Nosocomial infections: new therapeutic alternatives.

This symposium on nosocomial infections, antimicrobial resistance and the benefits of doripenem in this setting was held in Madrid, Spain, on 7 October 2009, and was supported by Janssen-Cilag. The topic was presented under an interdisciplinary approach by different international experts in the field.

Experience with injectable long-acting risperidone in long-term therapy after an acute episode of schizophrenia: the SPHERE Study.

BACKGROUND: Risperidone long-acting injectable (RLAI) is the first long-acting formulation of an atypical antipsychotic introduced into clinical practice. RLAI combines the benefits of atypical antipsychotic agents with an extended duration of activity and is intended for long-term management of schizophrenia. This study evaluated the use of RLAI as part of a long-term management strategy in patients with an acute episode of schizophrenia. OBJECTIVES: The primary objective was to determine clinicians' approaches to the use of RLAI in patients with an acute exacerbation of schizophrenia by examining the prescribing patterns of antipsychotic and other psychotropic medications. Other objectives were to evaluate the overall safety of switching patients to RLAI from previous antipsychotic therapy and to determine patients', caregivers' and relatives' attitudes towards RLAI treatment. METHODS: The Safety and Profile of Handling and Employing of Risperdal Consta in Emergency/Acute Care Settings (SPHERE) study was an observational, non-interventional, multicenter, retrospective study involving a large cohort of patients with acute psychotic exacerbation who attended Spanish emergency/acute care facilities (between August and December 2003) and were treated with RLAI during hospitalization. RESULTS: A total of 1232 patients (70% men; mean age 37 years; median of 8 months since most recent admission) were included in the analyses; 79% had been receiving antipsychotic therapy prior to admission. All patients received RLAI post-stabilization. The main reasons for initiating RLAI were the need for long-term treatment (76%) and a low adherence to previous treatment (71%). RLAI doses administered during hospitalization were: 25 (26%), 37.5 (29%), 50 (42%) and 75-100 mg (3%). The mean number of injections per patient (2 +/- 1) and mean hospitalization time (25 +/- 16 days) indicated that RLAI was administered every 2 weeks as per the manufacturer's recommendations. All patients were discharged on RLAI treatment; 62% were prescribed concomitant therapy, mainly oral risperidone (39%), anxiolytics (25%), antiparkinsonians (15%), hypnotics (11%) and anticonvulsants (11%). Only 5.7% of patients reported adverse events, most commonly extrapyramidal symptoms (1.1%) and somnolence (0.9%). CONCLUSIONS: As part of a long-term management strategy aimed at improving treatment adherence in schizophrenic patients, RLAI was prescribed to a wide spectrum of patients with an acute episode of schizophrenia during hospitalization and at the time of discharge from emergency/acute care facilities. RLAI was well tolerated in the study population and the overall impression of patients, primary caregivers and relatives to RLAI therapy was positive.

Risperidone in the treatment of behavioural and psychological symptoms of dementia in patients diagnosed with vascular or mixed-type dementia.

Objective Studies have found that the atypical antipsychotic drug, risperidone, reduces non-cognitive symptoms, such as aggression, agitation, and psychosis, in patients with Alzheimer's disease. This study assessed whether these effects extend to patients with vascular or mixed-type dementia. Methods In this multicentre, open-label, prospective study, 75 elderly patients with vascular or mixed-type dementia and concomitant behavioural and psychological symptoms were treated with risperidone for up to 6 months. Results Risperidone decreased the frequency and severity of overall behavioural and psychological symptoms, as determined by the Neuropsychiatric Inventory, to a mean total score of 7.2±0.7 at end-point compared with 21.0±1.5 at baseline (P<0.001). Risperidone improved functional capacity (Blessed Dementia Rating Scale, Reisberg's Global Deterioration Scale) and depression (Cornell Scale for Depression in Dementia). A total of four adverse events (5.3%) were spontaneously reported: two cases of hypotension, one of somnolence, and one of paresthesia. Scores on the Udvalg for Kliniske Undersogeler extrapyramidal symptom subscale remained stable from baseline to end-point. Conclusion Overall, these findings indicate that risperidone was effective in reducing behavioural and psychological symptoms and was well tolerated, particularly with respect to extrapyramidal symptoms, in this elderly population diagnosed with vascular or mixed-type dementia.