Successful Integration of Clinical Pharmacists in an OPAT Program: A Real-Life Multidisciplinary Circuit.

Outpatient parenteral antimicrobial therapy (OPAT) programs encompass a range of healthcare processes aiming to treat infections at home, with the preferential use of the intravenous route. Although several barriers arise during the implementation of OPAT circuits, recent cumulative data have supported the effectiveness of these programs, demonstrating their application in a safe and cost-effective manner. Given that OPAT is evolving towards treating patients with higher complexity, a multidisciplinary team including physicians, pharmacists, and nursing staff should lead the program. The professionals involved require previous experience in infectious diseases treatment as well as in outpatient healthcare and self-administration. As we describe here, clinical pharmacists exert a key role in OPAT multidisciplinary teams. Their intervention is essential to optimize antimicrobial prescriptions through their participation in stewardship programs as well as to closely follow patients from a pharmacotherapeutic perspective. Moreover, pharmacists provide specialized counseling on antimicrobial treatment technical compounding. In fact, OPAT elaboration in sterile environments and pharmacy department clean rooms increases OPAT stability and safety, enhancing the quality of the program. In summary, building multidisciplinary teams with the involvement of clinical pharmacists improves the management of home-treated infections, promoting a safe self-administration and increasing OPAT patients' quality of life.

Hypertensive crisis following the administration of tedizolid: possible serotonin syndrome.

Thiscase report concerns a 34-year-old male with a hip prosthesis infection, under treatment with antidepressant and antihypertensive drugs, who presented with an increase in blood pressure after four days of treatment with oral tedizolid. Tedizolid was discontinued, and the dose of antihypertensive was increased. The patient progressively achieved the normalisation of blood pressure values, which allowed a reduction in the antihypertensive agent dose to its usual regimen. No cases of hypertension or serotonin toxicity are described in the initial tedizolid studies, where patients treated with other serotonergic drugs were excluded. However, this does not mean that these effects may not occur in clinical practice, especially in patients under concomitant treatment with this type of medication, because of the greater risk of drug interactions. The causality of this suspected drug reaction was analysed and it was considered as possible. The case has been reported to the pharmacovigilance system.