Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add more filters










Database
Language
Publication year range
1.
Am J Health Syst Pharm ; 70(12): 1065-9, 2013 Jun 15.
Article in English | MEDLINE | ID: mdl-23719885

ABSTRACT

PURPOSE: Results of a study to determine the impact of a clinical pharmacist's temporary absence from a hospital's antimicrobial stewardship team are presented. METHODS: A retrospective chart review was conducted to compare the appropriateness of the use of selected antimicrobial medications with and without regular pharmacist involvement on the hospital's antimicrobial stewardship team. The charts of two samples of patients were evaluated: (1) 119 patients who had received prolonged (≥72 hours) imipenem-cilastatin, linezolid, or micafungin therapy over a three-month period during which a clinical pharmacist routinely provided interventions to help ensure the drugs were used according to institutional guidelines and (2) 111 patients treated with one of the three drugs during a three-month period when the clinical pharmacist did not serve on the stewardship team. RESULTS: Relative to the period of active pharmacist involvement in antimicrobial stewardship, rates of inappropriate use of imipenem-cilastatin, linezolid, and micafungin during the pharmacist's absence were deemed to have increased by 27, 39, and 35 percentage points, respectively, with corresponding increases in the average duration of therapy of 0.7, 4.0, and 3.2 days; in addition, the number of cases of Clostridium difficile infection increased more than threefold (from 8 to 25) during the pharmacist's absence. CONCLUSION: The temporary absence of a pharmacist from the antimicrobial stewardship team was associated with increased rates of inappropriate use of restricted antimicrobial agents and consequent increases in average durations of therapy.


Subject(s)
Anti-Infective Agents/therapeutic use , Medication Errors/statistics & numerical data , Medication Therapy Management/organization & administration , Patient Care Team/organization & administration , Pharmacy Service, Hospital/organization & administration , Acetamides/standards , Acetamides/therapeutic use , Anti-Infective Agents/standards , Antifungal Agents/standards , Antifungal Agents/therapeutic use , Cilastatin/standards , Cilastatin/therapeutic use , Cilastatin, Imipenem Drug Combination , Drug Combinations , Drug Resistance, Microbial/drug effects , Echinocandins/standards , Echinocandins/therapeutic use , Guideline Adherence/statistics & numerical data , Humans , Imipenem/standards , Imipenem/therapeutic use , Length of Stay/statistics & numerical data , Linezolid , Lipopeptides/standards , Lipopeptides/therapeutic use , Medication Therapy Management/standards , Micafungin , Ohio , Oxazolidinones/standards , Oxazolidinones/therapeutic use , Patient Care Team/standards , Pharmacy Service, Hospital/standards , Retrospective Studies , Workforce
2.
JPEN J Parenter Enteral Nutr ; 14(3): 306-9, 1990.
Article in English | MEDLINE | ID: mdl-2112647

ABSTRACT

The chemical stability and compatibility of imipenem-cilastatin sodium (Primaxin) in two different total parenteral nutrient (TPN) solutions was determined. TPN solutions consisted of 4.25% and 5% amino acids with 25% and 35% dextrose, respectively. Imipenem-cilastatin sodium was constituted with 10 ml of sterile water and admixed with 90 ml of TPN solution for a final concentration of 5 mg/ml of each drug. The final solutions were assayed at times 0 (immediately after admixture), 15 min, 30 min, 1, 4, 8, and 24 hr by a stability-indicating high-performance liquid chromatographic assay. Concurrently, test TPN solutions were monitored for pH changes, color changes, and precipitate formation. The potential effect of imipenem-cilastatin sodium on the stability of amino acids and other TPN additives was not evaluated. Imipenem and cilastatin sodium was stable (greater than or equal to 90% recovered) in each TPN solution at 15 min. A significant (greater than or equal to 10%) and steady decrease of imipenem recovery occurred at subsequent sampling times. Cilastatin appeared more stable than imipenem in both TPN solutions. A physical color change from colorless to dark orange appeared in each TPN solution over the 24-hr study period. Imipenem-cilastatin sodium is stable for 15 min in the TPN solutions studied; however, until the stability of the amino acids can be determined, the antibiotic should be administered through a separate line or Y-site while the TPN infusion is interrupted.


Subject(s)
Anti-Bacterial Agents/standards , Cilastatin/standards , Food, Formulated , Imipenem/standards , Parenteral Nutrition, Total , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/analysis , Chromatography, High Pressure Liquid , Cilastatin/administration & dosage , Cilastatin/analysis , Cilastatin, Imipenem Drug Combination , Drug Combinations/administration & dosage , Drug Combinations/analysis , Drug Combinations/standards , Drug Incompatibility , Drug Stability , Food, Formulated/analysis , Humans , Imipenem/administration & dosage , Imipenem/analysis
3.
Infection ; 17(5): 311-5, 1989.
Article in English | MEDLINE | ID: mdl-2599653

ABSTRACT

The in vivo activity of ciprofloxacin against Pseudomonas aeruginosa was studied in a septicemia model in neutropenic mice and compared to that of other antibiotics with established activity against P. aeruginosa. When given as a single agent, ciprofloxacin proved to be as effective as imipenem/cilastatin, whereas azlocillin and tobramycin were rather ineffective. After infection with higher challenge inocula, combinations of two (synergistic) antibiotics were more effective than single agent therapy in most instances. The combination of ciprofloxacin with azlocillin was at least as effective as that of imipenem/cilastatin with tobramycin. Selection of mutants with decreased sensitivity to ciprofloxacin occurred during therapy, however, post-therapy MICs of ciprofloxacin did not exceed a level of 1 mg/l and rises of MICs did not detrimentally influence treatment outcome. Taken together with the results of earlier studies, our data encourage the use of ciprofloxacin in gram-negative septicemia in neutropenic patients.


Subject(s)
Agranulocytosis/complications , Azlocillin/standards , Ciprofloxacin/standards , Neutropenia/complications , Pseudomonas Infections/drug therapy , Sepsis/drug therapy , Animals , Azlocillin/pharmacokinetics , Azlocillin/therapeutic use , Cilastatin/standards , Ciprofloxacin/pharmacokinetics , Ciprofloxacin/therapeutic use , Disease Models, Animal , Drug Evaluation, Preclinical , Drug Resistance, Microbial , Drug Therapy, Combination/standards , Male , Mice , Pseudomonas Infections/etiology , Sepsis/etiology , Tobramycin/standards
SELECTION OF CITATIONS
SEARCH DETAIL
...