The Canadian journal of hospital pharmacy最新文献

{"title":"Comparison of Tetrasodium EDTA 4% with Sodium Citrate 4% as Line-Locking Solutions at 2 Tertiary Hemodialysis Centres","authors":"Brittany Gage, Karen Shalansky, Wynnie Lau, Claire Harris, Mercedeh Kiaii","doi":"10.4212/cjhp.3447","DOIUrl":"https://doi.org/10.4212/cjhp.3447","url":null,"abstract":"Background: The patency of central venous catheters (CVCs) in patients undergoing hemodialysis (HD) is maintained by instilling sodium citrate 4% (SC 4%) locking solution. Alteplase, a thrombolytic agent, is administered to restore function if patency is lost. Objective: To compare SC 4% with a new line-locking solution, ethylenediaminetetraacetic acid 4% (EDTA 4%), in terms of CVC patency and alteplase use. Methods: This retrospective chart review included all HD patients who were switched from SC 4% to EDTA 4% locking solution at 2 tertiary HD centres between June and December 2021. Patients were switched to EDTA 4% if they had high usage of alteplase (receiving ≥ 2 doses of alteplase in a 2-week period). For each line-locking agent, HD pump speeds and alteplase use were analyzed over 2 consecutive 12-week periods. Mean serum calcium and ionized calcium values were recorded during each period. A cost analysis was also performed. Results: A total of 37 HD patients were switched to EDTA 4% during the study period. There was no difference in mean HD pump speed between SC 4% and EDTA 4% (307.7 vs 305.1 mL/min, p = 0.48). The number of catheter-use-days on which alteplase was required declined significantly, from 313 days with SC 4% to 94 days with EDTA 4% (p < 0.001), with an overall cost reduction of 34% ($13 183.21). The decrease in alteplase usage was primarily driven by 1 of the 2 sites. A statistically significant decrease in mean ionized calcium at site 2 (from 1.12 to 1.1 mmol/L, p = 0.037) was noted. As well, an intraluminal interaction between EDTA 4% and serum calcium caused 6 cases of low serum calcium. Conclusions: This study showed that use of EDTA 4% as a line- locking agent reduced alteplase usage in the CVCs of HD patients while maintaining adequate pump speed (i.e., ≥ 300 mL/min). Keywords: hemodialysis, ethylenediaminetetraacetic acid (EDTA), catheter, locking solution RÉSUMÉ Contexte : La perméabilité des cathéters veineux centraux (CVC) chez les patients hémodialysés (HD) est maintenue en instillant une solution de verrouillage de citrate de sodium à 4 % (CS 4 %). L’alteplase, un agent thrombolytique, est administré pour rétablir la fonction en cas de perte de perméabilité. Objectif : Comparer la solution de CS 4 % et une nouvelle solution de verrouillage, l’acide éthylènediaminetétraacétique 4 % (EDTA 4 %), en termes de perméabilité du CVC et d’utilisation de l’alteplase. Méthodes : Cet examen rétrospectif des dossiers a été réalisé pour tous les patients HD qui sont passés de la solution de verrouillage de CS 4 % à la solution d’EDTA 4 % dans 2 centres d’hémodialyse tertiaires au cours de la période de juin à décembre 2021. Les patients sont passés à l’EDTA 4 % en cas d’utilisation élevée de l’alteplase (≥ 2 doses d’alteplase reçues sur une période de 2 semaines). Pour chaque agent de verrouillage, les vitesses de la pompe d’hémodialyse et l’utilisation de l’alteplase ont été analysées sur 2 périodes consécutives de 12 semaine","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Une chambre des erreurs comme moyen d’apprentissage dans une faculté de pharmacie","authors":"Amal Ayed, Kaouther Zribi","doi":"10.4212/cjhp.3436","DOIUrl":"https://doi.org/10.4212/cjhp.3436","url":null,"abstract":"Background: Hospitalization can expose patients to numerous adverse events associated with their care. To make health care professionals aware of these events, medication errors were simulated using the “room of errors” model. Objectives: To describe the methods of implementing a “room of errors” and to evaluate participants’ performance in identifying errors. Methodology: This cross-sectional descriptive simulation study was carried out in the experimental pharmacy of a faculty of pharmacy over 2 days in December 2021 and January 2022. The study involved pharmacy interns and residents at various stages of their internships. Results: Thirty-six interns and 8 residents participated in the “room of errors” workshop. The overall correct response rate was 70.8% (n = 269/380). The error detection rate was 45.3% for pharmacy interns and 57.5% for residents, although this difference was not statistically significant. Certain hazards were identified by the majority of students (soiled compress on the treatment trolley, prescription of acetaminophen to a patient with an allergy to this drug), whereas others were rarely identified (a box containing food in the refrigerator, an empty bottle for hand sanitizer). Respondents to the satisfaction survey mainly considered this workshop to be a useful educational tool and would like to see this type of workshop integrated into their training. Conclusion: The “room of errors” seems to be an effective way of raising awareness about the risks associated with hospitalization and patient safety. This type of tool should be integrated into education and training programs. Keywords: medicine, safety, danger, educational workshop\" RÉSUMÉ Contexte : L’hospitalisation peut exposer les patients à de multiples évènements indésirables associés aux soins. Pour sensibiliser les professionnels de la santé à ces évènements, une simulation d’erreurs de médication a été créée en utilisant le modèle « Chambre des erreurs ». Objectifs : Les objectifs étaient de décrire les modalités de mise en œuvre d’une chambre des erreurs et d’évaluer la performance des participants dans l’identification des erreurs. Méthodologie : Il s’agit d’une étude descriptive transversale en simulation réalisée dans la pharmacie expérimentale à la faculté de Pharmacie sur une période de deux jours en décembre 2021 et janvier 2022. Ce travail a recueilli les internes et résidents en pharmacie à différents stades de leurs stages. Résultats : Trente-six internes et huit résidents ont participé à l’atelier « chambre des erreurs ». Le taux global de réponses correctes était de 70,8 % (n=269/380). Le taux de détection des erreurs était de 45,3 % pour les internes en pharmacie et de 57,5 % pour les résidents sans toutefois que cette différence ne soit statistiquement significative. Certains dangers ont été identifiés par la majorité des étudiants (compresse souillée sur le chariot de soins, prescription de l’acétaminophène à une patiente allergique) tandis que d’au","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of Resuscitation Carts and Medication Trays in a Level III Neonatal Intensive Care Unit: A Quality Improvement Initiative","authors":"Charles-Oliver Chiasson, Marie-Anne Pépin, Audrey Larone Juneau, Ahmed Moussa","doi":"10.4212/cjhp.3463","DOIUrl":"https://doi.org/10.4212/cjhp.3463","url":null,"abstract":"The CHU Sainte-Justine is a level III university-affiliated mother–child hospital located in Montréal, Québec. Approximately 900 babies are admitted to its 65-bed neonatal intensive care unit (NICU) every year. In 2016, a hospital-wide modernization transformed the NICU into a ward of single-patient rooms, which brought new challenges in the organization of neonatal resuscitation. In addition to the increase in surface area complicating access to the resuscitation carts, the organization and contents of the carts were inconsistent at the time, and the medications available were limited to agents needed for intubation. The multidisciplinary Neonatal Resuscitation Committee undertook the task of developing and implementing standardized resuscitation carts, with the goal of allowing complete resuscitation and initial stabilization of patients. Emergency resuscitations are stressful, and effective and rapid responses are required in these situations. Dangerous medication errors can occur in up to half of the cases involving medication administration in emergency situations.1 The standardization and systematic organization of resuscitation carts could facilitate the process of resuscitation and might even decrease medication errors, potentially improving patient safety. Literature reporting the benefits of using a standardized cart, in terms of the acquisition time for supplies and ease of use, is scarce.2-5 The current report describes the implementation of new standardized carts and medication trays in a NICU, the impact of these changes on clinical care, and staff perceptions of this quality improvement initiative.","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Tachycardia-Mediated Cardiomyopathy: Experience from the Vancouver General Hospital Cardiac Function Clinic (TMC-EXPLOR Study)","authors":"Aliya Daulat, Jenny MacGillivray, Margaret Sidsworth, Ricky D Turgeon","doi":"10.4212/cjhp.3368","DOIUrl":"https://doi.org/10.4212/cjhp.3368","url":null,"abstract":"Background: Tachycardia-mediated cardiomyopathy (TMC) is a reversible form of heart failure with reduced ejection fraction (HFrEF), most commonly caused by atrial fibrillation or atrial flutter. Evidence for its management is scarce, and practice patterns are highly variable. Objective: To describe management patterns for HFrEF and atrial arrhythmias in patients with TMC at a specialty heart failure clinic. Methods: This retrospective cohort study involved adults with HFrEF and a physician-determined diagnosis of TMC, with an initial visit for this problem between October 2018 and October 2019. The 2 primary outcomes, evaluated at 1 year after the initial visit, were the proportion of patients receiving triple therapy (combination of angiotensin receptor–neprilysin inhibitor [or angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker if ejection fraction improved to &gt; 40% by 1 year], ß-blocker, and mineralocorticoid receptor antagonist at any dose) and the proportion receiving or with a plan to receive rhythm control. Results: A total of 59 participants met the inclusion criteria. The mean age was 73 years, 39 patients (66%) were male, and 42 (71%) had hypertension. At 1-year follow-up, 42 (71%) were receiving triple therapy, and rhythm control was attempted or planned for 20 (34%). Among the 17 patients (29%) not receiving triple therapy, a mineralocorticoid receptor antagonist was the agent most commonly omitted. Conclusions: In a specialty heart failure clinic, most patients with TMC were receiving triple therapy, with a mineralocorticoid receptor antagonist being the agent most commonly missing among those not receiving triple therapy. One-third of patients with TMC had received a rhythm-control strategy. These gaps in HFrEF therapy and rhythm control represent key areas for quality improvement initiatives in the management of patients with TMC. Keywords: tachycardia-mediated cardiomyopathy, heart failure, atrial fibrillation, rhythm control, rate control, guideline-directed medical therapy RÉSUMÉ Contexte : La cardiomyopathie rythmique (CMR) est une forme réversible d’insuffisance cardiaque à fraction d’éjection réduite (HFrEF), le plus souvent causée par la fibrillation auriculaire ou le flutter auriculaire. Les données probantes relatives à sa prise en charge sont rares et les modèles de pratique sont très variables. Objectif : Décrire les schémas de prise en charge de l’HFrEF et des arythmies auriculaires chez les patients atteints d’une CMR dans une clinique spécialisée en insuffisance cardiaque. Méthodes : Cette étude de cohorte rétrospective impliquait des adultes atteints d’HFrEF et ayant reçu un diagnostic de CMR déterminé par un médecin, avec une première visite pour ce problème de santé entre octobre 2018 et octobre 2019. Les 2 résultats principaux, évalués 1 an après la première visite, étaient les suivants : 1) la proportion de patients recevant une trithérapie (association récepteur de l’angiotensine-néprilysi","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telepharmacy Implementation to Support Pharmaceutical Care Services during the COVID-19 Pandemic: A Scoping Review","authors":"Made Ary Sarasmita, I Wayan Sudarma, Made Krisna Adi Jaya, Lalu Muhammad Irham, Sri Susanty","doi":"10.4212/cjhp.3430","DOIUrl":"https://doi.org/10.4212/cjhp.3430","url":null,"abstract":"Background: Telepharmacy was effectively applied for remote pharmaceutical care during the COVID-19 pandemic. Objectives: To determine the implementation of telepharmacy services to support pharmacists in providing pharmaceutical care during the pandemic. Data Sources: Seven electronic databases were searched from inception to June 2021: PubMed, Ovid MEDLINE, Excerpta Medica database (Embase), Web of Science, Proquest, Scopus, and the Cochrane Database of Systematic Reviews. Study Selection and Data Extraction: The review followed PRISMA guidelines and was registered with the PROSPERO registry of systematic reviews. Reports of original research investigating the implementation of telepharmacy during the COVID-19 pandemic were retrieved. Researchers screened the title and abstract of each article, and then evaluated the full text of eligible articles to identify studies that met the inclusion criteria. Pharmacists’ responsibilities and actions were classified in relation to the International Pharmaceutical Federation guideline for managing the COVID-19 pandemic. Extracted data included study characteristics, pharmacists’ interventions delivered through a telepharmacy system, and the benefits of telepharmacy implementation. Data Synthesis: The database search yielded 1400 articles. After removal of duplicates and articles not meeting the specific inclusion criteria (n = 1381) , a total of 19 relevant original research articles were reviewed. According to these studies, telepharmacy was used to perform remote medication review and optimization, assess medication adherence, dispense and deliver medications, educate and counsel patients, promote disease prevention, collaborate with health care providers, and monitor treatment outcomes. Conclusions: This study highlighted the use of telepharmacy services to support pharmacists’ activities during the COVID-19 pandemic. Randomized clinical trials are needed to investigate the long-term efficacy and cost-effectiveness of telepharmacy services. Keywords: telepharmacy, telemedicine, pharmacist, hospital pharmacy, COVID-19 RÉSUMÉ Contexte : La télépharmacie a été efficacement utilisée pour les soins pharmaceutiques à distance pendant la pandémie de COVID-19. Objectifs : Déterminer comment des services de télépharmacie ont été mis en place pour soutenir les pharmaciens dans la prestation de leurs soins. Sources des données : Sept bases de données électroniques ont été utilisées pour effectuer les recherches, pour la période allant du début jusqu’à juin 2021 : PubMed, Ovid MEDLINE, Excerpta Medica (Embase), Web of Science, Proquest, Scopus et la Cochrane Database of Systematic Reviews. Sélection des études et extraction des données : L’examen suivait les lignes directrices PRISMA et a été enregistré dans le registre PROSPERO des revues systématiques. Des articles rapportant des recherches originales sur la mise en oeuvre de la télépharmacie pendant la pandémie de COVID-19 ont été extraits. Les chercheurs ont e","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Provincial Hospital Drug Formulary from 12 Former Regional Health Authority Formularies: Methods of Alignment","authors":"Jillian Madey, Mellissa Glab, Leah Heilman, Crystal Richter, Kassandra Stahl, Kirsten Fox","doi":"10.4212/cjhp.3400","DOIUrl":"https://doi.org/10.4212/cjhp.3400","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Calcitonin Gene– Related Peptide-Binding Monoclonal Antibodies for Migraine Prevention: A Systematic Review","authors":"Andrea Zovi, Roberto Langella, Anna Chiara Aloisi, Cosimo De Giorgio, Marta Del Vecchio, Chiara Dondi, Giulia Handschin, Claudia Lauria, Carlotta Marchetti, Oscar Martinazzoli, Renata Nozza, Valentina Scalzi, Elena Tratta, Costantino Jemos, Ruggero Lasala","doi":"10.4212/cjhp.3382","DOIUrl":"https://doi.org/10.4212/cjhp.3382","url":null,"abstract":"Background: Migraine is a neurological disease with a high incidence. The new anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) have demonstrated effectiveness in preventing episodic and chronic migraine. Objective: To collect evidence of the real-world effectiveness of anti-CGRP mAbs by assessing outcomes such as reduction in monthly migraine days (MMDs), reduction in monthly headache days (MHDs), and percentage of patients having a 50% reduction in MMDs. Data Sources: The PubMed database was searched for the period from inception to October 20, 2021. Study Selection and Data Extraction: Of interest for this review were studies that evaluated the real-world effectiveness of anti-CGRP mAbs in terms of MMDs and reduction in MHDs. The search terms included “migraine”, “monthly migraine days”, and various drug names. The data are reported in terms of patients’ baseline characteristics and treatment effectiveness. Data Synthesis: A total of 46 studies were evaluated, of which 30 (enrolling a total of 4273 patients across 10 countries) were included in the systematic review. The greatest absolute reduction in MMD was from 20.4 at baseline to 10.7 after 3 months of treatment. After 6 months, the greatest absolute difference was 10, relative to baseline. The largest absolute reduction in MHD at 3 months was from 22 to 8, whereas at 6 months, the greatest absolute reduction in MHD was 13. The treatment could be considered clinically effective (≥ 50% reduction in MMDs) for 41% of patients at 3 months and about 44% of patients at 6 months. Conclusions: Despite substantial variability in baseline values, this review confirmed the effectiveness of anti-CGRP mAbs, which yielded important clinical reductions in both MMDs and MHDs. Keywords: anti-CGRP mAbs, migraine, effectiveness, real-life, prevention RÉSUMÉ Contexte : La migraine est une maladie neurologique à incidence élevée. Le nouvel anticorps monoclonal qui se lie au peptide lié au gène de la calcitonine (AcM anti-CGRP) a démontré son efficacité pour prévenir les migraines épisodiques et chroniques. Objectif : Recueillir des éléments probants concernant l’efficacité réelle des AcM anti-CGRP en évaluant des résultats comme la réduction du nombre de jours de migraine par mois (JMM), la réduction du nombre de jours de céphalées par mois (JCM) ainsi que le pourcentage de patients ayant une réduction de 50 % du nombre de JMM. Sources des données : La base de données PubMed a été utilisée pour mener une recherche pour la période allant du début jusqu’au 20 octobre 2021. Sélection des études et extraction des données : Les auteurs de la revue se sont intéressés aux études qui avaient évalué l’efficacité réelle des AcM anti-CGRP en termes de réduction du nombre de JMM et du nombre de JCM. Les termes de recherche comprenaient « migraine », « jours de migraine par mois » et divers noms de médicaments. Les données sont rapportées en termes de caractéristiques de base des patients et d’eff","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Prescribing Practices for Uncomplicated Streptococcal and Enterococcal Bacteremias: The NARRATE Study","authors":"Tracy Liu, Michelle Hinch, Victor Leung, Colin Lee","doi":"10.4212/cjhp.3391","DOIUrl":"https://doi.org/10.4212/cjhp.3391","url":null,"abstract":"Background: Bloodstream infections (BSIs) rank among the top causes of death in North America. Despite the prevalence of these infections, there remain significant practice variations in the prescribing of antibiotics. Objective: To investigate current prescribing practices for management of uncomplicated streptococcal and enterococcal BSIs. Methods: A retrospective cohort study was conducted using charts forpatients admitted to an acute care centre in British Columbia between November 16, 2019, and October 20, 2020. Adult patients (≥ 18 years of age) with a diagnosis of uncomplicated streptococcal or enterococcal BSI were included. Patients were excluded if they had polymicrobial bacteremia or deep-seated infection or had been admitted for no more than 48 hours. The primary outcomes were duration of antibiotic therapy (IV and oral) and time to appropriate oral therapy for treatment of BSI. The secondary outcomes were observed rates of re-initiation of antibiotics and readmission with recurrent BSI. Descriptive statistics were calculated and regression analysis was performed for the primary and secondary outcomes. Results: A total of 96 patients met the inclusion criteria. The median total duration of therapy for uncomplicated streptococcal and enterococcal BSI was about 2 weeks. Streptococcus pneumoniae BSIs were associated with a significantly shorter duration of IV therapy and were more likely to be associated with transition to oral antibiotics. No recurrent BSIs were observed in patients for whom therapy was transitioned to oral antibiotics. Conclusions: Further study is warranted to explore shorter duration of antibiotic therapy and transition to oral therapy as treatment approaches for uncomplicated streptococcal and enterococcal BSI. Other outcomes of interest for future research include determining the optimal time for transition to oral therapy. Keywords: bacteremias, streptococcal infection, enterococcal infection, antimicrobial stewardship, bloodstream infection RÉSUMÉ Contexte : Les infections du sang (IS), ou bactériémies, se classent parmi les causes principales de décès en Amérique du Nord. Malgré leur prévalence, la pratique de la prescription d’antibiotiques continue de varier grandement. Objectif : Étudier les pratiques actuelles de la prescription pour la gestion des bactériémies à streptocoque et à entérocoque non compliquées. Méthodes : Une étude de cohorte rétrospective a été menée à l’aide de dossiers de patients admis à un centre de soins aigus en Colombie-Britannique entre le 16 novembre 2019 et le 20 octobre 2020. Des patients adultes (≥ 18 ans) ayant reçu un diagnostic de bactériémie a streptocoque ou à entérocoque non compliquée ont été inclus. Les patients étaient exclus s’ils présentaient une bactériémie polymicrobienne ou une infection profonde ou s’ils avaient été hospitalisés depuis moins de 48 heures. Les résultats principaux étaient la durée de l’antibiothérapie (IV et orale) et le temps écoulé avant la transit","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De sages paroles du bon docteur (Seuss).","authors":"Ashley Walus","doi":"10.4212/cjhp.3540","DOIUrl":"10.4212/cjhp.3540","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"347"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatments and Outcomes of Critically Ill Patients with <i>Candida</i> spp. Colonization of the Lower Respiratory Tract in Regina, Saskatchewan.","authors":"Adam Lanigan, Jonathan F Mailman, Sandy Kassir, Kristin Schmidt, Stephen B Lee, Eric Sy","doi":"10.4212/cjhp.3408","DOIUrl":"10.4212/cjhp.3408","url":null,"abstract":"<p><strong>Background: </strong>Among critically ill patients receiving mechanical ventilation, Candida spp. are commonly detected in the lower respiratory tract (LRT). This is generally considered to represent colonization.</p><p><strong>Objective: </strong>To evaluate the use of antifungal treatments and the clinical outcomes of patients with Candida colonization of the LRT.</p><p><strong>Methods: </strong>This retrospective analysis involved consecutive patients admitted to the intensive care unit between April 2016 and May 2021with positive results on Candida spp. testing of LRT samples. Data related to antifungal treatment and clinical outcomes were analyzed descriptively, and multivariable logistic regression was performed.</p><p><strong>Results: </strong>Of 200 patients initially identified, 160 (80%) died in hospital. Antifungal therapy was given to 103 (51.5%) of the patients, with treatment being more likely among those with shock and those who received parenteral nutrition. Mortality was high among patients with positive Candida results on LRT culture, regardless of treatment. Multivariable logistic regression, with adjustment for age, sex, comorbidities, and sequential organ failure assessment (SOFA) score, showed that antifungal treatment was associated with lower odds of death (odds ratio 0.39, 95% confidence interval 0.17-0.87) compared with no treatment (p = 0.021).</p><p><strong>Conclusions: </strong>This study showed higher mortality rates than have been reported previously. Further investigation into the role of antifungal therapy among critically ill patients with Candida spp. colonization is required.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"309-313"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}