Annals of Pharmacotherapy最新文献

{"title":"Influence of Kidney Function Estimation Methods on Carboplatin Dosing and Clinical Outcomes.","authors":"Omar El Khatib, Sara Zekery-Saad, Emna Abidi, Ahmed Abdelaziz, Osama Abu Tabar, Mohammed Ahmed, Anum Farooq, Wasim S El Nekidy","doi":"10.1177/10600280261430829","DOIUrl":"https://doi.org/10.1177/10600280261430829","url":null,"abstract":"<p><strong>Background: </strong>The use of the Calvert formula for carboplatin dosing is well established. However, controversy persists regarding the choice of kidney function estimation equations, with oncology and nephrology guidelines offering differing recommendations.</p><p><strong>Objective: </strong>This study aimed to compare the actual carboplatin doses administered to patients with those estimated using various kidney function equations, and to assess whether these differences could influence clinical outcomes.</p><p><strong>Methods: </strong>This retrospective chart review included adult patients who received at least 1 dose of carboplatin at our institution between May 2015 and March 2024. Carboplatin doses were estimated using the Calvert formula with different kidney function equations and compared with the actual doses administered.</p><p><strong>Results: </strong>A total of 360 patients met the inclusion criteria, with a median age of 57 years (46-68), a median weight of 72 kg (61-84), and 248 (68.9%) were female. Significant inter-method variability was observed in the median estimated kidney function and corresponding median carboplatin dosing across equations. Cockcroft-Gault (C-G) using actual body weight (110 mL/min, 677 mg), C-G with adjusted body weight (94 mL/min, 602 mg), 2021 CKD-EPI (chronic kidney disease epidemiology collaboration) (100 mL/min/1.73 m², 649 mg), 2021 CKD-EPI_BSAAdj (101 mL/min, 658 mg), and the Janowitz equation (83 mL/min, 577 mg), <i>P</i> < 0.001. Hematologic toxicity, including febrile neutropenia, was significantly more common in patients dosed using C-G equation with actual body weight compared with adjusted body weight, occurring in 14/20 (70%) versus 5/115 (4.3%), respectively (<i>P</i> < 0.001).</p><p><strong>Conclusion and relevance: </strong>Carboplatin dosing varies significantly depending on the kidney function estimation method used. There is an urgent need for standardized, interdisciplinary dosing guidelines.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280261430829"},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607663","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":"Association of CYP2C19 Phenotype on Historical Medication Prescribing for Gastroesophageal Reflux Disease.","authors":"Jennifer Cole, Leela Kodali, Jennifer Stark, Jordan Fischer","doi":"10.1177/10600280251367432","DOIUrl":"10.1177/10600280251367432","url":null,"abstract":"<p><strong>Introduction: </strong>While consensus guidelines exist for phenotype-guided proton pump inhibitor (PPI) dosing in <i>Helicobacter pylori</i> infection, the impact in gastroesophageal reflux disease (GERD) treatment in a real-world setting is unknown. The study aims were to determine whether <i>CYP2C19</i> rapid metabolizers (RMs) and ultrarapid metabolizers (UMs) have higher PPI doses and more treatment failures than normal metabolizers (NMs) in the treatment of GERD.</p><p><strong>Methods: </strong>In this retrospective chart review, adults with pharmacogenetic (PGx) testing results at the study center and treated with PPI therapy for GERD were included for enrollment into 1 of 3 cohorts: <i>CYP2C19</i> UM, RM, and NM. Pertinent baseline characteristics collected were age, body mass index, tobacco, and alcohol history. The primary outcome was the comparison of total daily omeprazole equivalents (OEs) of the highest prescribed PPI dose. Secondary outcomes included incidence of upper gastrointestinal bleed (UGIB) and historical trials of PPIs, histamine-2 blockers, antacids, sucralfate, and prokinetics. Continuous outcomes were compared with one-way analysis of variance, and nominal outcomes were compared with a χ² in RStudio.</p><p><strong>Results: </strong>There were 48 UM, 298 RM, and 432 NM that met study inclusion. Baseline characteristics were similar across cohorts. Mean total OE did not differ between groups: UM 41.6 mg, RM 40.1 mg, NM 38.5 mg (<i>P</i> = 0.52). There were no differences seen among individual gastric agents or mean total number of historical gastric medications trialed: UM 2.5, RM 2.4, NM 2.3 (<i>P</i> = 0.17) medications. The incidence of UGIB was not statistically different between cohorts: UM 12.5%, RM 12.8%, NM 9.3% (<i>P</i> = 0.13).</p><p><strong>Conclusion and relevance: </strong>There was no association between <i>CYP2C19</i> phenotype and historical medication prescribing for GERD.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"366-371"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102630","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 Recombinant Human Thrombopoietin on Severe Thrombocytopenia in Patients With Acute Type A Aortic Dissection.","authors":"Qianxiao Bao, Hui Song, Yizhou Zhou, Yefang Zhao, Weiguo Bao","doi":"10.1177/10600280251359678","DOIUrl":"10.1177/10600280251359678","url":null,"abstract":"<p><strong>Background: </strong>Postoperative thrombocytopenia in patients with acute type A aortic dissection (AAD) necessitates platelet transfusions and is associated with higher morbidity and mortality.</p><p><strong>Objective: </strong>This retrospective study aimed to evaluate the effects of recombinant human thrombopoietin (rhTPO) on AAD patients who experienced severe postoperative thrombocytopenia (platelet count nadir <20 × 109/L).</p><p><strong>Methods: </strong>We retrospectively evaluated 43 AAD patients who underwent open aortic repair surgery with subsequent severe thrombocytopenia at the Second Hospital of Shandong University between June 2019 and June 2022. We compared patient outcomes between rhTPO-treated patients (n = 20) with nontreated patients (n = 23). The primary outcome was to evaluate the association of the rhTPO treatment with postoperative platelet count response. The secondary outcomes included transfusions of blood components and length of hospital stay.</p><p><strong>Results: </strong>Compared with nontreated controls, significantly higher levels of platelet count were observed in rhTPO-treated patients on POD7 (110.1 ± 18.1 vs 83.6 ± 19.1 [×109/L]; <i>P</i> < 0.001). The time required for the platelet count to increase to >100 × 109/L was significantly less in rhTPO-treated patients compared with controls (6.8 ± 0.85 vs 8.5 ± 1.5 days; <i>P</i> < 0.001). The rhTPO treatment was significantly correlated with the reductions in perioperative plasma transfusion (1435 ± 114 vs 1743 ± 206 mL; <i>P</i> < 0.001) and days of hospital stay (<i>P</i> = 0.003).</p><p><strong>Conclusions and relevance: </strong>We concluded that rhTPO treatment was significantly associated with increased platelet count recovery in postcardiac surgery AAD patients suffering from severe thrombocytopenia. Besides, the rhTPO therapy appeared to be correlated with reduced blood transfusions and length of hospital stay.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"372-377"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074292","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 Substantial Weight Loss on Digoxin Intoxication During Long-term Therapy.","authors":"Hirokazu Nakayama, Tsuyoshi Shiga, Masayo Tanaka","doi":"10.1177/10600280251369114","DOIUrl":"10.1177/10600280251369114","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous safety studies on digoxin, the association of substantial body weight loss with the development of digoxin intoxication and the transition of risk factors over time in patients on long-term digoxin treatment remain unclear.</p><p><strong>Objective: </strong>This study aimed to reveal whether the risk factors of digoxin intoxication, including substantial body weight loss, change over the course of treatment.</p><p><strong>Methods: </strong>A retrospective study was conducted in adult patients newly prescribed digoxin between January 2010 and December 2021. Multiple logistic analysis was performed to identify clinical features associated with digoxin intoxication over time.</p><p><strong>Results: </strong>A total of 329 patients followed for a median period of 139 (interquartile range, 29-909) days were selected for analysis. Among them, 36 patients (11%) developed digoxin intoxication. Multivariate analysis identified concomitant diuretics (odds ratio, 36.64; 95% confidence interval, 5.77-232.56), comorbid cancer (8.76; 1.95-39.31), estimated glomerular filtration rate (eGFR) reduction ≥ 30% from baseline (9.01; 2.31-35.16), and hemodialysis (47.30; 5.77-387.49) as risk factors associated with digoxin intoxication occurring within 6 months of digoxin treatment; while weight loss >6% during the last 6-12 months (16.07; 2.99-86.48), and eGFR reduction ≥ 30% from baseline (11.55; 2.37-56.35) were risk factors of intoxication occurring after 6 months of treatment.</p><p><strong>Conclusion and relevance: </strong>Concomitant diuretics and comorbid cancer were risk factors of digoxin intoxication during early treatment, whereas substantial body weight loss ≥ 6% became the risk factor after prolonged treatment, and impaired renal function was the risk factor spanning early to prolonged treatment. Thus, transition of risk factors of digoxin intoxication during prolonged course of treatment was observed.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"347-356"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237757","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":"Predictors of Discrepancies Between Cockcroft-Gault and Chronic Kidney Disease-EPI Creatinine-Cystatin in Hospitalized Patients.","authors":"Savannah S Poole, Audis Bethea, Eden Brewington, Clifford Cornett, Jordan L Kelley, Ann Marie Stoll, Aric Schadler, Abigail Leonhard, Hunter Matthews, Alexandra Sutphin","doi":"10.1177/10600280251356492","DOIUrl":"10.1177/10600280251356492","url":null,"abstract":"<p><strong>Background: </strong>Cockcroft-Gault (eCrCl) remains the industry standard for estimating renal function in hospitalized patients despite known limitations. Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-cystatin C (eGFRcr-cys) equation was developed to ameliorate these limitations and is now preferred in specific outpatient scenarios.</p><p><strong>Objective: </strong>This study aims to determine patient-specific factors associated with a >25 milliliters per minute (mL/min) difference where eCrCl exceeds eGFRcr-cys.</p><p><strong>Methods: </strong>This retrospective, Institutional Review Board approved, observational review included data from June 2021 to December 2022. Adults with serum cystatin C and creatinine collected within 24-hours of admission were included. Exclusions included pregnancy or renal replacement therapy. The primary endpoint was to identify patient-specific predictors of a >25 mL/min discrepancy between eCrCl and eGFRcr-cys. The secondary outcome was to determine odds ratios for identified patient-specific characteristics.</p><p><strong>Results: </strong>Of 235 encounters, 67 had a >25 mL/min difference where eCrCl exceeded eGFRcr-cys. Multivariate regression identified the following independent predictors of this difference: age <58 years (odds ratio [OR] 2.722; 95% confidence interval [CI] 1.357-5.459), weight >105 kg (OR: 9.079; 95% CI: 4.344-18.978), intensive care unit (ICU) admission within 24 hours (OR 2.779; 95% CI 1.248-6.188) and diagnosis of paraplegia or quadriplegia (OR 5.490; 95% CI 1.523-19.796).</p><p><strong>Conclusion and relevance: </strong>This study concluded that eCrCl may exceed eGFRcr-cys by >25 mL/min in patients presenting for hospital admission with one or more predictors: age <58 years, weight >105 kg, intensive care unit (ICU) admission, or diagnosis of paraplegia or quadriplegia. Current literature suggests improved accuracy of renal clearance estimations with eGFRcr-cys. Accordingly, practitioners should consider eGFRcr-cys when evaluating new admissions with these characteristics.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"338-346"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939497","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":"Comparative Efficacy of High- and Low-Dose Ceftriaxone Regimens: A Systematic Review and Meta-Analysis.","authors":"Lindsay Brust-Sisti, Gwang-Yee Hu, Matthew Bridgeman, Luigi Brunetti, Jimmy Gonzalez","doi":"10.1177/10600280251346777","DOIUrl":"10.1177/10600280251346777","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of ceftriaxone (CRO) 1 g intravenously (IV) daily to higher doses for treating non-central nervous system (CNS) infections in adults.</p><p><strong>Data sources: </strong>PubMed, Embase, Scopus, and Web of Science were used. A search was run from database inception to August 8, 2023 and rerun May 12, 2025. Search terms were CRO, Rocephin, pneumonia, intra-abdominal infections, appendicitis, typhlitis, pyelonephritis, bacteremia, and sepsis.</p><p><strong>Study selection and data extraction: </strong>Articles included had to compare CRO 1 g IV daily to higher dosing for the outcomes of interest: clinical cure (CC), hospital length of stay (LOS), mortality, and toxicity. Randomized controlled trials (RCTs) or observational studies were included. Studies including pediatric, pregnant, and outpatient administration were excluded. Clinical cure was evaluated using a Mantel-Haenszel random-effects model with Peto odds ratios (pORs), and 95% confidence intervals (CIs) were calculated. Heterogeneity was identified using Cochrane <i>I</i>² statistic.</p><p><strong>Data synthesis: </strong>Eight studies (5145 patients) were included. No statistically significant difference was found for CC (pOR 0.958; 95% CI [0.525-1.749]; <i>I</i>² = 60.23; <i>P</i> = .888); LOS (Std difference in means, 0.052; 95% CI [-0.418, 0.523]; <i>I</i>² = 96.047; <i>P</i> = .828); or mortality (pOR 0.932; 95% CI [0.789-1.100]; <i>I</i>² = 0.000; <i>P</i> = .405).</p><p><strong>Relevance to patient care and clinical practice: </strong>Ceftriaxone dosing ranges from 1 to 2 g IV daily for treating non-CNS infections. Optimal dosing remains controversial, as RCTs have used different doses. This meta-analysis showed no difference between high and low CRO dosing for efficacy and safety. Because infection type and pharmacokinetic factors were not accounted for, findings may not be applicable to certain high-risk infections or situations where CRO pharmacokinetics are altered, such as hypoalbuminemia. Prospective studies can compare regimens and confirm findings.</p><p><strong>Conclusions: </strong>Ceftriaxone doses greater than 1 g IV daily did not improve CC, LOS, or mortality.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"357-365"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939575","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":"Efficacy and Safety of Pitolisant for Excessive Daytime Sleepiness in Narcolepsy and Obstructive Sleep Apnea: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Amna Amir Jalal, Syed Ibad Hussain, Muhammad Saad Khan, Erum Siddiqui, Harshika Khaim Chandani, Ali Jawwad Karim, Shanza Shakir","doi":"10.1177/10600280251390557","DOIUrl":"10.1177/10600280251390557","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy and safety of pitolisant, a selective histamine H₃ receptor antagonist/inverse agonist, for excessive daytime sleepiness (EDS) in narcolepsy or obstructive sleep apnea (OSA).</p><p><strong>Data sources: </strong>PubMed, Cochrane, Embase, Scopus, and Web of Science were searched through August 2025 for randomized placebo-controlled trials (RCTs).</p><p><strong>Study selection and data extraction: </strong>Eligible RCTs reported Epworth Sleepiness Scale (ESS) or Pediatric Daytime Sleepiness Scale (PDSS), mean sleep latency, EQ-5D, or global impression outcomes. Two reviewers independently screened studies, extracted data, and assessed bias using Cochrane RoB 2.0. Publication bias was evaluated using funnel plots and Egger's test; certainty of evidence was rated with GRADE.</p><p><strong>Data synthesis: </strong>Six RCTs (<i>n</i> = 1149) met the inclusion criteria. Compared with placebo, pitolisant significantly reduced Sleepiness Scale scores (SSS) (mean difference [MD] = -2.97; 95% confidence interval [CI] -3.62 to -2.33), increased mean sleep latency (MD = 3.06; 95% CI 2.12-3.99), and improved EQ-5D scores (MD = 2.68; <i>P</i> = 0.009). Patient global opinion (risk ratio [RR] = 1.40) and clinical global impression of change (CGI-C) (RR = 1.41) also favored pitolisant. Rates of treatment-emergent adverse events, serious adverse events, and withdrawals were comparable with placebo, and common adverse effects, such as headache, insomnia, nausea, and anxiety, were infrequent and not significantly increased.</p><p><strong>Relevance to patient care and clinical practice: </strong>Pitolisant provides an effective, nonstimulant option for EDS in narcolepsy and OSA, including residual symptoms despite continuous positive airway pressure (CPAP). Its distinct mechanism and tolerability profile make it a valuable alternative or adjunct to existing therapies, supporting personalized care and enhanced daily functioning.</p><p><strong>Conclusion and relevance: </strong>Pitolisant significantly improves subjective and objective wakefulness and quality of life in EDS due to narcolepsy or OSA, with robust evidence for ESS benefit and a favorable safety profile.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"394-408"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646950","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":"Cardiac Adverse Events Associated With Elotuzumab: A Disproportionality Analysis Using FDA Adverse Event Reporting System.","authors":"Muhammed Favas K T, Beema T Yoosuf, Dipika Bansal","doi":"10.1177/10600280251359849","DOIUrl":"10.1177/10600280251359849","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"418-419"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774536","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":"Evaluating Risk Factors for Short Versus Long Hospital Stay for Cellulitis to Guide the Development of a Long-acting Lipoglycopeptide Use Decision Algorithm.","authors":"Cole Orlikowski, Lisa E Dumkow, Kyle J Schmidt, Andrew P Jameson","doi":"10.1177/10600280251355631","DOIUrl":"https://doi.org/10.1177/10600280251355631","url":null,"abstract":"<p><strong>Background: </strong>Cellulitis is a common cause of hospitalization imposing significant burden on healthcare systems. Treatment disposition is dependent on extent and severity of infection with a range of possibilities from ambulatory to inpatient management. Limited evidence is available, aside from expert opinion, to guide the use of long-acting lipoglycopeptides (LaLGPs) to reduce hospitalizations.</p><p><strong>Objective: </strong>Identify patient-specific risk factors associated with short-stay hospitalizations (<72 hours) for cellulitis to guide development of an emergency department (ED) LaLGP decision algorithm.</p><p><strong>Methods: </strong>Adult patients with cellulitis treated with antibiotic monotherapy were screened. Three cohorts were identified based on length of hospitalization (ED discharge, <72 hours, ≥72 hours). The primary outcome was to identify risk factors associated with short-stay hospitalization. Patients were excluded if they required surgical intervention in the operating room, received polymicrobial therapy, required intensive care unit admission, received cellulitis treatment in the past 30 days, or were treated for multiple infections.</p><p><strong>Results: </strong>A total of 161 patients were analyzed (ED discharge, n = 75; Short-stay, n = 46; and Long-stay, n = 40). Need for incision and drainage (odds ratio [OR] 1.8; 95% confidence interval [CI]: 0.76-2.36), advancing age (OR 1.02; 95% CI 1.00-1.05), or presenting with fever (OR 32.7; 95% CI 5.89-616.5) were associated with short-stay hospitalization compared to ED discharge. Diabetes (OR 3.02, 95% CI 1.31-7.11), presence of purulence (OR 3.86, 95% 1.09-13.79), and history of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) (OR 4.31, 95% CI 1.08-17.96) were independently associated with long-stay hospitalizations.</p><p><strong>Conclusion and relevance: </strong>Fever was the only factor independently associated with short-stay hospitalization, compared to patients discharged directly from the ED. Diabetes, purulence, and history of MRSA were associated with longer hospitalizations. Inclusion of these factors in a decision algorithm may help guide use of LaLGPs for cellulitis in the ED, potentially reducing cellulitis hospitalization rates.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":"60 4","pages":"328-337"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375860","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 Implementing a Pharmacy-Driven Intervention Bundle on Hospital Readmission Rates for Patients With Heart Failure.","authors":"Lara Tran, Christine Rahme, Sara Linnertz, Kenneth McCall","doi":"10.1177/10600280251363594","DOIUrl":"10.1177/10600280251363594","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a leading cause of hospitalization and readmission. An emerging body of literature has discussed the impact of pharmacy-driven interventions in reducing hospital readmission rates and improvement in patient outcomes.</p><p><strong>Objective: </strong>To evaluate the impact of a pharmacy-driven intervention bundle on 30-day readmission rates for patients with HF.</p><p><strong>Methods: </strong>The institutional review board granted exempt status for this pre-post interventional study. The control group included patients with a primary or secondary diagnosis of HF and received standard care between October 2022 and December 2022. The intervention group received a real-time heart failure-directed (HFD) pharmacy-driven intervention bundle from October 2023 to March 2024. The primary outcome was 30-day readmission rate. Secondary outcomes included the percentage of patients discharged on guideline-directed medical therapy (GDMT) and time to 30-day readmission.</p><p><strong>Results: </strong>In total, 18.5% (67/363) of patients in the HFD group were readmitted within 30 days compared with 21.2% (77/363) of patients in the control group (p = 0.352). The odds of readmission for the HFD group within 30 days were 0.766 (95% CI [0.518, 1.129]) compared with the control group. 127 (34.9%) patients in the HFD group were discharged on GDMT, compared with 31 (8.5%) patients in the control group (P < 0.0001). Time to 30-day readmission revealed a hazard ratio of 0.783 (95% CI [0.552, 1.108]) for patients in the HFD group compared with the control group.</p><p><strong>Conclusion: </strong>The odds of 30-day readmission were nonsignificantly lower in the HFD group. This study demonstrated that pharmacy-driven HFD interventions resulted in higher utilization of GDMT.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"317-327"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074326","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}