Annals of Pharmacotherapy最新文献

{"title":"Efficacy and Safety of Mepolizumab in Eosinophilic COPD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Rahul Bisht, Arusha Desai, Esteban Marcelo Mogrovejo Carrión, Anjali Bhardwaj, Sidharth Misra, Tejesh Bangalore Shivashankar, Ramita Gupta","doi":"10.1177/10600280261437728","DOIUrl":"https://doi.org/10.1177/10600280261437728","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of mepolizumab, a humanized monoclonal antibody that targets interleukin-5, a key mediator in eosinophilic inflammation, in reducing moderate-to-severe exacerbations among patients with eosinophilic chronic obstructive pulmonary disease (COPD).</p><p><strong>Data sources: </strong>PubMed, Scopus, Web of Science, and Cochrane databases were systematically searched using the terms: \"Mepolizumab,\" \"COPD,\" \"Chronic Obstructive Pulmonary Disease,\" for randomized controlled trials comparing subcutaneous mepolizumab (100 mg every 4 weeks) with placebo in patients with eosinophilic COPD from inception till July 2025.</p><p><strong>Study selection and data extraction: </strong>Randomized controlled trials comparing subcutaneous mepolizumab with placebo in adults with eosinophilic COPD were included. Two independent reviewers screened studies and extracted data. Finally, 4 studies with a total of 1953 patients were included. Of these, 978 (50.0%) received mepolizumab.</p><p><strong>Data synthesis: </strong>Statistical analysis was performed using R software (version 4.5.0). Mepolizumab significantly prolonged the time to first moderate or severe exacerbation (hazard ratio [HR] = 0.80; 95% confidence interval [CI] 0.69-0.92; <i>P</i> = 0.016) and reduced the rate of moderate-to-severe exacerbations (rate ratio 0.80; 95% CI 0.78-0.83; <i>P</i> < 0.001). The risk of adverse events (AEs) (risk ratio [RR] = 1.00; 95% CI 0.95-1.06; <i>P</i> = 0.962) was similar between groups, while the risk of serious adverse events or death (RR = 0.83; 95% CI 0.72-0.96; <i>P</i> = 0.031) was significantly lower in the mepolizumab group.Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs:Mepolizumab provides a targeted, biomarker-guided treatment option, potentially reducing exacerbations without the added safety concerns like infections and metabolic complications as seen with existing therapies.</p><p><strong>Conclusion and relevance: </strong>Mepolizumab reduces the time to first moderate or severe exacerbation and prolongs symptom-free periods in patients with eosinophilic COPD, without increasing the risk of AEs.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261437728"},"PeriodicalIF":2.3,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759844","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":"Emergency Department Visits for Adverse Medication Events for Adults With Intellectual or Developmental Disabilities.","authors":"Steven R Erickson, Jeremiah Jean, Vincent D Marshall","doi":"10.1177/10600280261439952","DOIUrl":"https://doi.org/10.1177/10600280261439952","url":null,"abstract":"<p><strong>Background: </strong>Persons with intellectual or developmental disabilities (IDD) are at risk of adverse medication events (AMEs). Polypharmacy, complex medication regimens, and reliance on others to manage medications are a few risk factors that are more common in this group of patients than in the general population.</p><p><strong>Objective: </strong>To determine the likelihood that an emergency department (ED) visit for an AME is greater for adults with IDD than for the general adult population.</p><p><strong>Methods: </strong>This exploratory study used the 2018 National (Nationwide) Emergency Department Sample (NEDS) of the Healthcare Cost and Utilization Project (HCUP) databases and applied a multivariable logistic regression analysis for complex surveys to determine the likelihood that an ED visit was for an AME and was different for adults with IDD compared to those without IDD, controlling for patient characteristics.</p><p><strong>Results: </strong>A greater proportion of ED visits for adult patients with IDD were for AMEs (4.4%) compared to patients without IDD (2.6%). The unadjusted odds ratio for IDD when compared with non-IDD was 1.695, with a 95% confidence interval of 1.649 to 1.743. In the multivariable logistic regression model, the odds ratio associated with a patient with IDD was 1.795 (95% confidence interval 1.75, 1.84), indicating that the ED admission was significantly more likely to be due to an AME for patients with IDD compared to patients without IDD.</p><p><strong>Conclusion and relevance: </strong>Adults with IDD have a higher likelihood that an ED visit is due to an AME compared with the general population. Knowing this, clinicians and researchers can begin to investigate the reasons for this disparity, in an effort to ensure the safe and effective use of medications by persons with IDD.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261439952"},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759781","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":"Comparison of Bicarbonate-Based Versus Heparin-Based Impella® Purge Solution.","authors":"Bridget A Betts, Miranda J Moser, Ju Hee Kim, Danielle M Knowles, Edmond J Solomon, Andrew Tom, Alexander Y Toyoda, Brian R Schuler","doi":"10.1177/10600280261437140","DOIUrl":"https://doi.org/10.1177/10600280261437140","url":null,"abstract":"<p><strong>Background: </strong>The Impella® is a continuous axial flow pump that utilizes a purge solution to create a positive pressure barrier and prevent pump thrombosis. Bicarbonate-based purge solution (BBPS) is currently Food and Drug Administration-approved specifically for patients who are unable to tolerate heparin or have a contraindication to heparin, but solution choice between BBPS and heparin-based purge solution (HBPS) varies in clinical practice.</p><p><strong>Objective: </strong>This study aims to compare the efficacy and safety of the BBPS versus HBPS when BBPS is used as the standard of care. The major endpoint was a composite outcome of pump thrombosis, stroke, and bleeding events.</p><p><strong>Methods: </strong>This study was a retrospective analysis at 2 tertiary academic medical centers within the same health system (IRB Protocol #2023P002761). Adult patients were included if they required an Impella® device and received either the BBPS or HBPS for at least 72 hours between July 2022 and October 2023. The major endpoint was a composite outcome of pump thrombosis, stroke, and bleeding events. Pump thrombosis was defined as incidence of 2 or more purge pressures greater than 800 mmHg, the use of thrombolytic purge solution, or thrombus noted on imaging. Minor endpoints included intensive care unit (ICU) mortality, ICU length of stay, and vascular complications.</p><p><strong>Results: </strong>A total of 178 patients were evaluated of which 66 were included. The composite outcome occurred in 23 of 38 patients (60.5%) in the BBPS group and 17 of 28 patients (60.7%) in the HBPS group (<i>P</i> = 0.99). There was no difference in pump thrombosis, stroke, or bleeding events between cohorts. Vascular events were noted in 5 (17.9%) of HBPS and 13 (34.2%) of BBPS group (<i>P</i> = 0.14). Additional minor endpoints were not significantly different between the groups.</p><p><strong>Conclusion and relevance: </strong>This study found no differences in pump thrombosis, stroke, and bleeding events in the BBPS versus HBPS group. Although these findings are supportive of utilizing BBPS as standard of care, larger, multi-center studies are needed to confirm differences in bleeding or thrombotic outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261437140"},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759791","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 Nutritional Status and Body Composition on Osimertinib Tolerance in Non-Small-Cell Lung Cancer.","authors":"Claudia Barca-Díez, Lara González-Freire, Borja Franco-Sandar","doi":"10.1177/10600280261438838","DOIUrl":"https://doi.org/10.1177/10600280261438838","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261438838"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728119","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 Retrospective Analysis to Evaluate the Impact of Obesity on Therapeutic Enoxaparin Dosing in Pregnancy.","authors":"Reagan McGinn, Selena Beck, Rikki-Leigh Gaudet, Kayla Popova","doi":"10.1177/10600280261437929","DOIUrl":"https://doi.org/10.1177/10600280261437929","url":null,"abstract":"<p><strong>Background: </strong>In the United States, standard enoxaparin treatment dosing in pregnant patients is 1 mg/kg subcutaneously twice daily. For nonpregnant patients with obesity (body mass index (BMI) ≥30 kg/m²), literature supports empiric dose reductions to 0.8 mg/kg subcutaneously twice daily.</p><p><strong>Objective: </strong>To investigate whether pregnant patients with obesity require empiric enoxaparin treatment dose adjustments compared to pregnant patients without obesity.</p><p><strong>Methods: </strong>This retrospective chart review included pregnant adults who received therapeutic enoxaparin and had appropriately timed low-molecular-weight heparin (LMWH) anti-factor Xa levels. The primary endpoint compared initial LMWH anti-factor Xa levels between patients with and without obesity. Secondary endpoints included the frequency and extent of enoxaparin dose adjustments by BMI, among those with nontherapeutic initial levels. Safety was assessed by number and severity of bleeding events. Statistical analyses included the Kruskal-Wallis test, Student's T-test, and one-way ANOVA.</p><p><strong>Results: </strong>Of 121 patients identified, 74 met inclusion criteria. Participants were classified as nonobese (n = 33) or obese (n = 41). Initial LMWH anti-factor Xa levels differed significantly between groups (<i>P</i> = 0.045). The mean BMI of patients with a subtherapeutic initial level (29.02 kg/m²) differed significantly from those with a supratherapeutic initial level (35.8 kg/m²) (<i>P</i> = 0.030). No significant difference was found in adjusted enoxaparin dose between participants with and without obesity, but a significant difference existed between subtherapeutic and supratherapeutic groups (<i>P</i> < 0.001). Each group had 1 clinically relevant nonmajor bleed. Limitations included single-center design and small sample size.</p><p><strong>Conclusions and relevance: </strong>Pregnant patients with obesity receiving treatment enoxaparin are likely to achieve target LMWH anti-factor Xa levels without initial dose adjustments. Morbidly obese patients, however, may still risk supratherapeutic levels. Pregnant patients without obesity were prone to subtherapeutic LMWH anti-factor Xa levels necessitating enoxaparin dose adjustments. Routine LMWH anti-factor Xa monitoring may be beneficial for obstetric patients receiving therapeutic enoxaparin, regardless of BMI.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261437929"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728122","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":"Enteral Phosphate Replacement in the Intensive Care Unit.","authors":"Kayla M Wesley, Ji Tong Liu, Chelsea Wampole, Caitlin S Brown, Jonathan Bourque, Kathryn E Smith","doi":"10.1177/10600280261432239","DOIUrl":"https://doi.org/10.1177/10600280261432239","url":null,"abstract":"<p><strong>Background: </strong>Enteral phosphate replacement offers multiple advantages over intravenous phosphate replacement, but optimal dosing and administration are unclear.</p><p><strong>Objective: </strong>This study aimed to compare 2 different dosing strategies (PRE vs POST) of enteral phosphate replacement for mild hypophosphatemia (serum phosphorus = 2.1-2.5 mg/dL) and to evaluate our dosing strategy for moderate hypophosphatemia (serum phosphorus = 1.5-2 mg/dL) in critically ill patients.</p><p><strong>Methods: </strong>This single-center quasiexperimental, institutional review board-approved study was conducted in adult patients admitted to an intensive care unit (ICU) who received enteral phosphate replacement with a follow-up serum phosphorus level obtained within 24 hours of replacement. Patients were excluded if they had diabetic ketoacidosis, acute kidney injury, or received total parenteral nutrition or targeted temperature management. The mild PRE and POST groups received 48 and 72 mmol of enteral phosphate, respectively. The moderate group received 72 mmol of enteral phosphate. Effectiveness outcomes included normalization of serum phosphorus, defined as 2.6 to 4.5 mg/dL, and median change in phosphorus concentration. Safety outcomes included the incidence of new onset diarrhea and hyperphosphatemia (serum phosphorus >4.5 mg/dL) within 24 hours after phosphate replacement.</p><p><strong>Results: </strong>Of the 138 patients included, the median age was 59 (44-70) years and 69.6% were admitted to the surgical trauma ICU. Normalization of serum phosphorus occurred in 55 (58.2%) patients in mild PRE and 44 (72.7%) patients in mild POST (<i>P</i> = 0.13). Change in serum phosphorus was 0.4 (0.1-0.9) mg/dL in mild PRE vs 0.7 (0.3-1.2) mg/dL in mild POST (<i>P</i> = 0.06). Normalization occurred in 39 (66.7%) patients in the moderate group with a change in serum phosphorus of 1.0 (0.6-1.6) mg/dL. Rates of new onset diarrhea and hyperphosphatemia were not significantly different between groups.</p><p><strong>Conclusion and relevance: </strong>Enteral phosphate replacement appears safe and effective in critically ill patients with mild-to-moderate hypophosphatemia and may serve as an alternative to intravenous phosphate.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261432239"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728136","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":"Effect of Body Weight on Hemodynamic Response to Vasopressin in Patients With Septic Shock.","authors":"Eli O Jorgensen, Marco M Custodio, Ruina He, George A Urias","doi":"10.1177/10600280261436423","DOIUrl":"https://doi.org/10.1177/10600280261436423","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend arginine vasopressin (AVP) at a fixed dose for patients with septic shock who remain hypotensive after fluid resuscitation and norepinephrine, regardless of body weight.</p><p><strong>Objective: </strong>This study seeks to evaluate whether body weight affects hemodynamic response (HDR) to AVP in critically ill patients with septic shock.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study of adult patients with septic shock. Patients received AVP at a fixed rate of 0.03 units/min in addition to catecholamine vasopressors and were grouped into 4 categories according to admission body weight. The primary endpoint was the time from AVP initiation to HDR, defined as a decrease in norepinephrine equivalents (NEEs) by at least 0.03 mcg/kg/min while maintaining a mean arterial pressure of at least 65 mm Hg for 1 hour. Secondary endpoints included a time to HDR defined as reduction in NEE of 0.05 mcg/kg/min, intensive care unit (ICU) length of stay (LOS), total duration of vasoactive agents, incidence of renal replacement therapy (RRT), and 28-day mortality.</p><p><strong>Results: </strong>A total of 170 patients were included in the study. No differences were observed between categories in time to HDR of 0.03 NEE (<i>P</i> = 0.854) or 0.05 NEE (<i>P</i> = 0.985). The total duration of vasopressors and ICU LOS were also similar between categories (<i>P</i> > 0.05). Patients weighing <75 kg had a lower incidence of RRT (<i>P</i> < 0.001) and patients weighing <100 kg had a lower 28-day mortality (<i>P</i> = 0.006). These findings remained significant after regression analysis.</p><p><strong>Conclusion and relevance: </strong>Although body weight did not have a significant impact on the time to HDR, there was a significant difference in the incidence of RRT and 28-day mortality favoring those who weighed <75 and <100 kg, respectively. These findings contribute to the existing body of evidence, though larger trials are warranted to assess this further.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261436423"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728092","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":"Erenumab and Galcanezumab for Chronic Migraine Refractory to OnabotulinumtoxinA: A Real-World Comparative Study.","authors":"Sara Martín-Yeves, Ana Colón-López de Dicastillo, Javier Riancho, José Ramón Sánchez-de la Torre, Yésica Jiménez-López, Sonia Setién, Mercedes Misiego-Peral, Daniel Gallo, Patricia Zunzunegui-Arroyo, Arancha Sainz-Pelayo, Manuel Delgado-Alvarado","doi":"10.1177/10600280261429460","DOIUrl":"https://doi.org/10.1177/10600280261429460","url":null,"abstract":"<p><strong>Background: </strong>Resistant chronic migraine remains a major therapeutic challenge, particularly in patients who continue to be symptomatic despite OnabotulinumtoxinA. Anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies may provide effective preventive options, but comparative real-world data and quantification of acute medication reduction remain limited.</p><p><strong>Objective: </strong>To compare the real-world effectiveness of erenumab versus galcanezumab in patients with chronic migraine refractory to OnabotulinumtoxinA and to evaluate changes in acute medication use.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of consecutive patients treated at a neurology outpatient clinic in Cantabria, Spain (ethics approval code 2022.204). Monthly migraine days (MMD) were recorded at baseline and during 3 follow-up visits. Acute medication use (monthly units of triptans and NSAIDs) was obtained from the electronic prescription dispensing system for the 6 months before and after treatment initiation. Changes in MMD were analyzed using a linear mixed-effects model. Acute medication changes were analyzed using a 2-way repeated-measures ANOVA (time pre/post × treatment group).</p><p><strong>Results: </strong>Forty-five patients were included (erenumab n = 24; galcanezumab n = 21). Mean MMD decreased from 20.1 ± 7.9 at baseline to 8.0 ± 6.6, 8.1 ± 7.3, and 6.4 ± 7.7 at visits 1-3 (<i>P</i> < 0.001), with no between-group differences (group <i>P</i> = 0.576; interaction <i>P</i> = 0.524). Across visits, ≥50% responder rates ranged from 57.1% to 85.0% and ≥75% responder rates from 35.0% to 57.1%, with no differences between treatments (all <i>P</i> > 0.05). Triptan use decreased significantly over time (<i>P</i> = 0.033), whereas NSAID use did not (<i>P</i> = 0.344).</p><p><strong>Conclusion and relevance: </strong>In patients with chronic migraine refractory to OnabotulinumtoxinA, erenumab and galcanezumab produced comparable and sustained reductions in migraine frequency, with high responder rates. Treatment was associated with reduced triptan use, supporting the clinical relevance of anti-CGRP monoclonal antibodies in this population.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261429460"},"PeriodicalIF":2.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669735","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":"Gepotidacin for the Treatment of Uncomplicated Urogenital Gonorrhea.","authors":"Spencer H Durham, Amanda K McAllister, Elias B Chahine","doi":"10.1177/10600280261435593","DOIUrl":"https://doi.org/10.1177/10600280261435593","url":null,"abstract":"<p><strong>Objective: </strong>To review the efficacy and safety of gepotidacin for the treatment of uncomplicated urogenital gonorrhea (uUGG).</p><p><strong>Data sources: </strong>A literature search of PubMed and Google Scholar (January 2010 to January 2026) was conducted using the terms gepotidacin and GSK2140944. Additional sources included conference abstracts, the manufacturer's website, and prescribing information.</p><p><strong>Study selection and data extraction: </strong>Relevant English-language studies evaluating the efficacy and safety of gepotidacin for uUGG were included.</p><p><strong>Data synthesis: </strong>Gepotidacin is a first-in-class triazaacenaphthylene antibiotic with a novel mechanism of action and potent activity against <i>Neisseria gonorrhoeae</i>. In the phase 3 EAGLE-1 trial, gepotidacin demonstrated noninferiority to ceftriaxone plus azithromycin for uUGG treatment. It was generally well tolerated, with gastrointestinal adverse effects most commonly reported. Gepotidacin is administered as 3000 mg orally every 12 hours for 2 doses and is approved for adults and pediatric patients aged ≥12 years weighing ≥45 kg with limited or no alternative treatment options. Administration with food is recommended to reduce gastrointestinal adverse effects.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Gepotidacin provides a new 2-dose oral option for uUGG treatment. Compared with ceftriaxone, the current drug of choice, oral administration may improve convenience and access. Similar to cefixime and zoliflodacin, its oral formulation may facilitate treatment while potentially reducing microbiome disruption compared with ceftriaxone.</p><p><strong>Conclusions: </strong>Gepotidacin is a promising oral antibiotic with a novel mechanism of action and demonstrated efficacy for uUGG treatment.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261435593"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653680","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":"Effect of Non-benzodiazepine Versus Benzodiazepine Sedation on Days Alive and Free of Mechanical Ventilation in the Surgical/Trauma Intensive Care Unit.","authors":"Travis VanOtterloo, Kyllie Ryan-Hummel, Rebecca Attridge, Dana Foster, Susannah Nicholson, Jacob Tondre, Savanna Pittman, Sarah Berman","doi":"10.1177/10600280261433047","DOIUrl":"https://doi.org/10.1177/10600280261433047","url":null,"abstract":"<p><strong>Background: </strong>Data comparing benzodiazepine (BZD) to nonbenzodiazepine (non-BZD) sedatives in patients on mechanical ventilation (MV) demonstrate non-BZD sedation is associated with reduced duration of MV and lower mortality and delirium rates in medical and cardiac intensive care unit (ICU) populations. Limited data exist in surgical/trauma ICU (STICU) populations.</p><p><strong>Objective: </strong>Evaluate BZD versus non-BZD sedation on days alive and free of MV at 28 days in STICU patients.</p><p><strong>Methods: </strong>This single-center, institutional review board-approved, retrospective cohort study evaluated adult patients admitted to the STICU, intubated for ≥24 hours, and required continuous non-BZD versus BZD sedation in a level I trauma academic hospital. Primary outcome was days alive and free of MV at 28 days. Secondary outcomes included percent of time patients were oversedated and rates of delirium and ventilator-associated pneumonia (VAP). A multivariable model was constructed to determine independent predictors of being alive and free of MV at 28 days.</p><p><strong>Results: </strong>After screening, 209 patients were included (BZD, n = 88; non-BZD, n = 121). BZD patients had higher Charlson comorbidity index (CCI) and APACHE II scores. Non-BZD patients had higher rates of traumatic brain injury. Patients receiving non-BZD sedation experienced more days alive and free of MV at 28 days compared with BZD sedation (24 [interquartile range, IQR = 22-25] vs 24 [IQR = 20-25]; <i>P</i> = 0.002). In a multivariable model, including APACHE II score and CCI, non-BZD sedation remained independently associated with increased odds of being alive and free of MV at 28 days (adjusted odds ratio: 6.98; <i>P</i> = 0.002). In addition, non-BZD sedation was associated with less time being oversedated (<i>P</i> < 0.0001), less delirium (<i>P</i> = 0.003), and lower rates of VAP (<i>P</i> = 0.0007).</p><p><strong>Conclusions and relevance: </strong>In STICU patients requiring MV, non-BZD sedation was associated with more ventilator-free days, less time oversedated, reduced delirium, and reduced VAP. These findings extend prior ICU sedation data into the STICU population supporting the use of non-BZD strategies when clinically appropriate to optimize patient outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261433047"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621364","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}