Annals of Pharmacotherapy最新文献

{"title":"Retrospective Analysis of Tacrolimus Levels: The First 56 Days Following Allogeneic Hematopoietic Stem Cell Transplant and Patient Outcomes.","authors":"Kateryna Kovalenko, Joseph Bubalo, Jennifer Saultz, Pavani Malla","doi":"10.1177/10600280251321324","DOIUrl":"https://doi.org/10.1177/10600280251321324","url":null,"abstract":"<p><strong>Background: </strong>Despite prophylaxis, acute graft-versus-host disease (aGVHD) occurs in up to 40% to 60% of patients undergoing an allogeneic hematopoietic stem cell transplantation (alloHSCT). Tacrolimus remains a common GVHD prophylactic medication used in combination with mycophenolate or methotrexate.</p><p><strong>Objective: </strong>The purpose of this study was to compare tacrolimus levels up to day +56 to clinical outcomes in patients who underwent alloHSCT.</p><p><strong>Methods: </strong>This was a retrospective cohort study of adult patients who underwent alloHSCT between January 2009 and April 2019 at Oregon Health and Science University (OHSU) Hospital. A logistic regression analysis was performed using SAS software to evaluate the association between tacrolimus concentration range and the GVHD grade outcome.</p><p><strong>Results: </strong>There were 295 patients included in the study. The median patient age was 53 years (range 18-72), the majority were males (55%), with a median comorbidity index of 2 (range 0-9). Most patients received peripheral blood stem cell transplant (95%). The median tacrolimus levels were divided into 4 groups: (1) between 3.8 and 4.9 ng/mL, (2) 5.0 and 7.9 ng/mL, (3) 8.0 and 9.9 ng/mL, and (4) 10.0 and 10.7 ng/mL in 8 (2.7%), 206 (69.8%), 71 (24.1%), and 10 (3.4%) of patients, respectively. The odds ratio of 0.193 (95% confidence interval [CI]: 0.045-0.836) suggested that patients in the tacrolimus 8 to 12 ng/mL range were approximately 80.5% less likely to have grade 3 to 4 aGVHD compared to those in the 5 to 8 ng/mL range.</p><p><strong>Conclusion and relevance: </strong>Overall, we found that higher levels of tacrolimus (range 8-12 ng/mL) in the first 8 weeks post-transplant were associated with improved outcomes without increased rate of relapse.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251321324"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514439","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 Randomized Controlled Trial Plus a Systematic Review and Meta-Analysis of Published Studies Evaluating a Conventional Prophylactic Regimen of Oral Dexamethasone vs Short-Course Intravenous Dexamethasone in Preventing Paclitaxel-Associated Hypersensitivity Reactions in Patients With Gynecologic Malignancies.","authors":"Kofi N Donkor, Hyeree Jang, Julie Hana Selim, Yevgeniya J Ioffe, Linda J Hong","doi":"10.1177/10600280251320067","DOIUrl":"https://doi.org/10.1177/10600280251320067","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity reactions (HSRs) are often encountered in patients receiving paclitaxel infusions. The conventional method, comprising dexamethasone 20 mg (Dex20) taken 12 and 6 hours before paclitaxel plus histamine (H)1 and H2-antagonists administered 30 minutes before paclitaxel, is an effective but cumbersome method in reducing HSRs in gynecologic oncology patients.</p><p><strong>Objective: </strong>Determine the effectiveness of a simplified premedication method (short-course) comprising Dex20 and H1 and H2 antagonists administered 30 minutes before paclitaxel vs the conventional method in preventing HSRs.</p><p><strong>Methods: </strong>The effectiveness of the short-course vs the conventional method was investigated via a Randomized Controlled Trial (RCT) and a Systematic Review and Meta-analysis by searching PubMed, EMBASE, and the Cochrane Library from inception to December 4, 2024. Primary outcomes were any-grade and grade ≥3 HSRs. Differences in effectiveness were presented as risk difference (RD) using the Mantel-Haenszel estimation and expressed with 95% confidence intervals (CIs). <i>P</i>-values <0.05 were considered statistically significant. The Cochrane Handbook for Systematic Reviews and Newcastle-Ottawa Score determined the quality of RCTs and observational studies.</p><p><strong>Results: </strong>Three RCTs and 2 observational studies totaling 905 patients were analyzed. The short-course method showed a significantly higher incidence of any-grade HSRs than the conventional method (RD = 7%, 95% confidence interval [CI] = 0.3% to 12.8%, <i>P</i> = 0.04). Although in favor of the conventional method, there was no significant difference in grade ≥3 HSRs (RD = 2%, 95% CI = -0.4% to 4.8%, <i>P</i> = 0.09). Subgroup analyses of RCTs showed no significant differences in any-grade HSRs (RD = 6%, 95% CI = 0.3% to 12.8%, <i>P</i> = 0.39) or grade ≥3 HSRs (RD = 1%, 95% CI = -1.1% to 2.4%, <i>P</i> = 0.48).</p><p><strong>Conclusion and relevance: </strong>The conventional method is favored over the short-course in preventing paclitaxel-associated HSRs. The short-course method is a plausible alternative for patients unable to comply with the conventional method's requirements. Included studies were either observational studies prone to bias and inconclusive inferences or RCTs, which may not be statistically powerful enough to produce reliable results. Larger sample size prospective studies are needed to authenticate findings.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251320067"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514415","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":"Adverse Reactions by Radiopharmaceuticals: Retrospective Analysis of the Portuguese National Pharmacovigilance System.","authors":"Sara Martins, Ângelo Jesus, Ricardo Andrade, Mariana Rocha, Ana Martín-Suarez","doi":"10.1177/10600280251316542","DOIUrl":"https://doi.org/10.1177/10600280251316542","url":null,"abstract":"<p><strong>Background: </strong>Radiopharmaceuticals are essential in the field of nuclear medicine, but like any other medicinal product, radiopharmaceuticals can potentially cause adverse reactions in patients.</p><p><strong>Objective: </strong>To describe the adverse reactions to radiopharmaceuticals reported to the Portuguese National Pharmacovigilance System (SNF).</p><p><strong>Methods: </strong>We performed a retrospective, observational study by examining individual case safety reports (ICSRs) provided by the SNF related to all radiopharmaceuticals commercially available in Portugal from 2010 to 2023.</p><p><strong>Results: </strong>The SNF received a total of 84 ICSRs. These reports resulted in a total of 224 adverse drug reactions (ADR), which involved a total of 15 different radiopharmaceuticals. The mean age of patients was 61.9 years old. Twenty-one different system organ classes (SOCs) were identified, with the most prevalent situations being \"Gastrointestinal Disorders\" (18.3%; n = 41) followed by \"General disorders and administration site conditions\" (16.5%; n = 37), \"Skin and subcutaneous tissue disorders\" (11.2%; n = 25) and \"Blood and lymphatic system disorders\" (10.3%; n = 23). Fifty-seven reports (67.85%) showed at least 1 serious ADR. Most notified radiopharmaceuticals were, respectively, radium-223 (n = 36, 41.4%), lutetium-177 oxotreotide (n = 12, 13.8%) and iodide-131 (n = 9, 10.3%).</p><p><strong>Conclusion and relevance: </strong>Although the number of notifications is limited, these findings provide valuable insights into the types and frequencies of adverse reactions associated with radiopharmaceuticals used in Portugal between 2010 and 2023. The data highlight the importance of continued pharmacovigilance efforts to monitor the safety of these specialized medical products and inform clinical decision-making.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280251316542"},"PeriodicalIF":2.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482117","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":"https://doi.org/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":"10600280251317495"},"PeriodicalIF":2.3,"publicationDate":"2025-02-23","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":"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":"https://doi.org/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":"10600280251315950"},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","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":"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":"https://doi.org/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":"10600280251318012"},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","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}

{"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":"https://doi.org/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":"10600280251313874"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","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":"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":"https://doi.org/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":"10600280251318017"},"PeriodicalIF":2.3,"publicationDate":"2025-02-16","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":"Corrigendum to \"Live Biotherapeutic Products for the Prevention of Recurrent Clostridioides difficile Infection\".","authors":"","doi":"10.1177/10600280241310646","DOIUrl":"https://doi.org/10.1177/10600280241310646","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241310646"},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","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":"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":"https://doi.org/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":"10600280251314018"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","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}