was numerically longer with IBW but was not significantly different from other groups. The need for RRT, neurotoxicity, and mortality did not differ between groups.</p><p><strong>Conclusion and relevance: </strong>In obese patients, either AdjBW or IBW dosing of IV acyclovir appears to be safer than TBW. The IBW dosing had the lowest odds of AKI among the 3 dosing strategies.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"801-808"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of Iloperidone for Mania in Bipolar I Disorder.","authors":"Kelen Caskey, Leigh Anne Nelson","doi":"10.1177/10600280241308287","DOIUrl":"10.1177/10600280241308287","url":null,"abstract":"<p><strong>Objective: </strong>To review the efficacy of iloperidone for mania associated with bipolar I disorder and discuss its safety profile (eg, QTc prolongation, orthostatic hypotension, and metabolic adverse effects).</p><p><strong>Data sources: </strong>Literature was identified using PubMed (1966-September 2024), OVID (1984-November 2024), and clinicaltrials.gov. Search terms included iloperidone, bipolar disorder, and mania.</p><p><strong>Study selection and data extraction: </strong>The study included trials evaluating iloperidone for treating bipolar mania.</p><p><strong>Data synthesis: </strong>In one phase 3 study, iloperidone demonstrated significant improvement in mania symptoms at day 28 on all primary (ie, Young Mania Rating Scale) and secondary outcomes (Clinical Global Impression-Severity/Change scales) compared to placebo. Iloperidone was well tolerated, with tachycardia, dizziness, dry mouth, alanine aminotransferase elevation, nasal congestion, increased weight, and somnolence reported as common adverse effects.Relevance to patient care and clinical practice in comparison to existing drugs:Since there are no head-to-head studies comparing iloperidone with other second-generation antipsychotics for bipolar mania, other treatment considerations drive medication selection. Iloperidone is unavailable in a generic formulation; thus, its use will be associated with higher costs. It is dosed twice daily, which may negatively impact adherence. Iloperidone is associated with a moderate risk of QTc prolongation, metabolic adverse effects, and orthostatic hypotension, which will limit its use in certain patient populations. QTc prolongation is dose related, so drug interactions involving CYP2D6 and CYP3A4 inhibition can have serious consequences.</p><p><strong>Conclusion: </strong>In the pivotal trial, iloperidone was effective in treating adults with an acute manic or mixed episode associated with bipolar I disorder and was safe and well tolerated.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"839-849"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Strategies for Respiratory Syncytial Virus (RSV): A Review Article of Preventive Agents and Vaccines for RSV.","authors":"Nick Howard, Edward Pudim","doi":"10.1177/10600280241302085","DOIUrl":"10.1177/10600280241302085","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to describe the pharmacology, efficacy, safety, and recommendations for the use of newly approved preventive agents and vaccines for respiratory syncytial virus (RSV) and discuss their uptake during the 2023 to 2024 RSV season.</p><p><strong>Data sources: </strong>A literature search of PubMed was performed (January 2020 to February 2024) with the search terms RSV vaccine, preventive antibody, and RSV prevention. Utilization data were collected from TriNetX using the US Collaborative Network (May 2024) using the terms palivizumab, nirsevimab, and RSV prefusion F protein.</p><p><strong>Study selection and data extraction: </strong>Relevant English-language studies assessing the use of Food and Drug Administration (FDA)-approved preventive agents and vaccines for RSV in humans were considered. Population-level utilization data were extracted from TriNetX.</p><p><strong>Data synthesis: </strong>Nirsevimab was observed to have noninferior efficacy and safety compared with palivizumab with less frequent administration. Nirsevimab is recommended to replace palivizumab for RSV prophylaxis in all eligible infants. Arexvy and Abrysvo are effective at reducing the risk of RSV infection in adults aged ≥60 years, and Arexvy is indicated in adults aged ≥50 years. These vaccines are equally recommended for use in the elderly adult population, but only Abrysvo is indicated and recommended for maternal administration. Most infants only require prophylaxis through either maternal RSV vaccination or nirsevimab administrationRelevance to patient care and clinical practice:This review compares the indications for use, guideline recommendations, and clinical trial efficacy and safety data for palivizumab, nirsevimab, Abrysvo, and Arexvy to guide clinical decision-making.</p><p><strong>Conclusions: </strong>Novel RSV preventive agents, including Abrysvo, Arexvy, and nirsevimab, offer less burdensome dosing and administration compared with palivizumab, show promising efficacy and safety data, and expand the populations eligible for RSV prevention. Updated clinical guidance supports immediate adoption of these agents in practice, and population-level data suggest these agents were used during the 2023 to 2024 RSV season.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"850-861"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hypoalbuminemia on Clinical Outcomes in Patients Receiving Cefazolin for Methicillin-Susceptible <i>Staphylococcus aureus</i> Bacteremia.","authors":"Kaylee M Whitenack, Dan Ilges, Kevin L Epps, Alyssa McGary, John C Robinson","doi":"10.1177/10600280251313874","DOIUrl":"10.1177/10600280251313874","url":null,"abstract":"<p><strong>Background: </strong>Cefazolin is a preferred treatment option for methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA) bacteremia. Recent studies have suggested a potential impact on clinical outcomes in patients with hypoalbuminemia treated with highly protein-bound antimicrobials.</p><p><strong>Objective: </strong>The purpose of this study was to determine if there are any differences in clinical outcomes between normoalbuminemic and hypoalbuminemic patients treated with cefazolin for bacteremia.</p><p><strong>Methods: </strong>A retrospective, multicentered cohort study of patients hospitalized between 2019 and 2023 with MSSA bacteremia treated with cefazolin for at least 24 hours prior to culture clearance. Patients were divided into hypoalbuminemia (serum albumin ≤2.5 mg/dL) or normoalbuminemia groups. The primary outcome was time to culture clearance.</p><p><strong>Results: </strong>Of 69 patients included (50 in normoalbuminemia group and 19 in hypoalbuminemia group), the most common sources of bacteremia were line-related, osteoarticular, and infective endocarditis. Deep-seated infections were present in 24% of the normoalbuminemia group and 58% of the hypoalbuminemia group. Patients with hypoalbuminemia had a significantly longer mean hospital length of stay (12 vs 7 days, <i>P</i> = 0.016). After adjusting for deep-seated infection, hypoalbuminemia was associated with increased time to culture clearance by 1.2 days (<i>P</i> = 0.039). In-hospital mortality was significantly higher in the hypoalbuminemia group (26% vs 4%, <i>P</i> = 0.015).</p><p><strong>Conclusion and relevance: </strong>Limited research is available describing the relationship between serum albumin levels and clinical outcomes. Our study suggests patients with hypoalbuminemia treated with cefazolin for MSSA bacteremia have significantly longer time to culture clearance, increased mortality, and longer length of stay.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"794-800"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrofurantoin Versus Comparators in the Treatment of Cystitis due to Extended-Spectrum β-Lactamase-Producing Enterobacterales: A Multicenter Cohort Study.","authors":"Abrar K Thabit, Khalid Al Sulaiman, Lulwa Alfaraj, Sarah A Radwan, Layan O Almadfaa, Raneen H Mokhtar, Shuroug A Alowais, Khalid Bin Saleh, Khalid Eljaaly, Abdulmajeed A Alzahrani, Abdulaziz J Alshehri, Fadwa S Alofi, Ohoud Aljuhani","doi":"10.1177/10600280251315950","DOIUrl":"10.1177/10600280251315950","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing bacteria has limited treatment options for cystitis. The recommendation of nitrofurantoin for treatment is based solely on in vitro studies.</p><p><strong>Objective: </strong>We aimed to evaluate the effectiveness of nitrofurantoin versus comparators in treating cystitis due to ESBL-producing Enterobacterales in the clinical setting.</p><p><strong>Methods: </strong>This was a multicenter retrospective cohort study of afebrile adults with symptomatic cystitis and a urine culture of ≥10⁵ CFU/mL of ESBL-producing organism susceptible to nitrofurantoin and comparator antibiotics. Patients were categorized based on treatment (nitrofurantoin vs comparator). Clinical cure was the primary endpoint. Reinfection and relapse were secondary endpoints.</p><p><strong>Results: </strong>Of 225 patients, 66 received nitrofurantoin and 159 received a comparator. Carbapenems were the most used comparator (57.2%). Clinical cure rates were not significantly different between the groups in crude (77.3% vs 86.2%; <i>P</i> = 0.101) and regression analyses (adjusted odds ratio [aOR], 0.82; 95% CI, 0.34-1.99). Of 35.4% of nitrofurantoin patients and 66.0% comparators group patients who had follow-up cultures, lower odds of relapse and reinfection were observed with nitrofurantoin, though not statistically significant (aOR, 0.28; 95% CI, 0.07-1.18 and aOR, 0.43 with 95% CI of 0.13-1.43, respectively). However, the inpatient setting was significantly associated with higher odds of relapse (aOR, 8.83; 95% CI, 1.07-72.74; <i>P</i> = 0.043).</p><p><strong>Conclusion and relevance: </strong>Nitrofurantoin was as effective as comparators in treating cystitis due to ESBL-producing Enterobacterales. The inpatient setting was associated with higher odds of relapse. Further larger research trials are needed to validate these findings.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"785-793"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiotensin-Converting Enzyme Inhibitor Washout Period Prior to Angiotensin Receptor/Neprilysin Inhibitor Initiation in the Inpatient Setting.","authors":"Kaanan Shah, Stella Mabhugu, Jessica Obioma, Quang Nguyen, Jessica Schillig, Brittany P Torres, Meredith Howard, Bryn Lindley","doi":"10.1177/10600280241282324","DOIUrl":"10.1177/10600280241282324","url":null,"abstract":"<p><strong>Background: </strong>The 2022 AHA-ACC HFSA Guideline for Management of Heart Failure recommend initiating an angiotensin receptor/neprilysin inhibitor (ARNI) in patients with heart failure with reduced ejection fraction (HFrEF) who can tolerate an angiotensin-converting enzyme inhibitor (ACEi). The manufacturer recommends initiating a 36-hour washout period when switching from ACEi to ARNI due to an increased risk of adverse effects, including angioedema. This study investigated the adherence to the washout period when transitioning from ACEi to ARNI at a community hospital.</p><p><strong>Objectives: </strong>The primary objective was to assess the rate of adherence to the 36-hour washout when transitioning patients from ACEi to ARNI. Secondary outcomes included heart failure exacerbation readmission rates within 90 days and the rate of adverse effects (angioedema, hypotension, acute kidney injury, and hyperkalemia).</p><p><strong>Methods: </strong>This was a retrospective cohort study including patients with HFrEF who were transitioned from ACEi to ARNI during their hospital stay between March 1, 2016 and December 31, 2022. Patients were excluded if they did not receive an ACEi or ARNI during their admission or if they had an ejection fraction >40%. Pearson chi-square was used to analyze categorical data.</p><p><strong>Results: </strong>Of 33 patients included in this study, 67% received the full 36-hour washout period when transitioning from ACEi to ARNI. There were no significant differences between the rates of hospital readmissions or adverse effects between the groups. No patients experienced hyperkalemia or angioedema.</p><p><strong>Conclusion and relevance: </strong>This is the first study to our knowledge to describe real-world prescribing practices when transitioning patients from ACEi to ARNI for the treatment of HFrEF. Larger, multicenter studies are needed to provide more data on prescribing practices outside this single center. Future research should also include pharmacist's role in adhering to the recommended washout.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"835-838"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Perioperative Fungal Prophylaxis Protocol Change in Orthotopic Liver Transplant.","authors":"Megan M Singlar, Xhilda Xhemali, Kyle D Brizendine, Jamie Eckardt, Jessica Ward, Nicole Palm","doi":"10.1177/10600280251314018","DOIUrl":"10.1177/10600280251314018","url":null,"abstract":"<p><strong>Background: </strong>Orthotopic liver transplant (OLT) carries a risk for invasive fungal infections (IFI). A targeted antifungal prophylaxis protocol can identify OLT patients who warrant antifungal prophylaxis. The optimal protocol and appropriate risk factors have yet to be confirmed.</p><p><strong>Objective: </strong>This study aimed to describe the impact of a targeted antifungal prophylaxis protocol post OLT on rates of IFI and protocol adherence.</p><p><strong>Methods: </strong>This was a retrospective observational cohort study of patients ≥18 years old with an OLT at Cleveland Clinic. Pre-protocol was defined as June 1, 2019 to May 31, 2020 and post-protocol was June 1, 2021 to May 31, 2022. The primary objective was to determine adherence to the prophylaxis protocol on postoperative day (POD) 0. Secondary objectives included comparing the 90-day incidence of proven or probable IFI post-OLT between groups.</p><p><strong>Results: </strong>The pre-protocol group included 134 patients, whereas the post-protocol group included 166. Prior to protocol implementation, 73% received clotrimazole, 13% fluconazole, 13% micafungin, and 1% nystatin. After protocol implementation, 63% received clotrimazole, 16% fluconazole, and 21% micafungin. Adherence to the protocol was 66% on POD0 and increased to 84% over the duration of prophylaxis. Rates of IFI development decreased to 3.6% after implementation from 6.7% prior to the protocol (<i>P</i> = 0.22). Median time to IFI was 8 days (interquartile range [IQR] = 2-19) pre-protocol and 15 days (IQR = 6-17) post-protocol.</p><p><strong>Conclusions and relevance: </strong>The implementation of a post-OLT-targeted antifungal prophylaxis protocol can promote consistency in antifungal prophylaxis. This study showed an 84% adherence rate to the implemented protocol, with numerically lower rates of IFIs post-protocol compared with pre-protocol.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"822-829"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Nervous System Disorders: A Systematic Review and Meta-Analysis.","authors":"Bo Xu, Mingxia Yang, Shaoqian Li, Bo Kang, Jiecan Zhou","doi":"10.1177/10600280251317495","DOIUrl":"10.1177/10600280251317495","url":null,"abstract":"<p><strong>Background: </strong>Adults with type 2 diabetes mellitus (T2DM) are at an increased risk for certain brain or psychiatric disorders, as are those with or without chronic kidney disease or heart failure. Whether sodium-glucose cotransporter 2 (SGLT2) inhibitors are associated with these diseases is unclear.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to investigate the effects of SGLT2 inhibitors on nervous system disorders.</p><p><strong>Methods: </strong>We searched PubMed, ClinicalTrials.gov, and Web of Science for randomized, double-blind placebo-controlled trials of at least ≥24 weeks. We used Mantel-Haenszel statistical method, risk ratio (RR), and 95% confidence interval (CI) to dichotomous variables.</p><p><strong>Results: </strong>We included 52 publications/trials covering 111 376 participants (SGLT2 inhibitors 62 192; Placebo 49 184). Sodium-glucose cotransporter 2 inhibitors had no significant effect on ischaemic stroke (RR = 0.97; 95% CI = 0.87-1.09; <i>P</i> = 0.64), cerebrovascular accident (RR = 1.05; 95% CI = 0.91-1.22; <i>P</i> = 0.50), dementia (RR = 1.29; 95% CI = 0.78-2.12; <i>P</i> = 0.32), carotid artery occlusion/carotid artery stenosis (RR = 1.18; 95% CI: 0.92-1.53; <i>P</i> = 0.20), haemorrhagic stroke (RR = 0.84; 95% CI = 0.62-1.12; <i>P</i> = 0.23), and transient ischaemic attack (RR = 0.97; 95% CI = 0.82-1.15; <i>P</i> = 0.73) compared to placebo. No significant heterogeneity was observed. However, SGLT2 inhibitors showed slight effects to reduce the risk of Parkinson's disease (major heart failure subgroup). Empagliflozin and dapagliflozin significantly increased the risk of syncope (RR = 1.65; 95% CI = 1.15-2.38; <i>P</i> < 0.01) and carotid artery occlusion/carotid artery stenosis (RR = 1.65; 95% CI = 1.04-2.61; <i>P</i> = 0.03), respectively.</p><p><strong>Conclusion and relevance: </strong>No significant effect of SGLT2 inhibitors on nervous system disorders was observed. There was reduced risk for Parkinson's Disease observed in some specific populations. In addition, the risks of empagliflozin and dapagliflozin concerning syncope and carotid artery occlusion/carotid artery stenosis are worth attention.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"809-821"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Live Biotherapeutic Products for the Prevention of Recurrent Clostridioides difficile Infection\".","authors":"","doi":"10.1177/10600280241310646","DOIUrl":"10.1177/10600280241310646","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"868-871"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Outcomes of Standard Weight-Based and Capped Doses of Albumin for Spontaneous Bacterial Peritonitis.","authors":"Lily Huang, Avery Marcotte, Taryn S Murray, Jordan Barkes, Alissa Clayton","doi":"10.1177/10600280251318012","DOIUrl":"10.1177/10600280251318012","url":null,"abstract":"<p><strong>Background: </strong>Albumin is recommended in the management of patients with spontaneous bacterial peritonitis (SBP) to reduce rates of renal injury and mortality. Current guideline recommendations suggest an intravenous albumin dosing regimen of 1.5 g/kg on day 1 and 1 g/kg on day 3, although a maximum dosing strategy is not well-defined.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate differences in renal injury for patients with SBP treated with a capped dose less than or equal to 100 g vs a weight-based dose greater than 100 g.</p><p><strong>Methods: </strong>A retrospective analysis was conducted at a single academic medical center for patients with a diagnosis of cirrhosis treated with albumin for SBP. The primary outcome examined rates of acute renal injury at 5 days between patients treated with capped dose vs weight-based doses of intravenous albumin. Secondary outcomes included resolution of SBP by day 5, death by day 5, death by day 30, and change in serum creatinine from day 0 to day 5.</p><p><strong>Results: </strong>In total, 258 patient encounters were analyzed, with 154 included in this study. There were 70 encounters encompassing the capped dose and 84 in the non-capped. Acute renal injury at day 5 was observed in 10% (n = 7) of the capped dosed group and 6% (n = 5) of the non-capped group (<i>P</i> = 0.381).</p><p><strong>Conclusion and relevance: </strong>This study did not show a significant difference in outcomes associated with a capped albumin dose at 100 g for SBP. Application of these data may aid in reducing health system and patient costs.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"830-834"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}