Modificación del tratamiento antibiótico empírico en las primeras 72 horas de hospitalización / Modification of empirical antimicrobial regimen during the first 72 hours of hospitalisation

Objetivo: Los objetivos del presente estudio fueron describir la modificación que se realiza de la antibioterapia empírica indicada a los pacientes ingresados desde el área de urgencias en los primeros días de estancia en la planta de hospitalización y conocer las características de dicho tratamiento antibiótico. Método: Estudio prospectivo y observacional en el que se incluyó a pacientes mayores de 14 años que ingresaron desde el área de urgencias con al menos un antibiótico prescrito y tuvieron una hospitalización de al menos 72 h. Se realizó un seguimiento diario de cada caso durante los primeros 3 días de hospitalización, documentando el tipo de infección diagnosticada, los datos microbiológicos y la antibioterapia empírica prescrita y sus modificaciones. Resultados: Se incluyó a 225 pacientes. Los diagnósticos más frecuentes fueron infección respiratoria, neumonía e infección de la piel y los tejidos blandos, y los antibióticos más empleados fueron amoxicilina-ácido clavulánico, levofloxacino y cefalosporinas de tercera generación. Se solicitó al menos un tipo de muestra microbiológica a 80 enfermos (36%). De las 225 pautas antibióticas prescritas en urgencias, 94 (42%) fueron modificadas durante las primeras 72 h de hospitalización: 37 (16%) pautas se cambiaron por completo, 31 (14%) se suspendieron totalmente y en 26 (12%) se añadió o suspendió algún antimicrobiano, aunque sólo en 40 de ellas (42%) se dispuso de cultivos para dirigir el tratamiento. Conclusiones: La frecuencia con la que las pautas antimicrobianas prescritas en urgencias se modificaron durante los primeros días de estancia en la planta de hospitalización es elevada, y destaca la escasa utilización de los resultados microbiológicos para realizar estos cambios (AU)

Objective: The aims of this study were to determine the empirical antibiotic therapy used in patients admitted to the Emergency Department who were later hospitalised, and to describe the antibiotic changes during their first days of hospitalisation. Method: All 14-year-old patients admitted to the Emergency Department who were started on antibiotic therapy and subsequently were hospitalised for at least 72 hours in an in-patient hospital ward, were included in a prospective observational study. Patients underwent daily follow-up during the first three days of hospitalisation. The type of infection, microbiological data and empirical antibiotic therapy and its changes were registered. Results: 225 patients were included in this study. The most frequent types of infection diagnosed were infection of the respiratory airways, pneumonia and skin and soft-tissue infection. Amoxicillin-clavulanic acid was the most widely prescribed antibiotic followed bylevofloxacin and third generation cephalosporins. Microbiological samples were taken in 80 (36%) patients. Of the 225 antimicrobial regimens started in the Emergency Department, 94 (42%) were changed during the first 72 hours of hospitalisation: 37 (16%) were completely modified, 31 (14%) were discontinued and antibiotics were added or stopped from the existing regimen in 26 cases(12%). Among these 94 patients whose treatment was changed, only in 40 (42%) there was a microbiological result for aiding in the adjustment of the antibiotic therapy. Conclusion: The frequency of early changes during inpatient hospitalisation to antimicrobial regimens which were initially prescribed in the Emergency Department is high. Microbiological results were rarely used to guide these changes (AU)

[Modification of empirical antimicrobial regimen during the first 72 hours of hospitalisation]. / Modificación del tratamiento antibiótico empírico en las primeras 72 horas de hospitalización.

OBJECTIVE: The aims of this study were to determine the empirical antibiotic therapy used in patients admitted to the Emergency Department who were later hospitalised, and to describe the antibiotic changes during their first days of hospitalisation. METHOD: All 14-year-old patients admitted to the Emergency Department who were started on antibiotic therapy and subsequently were hospitalised for at least 72 hours in an in-patient hospital ward, were included in a prospective observational study. Patients underwent daily follow-up during the first three days of hospitalisation. The type of infection, microbiological data and empirical antibiotic therapy and its changes were registered. RESULTS: 225 patients were included in this study. The most frequent types of infection diagnosed were infection of the respiratory airways, pneumonia and skin and soft-tissue infection. Amoxicillin-clavulanic acid was the most widely prescribed antibiotic followed by levofloxacin and third generation cephalosporins. Microbiological samples were taken in 80 (36%) patients. Of the 225 antimicrobial regimens started in the Emergency Department, 94 (42%) were changed during the first 72 hours of hospitalisation: 37 (16%) were completely modified, 31 (14%) were discontinued and antibiotics were added or stopped from the existing regimen in 26 cases (12%). Among these 94 patients whose treatment was changed, only in 40 (42%) there was a microbiological result for aiding in the adjustment of the antibiotic therapy. CONCLUSION: The frequency of early changes during inpatient hospitalisation to antimicrobial regimens which were initially prescribed in the Emergency Department is high. Microbiological results were rarely used to guide these changes.

[A bibliometric analysis of the Farmacia Hospitalaria journal (2001-2006)]. / Análisis bibliométrico de la revista Farmacia Hospitalaria (2001-2006).

OBJECTIVE: To carry out a bibliometric analysis of the Farmacia Hospitalaria journal from 2001 to 2006. METHOD: A retrospective analysis of all of the articles published in Farmacia Hospitalaria from 2001-2006 was performed and the main bibliometric indicators for production, circulation, distribution and sales were calculated. RESULTS: 416 articles by 1,515 authors were analysed. Original articles were the most predominant with a growth of 30%. There were 4.6 +/- 2.3 authors per article. The Community of Valencia, Catalonia, Madrid and Andalusia were the autonomous communities with the highest levels of production. Four authors had a productivity index of > 1, with one group of 15 authors having an index of > 0.75. Only 14% of articles were included in presentations to congresses and 17% had funding. The subject matters of drug treatment and safety had the highest production levels. The publication delay remained constant. There was a circulation index of 0.74 in Medline. CONCLUSIONS: Farmacia Hospitalaria maintained or improved their bibliometric indicators between 2001 and 2006. There has been an increase in the publication of original articles and letters to the editor over recent years and this increase was in line with the journal s strategies. There has also been a decrease in literature reviews. There were some generational changes among the authors although the main authors remained the same. The subject matters and geographical origin of the authors corresponded to areas with the largest development of the specialty in Spain.

Análisis bibliométrico de la revista Farmacia Hospitalaria (2001-2006) / No disponible

Objetivo: Análisis bibliométrico de la revista Farmacia Hospitalaria en el periodo 2001-2006. Método: Análisis retrospectivo de todos los artículos publicados en Farmacia Hospitalaria durante el periodo 2001-2006 y cálculo de los principales indicadores bibliométricos de producción, circulación, dispersión y consumo. Resultados: Se analizan 416 artículos firmados por 1.515 autores. Predominan los originales con un crecimiento del 30%. El número de autores por artículo fue de 4,6 ± 2,3. Las comunidades autónomas con mayor producción fueron la Comunidad Valenciana, Cataluña, Madrid y Andalucía. Cuatro autores tienen un índice de productividad > 1, destacando un grupo de 15 autores que lo tienen > 0,75. Sólo el 14% de los artículos procedían de presentaciones a congresos y el 17% tenía financiación. Las áreas temáticas con mayor producción son farmacoterapia y seguridad. La demora en la publicación se mantiene constante. El índice de circulación en Medline fue de 0,74. Conclusiones: Farmacia Hospitalaria ha mantenido o mejorado sus indicadores bibliométricos entre los años 2001 y 2006. Se detecta un aumento en la publicación de originales y cartas al director en los últimos años de acuerdo con las estrategias de la revista, así como una disminución de las revisiones literarias. Se detecta una cierta renovación generacional en los autores aunque se mantienen los mismos grandes productores. Las áreas temáticas y la procedencia geográfica de los autores se corresponden con las de mayor desarrollo de la especialidad en España

Objective: To carry out a bibliometric analysis of the Farmacia Hospitalaria journal from 2001 to 2006. Method: A retrospective analysis of all of the articles published in Farmacia Hospitalaria from 2001-2006 was performed and the main bibliometric indicators for production, circulation, distribution and sales were calculated. Results: 416 articles by 1,515 authors were analysed. Original articles were the most predominant with a growth of 30%. There were 4.6 ± 2.3 authors per article. The Community of Valencia, Catalonia, Madrid and Andalusia were the autonomous communities with the highest levels of production. Four authors had a productivity index of > 1, with one group of 15 authors having an index of > 0.75. Only 14% of articles were included in presentations to congresses and 17% had funding. The subject matters of drug treatment and safety had the highest production levels. The publication delay remained constant. There was a circulation index of 0.74 in Medline. Conclusions: Farmacia Hospitalaria maintained or improved their bibliometric indicators between 2001 and 2006. There has been an increase in the publication of original articles and letters to the editor over recent years and this increase was in line with the journal’s strategies. There has also been a decrease in literature reviews. There were some generational changes among the authors although the main authors remained the same. The subject matters and geographical origin of the authors corresponded to areas with the largest development of the specialty in Spain

Estudio de utilización de eritropoyetina en el síndrome mielodisplásico / No disponible

Objetivos: Evaluar la efectividad de eritropoyetina (EPO) y estudiar el grado de aplicación de las recomendaciones publicadas acerca de su utilización en la anemia de pacientes con síndrome mielodisplásico (SMD).Material y método: Estudio observacional retrospectivo de pacientes con SMD que recibieron al menos una dosis de EPO.Los pacientes se seleccionaron de la base de datos de pacientes externos del servicio de farmacia y se recogieron de la historia clínicasus datos clínicos y farmacoterapéuticos. La efectividad clínicade EPO se evaluó a las 6, 12, 16 y 24 semanas de tratamiento aplicando dos criterios diferentes de respuesta eritroide. Con el finde determinar el grado de aplicación de las recomendaciones publicadas sobre la utilización eficiente de EPO se definieron tresítems que se evaluaron en cada enfermo.Resultados: Se incluyeron 11 pacientes. Tres de ellos presentaron respuesta a EPO en algún momento durante el seguimiento,coincidiendo en esto los dos criterios aplicados. Los tresítems que evaluaron la utilización eficiente de EPO, mostraron unos porcentajes de inadecuación muy elevados. Conclusiones: En nuestro estudio, la efectividad de EPO en el tratamiento de la anemia en los SMD es similar a la descrita en la literatura; sin embargo, al evaluar su utilización en nuestro hospital,se demuestra que este medicamento no se ha empleado conforme a las recomendaciones publicadas al respecto, las cuales promueven su utilización coste/efectiva. Nos parece interesante la colaboración del servicio de farmacia en la elaboración de un protocolo de utilización de EPO en elSMD, para así contribuir a su utilización eficiente (AU)

Objectives: To assess the effectiveness of erythropoietin(EPO) and to study the extent of application of published recommendations for use in treating anemia in patients with myelodysplastic syndrome (MDS).Materials and methods: An observational retrospective study of patients with MDS receiving at least one dose of EPO.Patients were selected from the outpatient database at the Pharmacy Department, and the medical history as well as both clinical and pharmacotherapeutic data were collected. The clinical effectiveness of EPO was assessed at 6, 12, 16 and 24 weeks aftertreatment using two distinct criteria for erythroid response. Three items were defined and assessed for each patient in order to establish the extent of application of published recommendations on the efficient use of EPO.Results: Eleven patients were enrolled. Three of them responded to EPO at some point during follow-up, according topre-defined criteria. All three items used in the assessment of theefficient use of EPO showed significantly high inadequacy rates.Conclusions: In our study, the effectiveness of EPO in the management of MDS-related anemia is similar to that described in the literature. However, upon the assessment of its use in our hospital, this drug was shown not to have been employed according to published recommendations, which promote its cost-effectiveuse.We believe that the cooperation of the Pharmacy Departmentin the design of a protocol for EPO use in MDS is of interest, and would contribute to EPO’s efficient use (AU)