Background During the fourth year of training, pharmacy residents perform a rotation with the team doctor on various wards. Purpose To describe and to classify the interventions made during the rotation through the wards and to assess the level of acceptance of the interventions by the doctor. Materials and methods Prospective study of the interventions made during 8 months of rotation. Data were collected from each patient: name, age, sex, allergies, weight, date of admission and discharge, harmful habits, medical history, primary diagnosis, drug treatment, income and home diagnostic tests performed. Any contribution made to drug treatment was considered an intervention. These were classified as: change in dose / frequency, start / stop treatment, drug substitution, modified via and other (request for information, diagnostic tests and pharmacokinetics). Databases such as Micromedex 2.0, Antimicrobial Clinical Practice Guideline 2010, BOT Plus and the hospital's drug substitution program were used to record the interventions. Results The wards were: Cardiology, Children's Oncology, Intensive Care, Gastroenterology, Internal Medicine HIV and Internal Medicine Infections. The average stay per unit was 1.3 months. The resident participated in the daily ward round and start and change of treatment. 98 interventions were performed in 85 patients treated (1.15 interventions / patient). Classification of interventions: change in dose (25.5%), request for information (23.5%), starting treatment (17.3%), discontinue treatment (9.2%), frequency change (8.2%), pharmacokinetic studies (6.1%), change in treatment (5.1%), modified via (3.1%), request additional tests (2%) and drug substitution (0%). 89% of the interventions were accepted. 11% of the interventions were not accepted, the initial stance was justified by the doctor. Conclusions The integration of the pharmacy residents onto the wards has been widely accepted because it has helped adjust the treatment at the time of prescribing, improving safety in the care process.
Background Nosocomial bloodstream infection (nBSI) is an important clinical concern among COVID-19 hospitalised patients. It can cause sepsis and septic shock leading to high morbidity, mortality, and the emergence of antibiotic resistance. The aim of this case-control study is to identify the risk factors associated with the nBSI development in COVID-19 hospitalised patients and its incidence. Methods and analysis A retrospective case-control study will be performed. Cases will include nBSI episodes of adult patients (≥18 years) admitted to Hospital Universitari Germans Trias i Pujol, Barcelona, Spain, from April to December 2020 with a diagnosis of SARS-CoV-2 pneumonia. Patients transferred from other hospitals will be excluded. Controls will include hospitalisation episodes of COVID-19 patients without nBSI. We will recruit a minimum of 74 nBSI episodes (cases) and 74 controls (according to sample size calculation). We will collect data on sociodemographics, clinical status at admission, hospital admission, in-hospital mortality, and exposure data (use of antivirals, glucocorticoids or immunomodulatory agents, length of hospitalisation, and use of medical devices such as intravenous catheters). A bivariate and a subsequent multivariate regression analysis will be performed to assess the independent effect of the associated risk factors after adjusting for confounders. The nBSI incidence rate will be estimated according to the number of nBSI episodes in admitted COVID-19 patients among the total person-month of follow-up. Ethics and dissemination The protocol of this study was approved by the Ethical Committee for Drug Investigation of the Hospital Universitari Germans Trias i Pujol. The results of this case-control study will be published in a peer reviewed journal.
Background Many patients visit the emergency department because of urinary tract infections (UTIs). Appropriate antibiotic prescriptions are necessary due to high resistance patterns and both the clinical and financial impact on the health system. Purpose To describe characteristics of population diagnosed with UTIs attended at a tertiary hospital emergency department as well as the antibiotic prescription at discharge. Materials and methods Retrospective study of adult patients attended at a hospital emergency department with a diagnosis at discharge of urinary tract infectious disease from January to June 2011. A random sample was selected. The authors analysed discharge reports to find: sex, age, main diagnosis, pregnancy, recent history of UTI and antibiotic prescription at discharge. Results A total of 201 patients were included. (70.1% women, mean age 49.7 years). UTI was the most frequent diagnosis (188 patients, 93.5%) and 13 had an added urological disease. Antibiotics were prescribed to 91.54% of patients. Most often antibiotics prescribed were third generation cephalosporins cefixime and ceftriaxone (27.9%), followed by fosfomycin (26.4%) and fluoroquinolones (14.9%). Oral cefuroxime was prescribed in 10.9% patients and amoxicillin- clavulanic acid in 7%. The authors found out that 39 patients (19.4%) had a recent history of UTI. In those patients, the most frequently prescribed antibiotics were cephalosporins (46.1%) followed by fosfomycin (25.6%). Seven of the 141 women included in the study were pregnant. Four of them received cephalosporin, 2 fosfomycin and one of them amoxicillyn-clavulanic acid. Conclusions Most patients attended at the emergency department due to UTI received an antibiotic prescription at discharge. The authors found a high rate of cephalosporin prescriptions. The authors should conduct a more extensive study including laboratory results and resistance rates in the region in order to assess the appropriate or inappropriate choice of the antibiotic therapy.
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