BackgroundRespiratory syncytial virus (RSV) infections can be prevented by good hygiene and prophylactic palivizumab, a monoclonal antibody against the fusion protein of VRS. The criteria for selecting patients for palivizumab prescription in our hospital are: <28 weeks preterm infants (PI) and age <12 months (criterion 1), <32 weeks PI and age <6 months (criterion 2), age <2 years with bronchopulmonary dysplasia (criterion 3), age <2 years with haemodynamically significant congenital heart disease (criterion 4).PurposeTo describe the use of palivizumab in the vaccination campaign in our hospital, evaluating the appropriateness of its use by the established criteria and its effectiveness.Material and methodsWe performed a retrospective observational study. All patients who received palivizumab between 01/10/2013 and 31/03/2014 were included. The data collected using the clinical records were: sex, gestational age, selection criteria, and number of hospitalizations due to acute bronchiolitis between 01/10/2013 and 30/09/2014. RSV was analysed in these patients by Polymerase Chain Reaction (PCR).ResultsPalivizumab was administered to 68 patients (48.5% female) with a median gestational age of 209 days (176–287). 24 patients (35.3%) fulfilled criterion 2, 14 (20.6%) criterion 1, 10 (14.7%) criterion 4, 5 (7.3%) criteria 1 and 3, 4 (5.9%) criteria 2 and 4, 3 (4.4%) criterion 3, 2 (2.9%) criteria 3 and 4. 4 patients did not meet any criteria and 2 had no data. Only 6 patients who received palivizumab were hospitalised with a diagnosis of acute bronchiolitis and their RSV PCRs were negative.ConclusionPalivizumab is used under the established criteria in our hospital. The study data show that immunising these at-risk patients with the palivizumab vaccine was an effective strategy for at least one year. Although the study period was 1 year, it would be desirable to measure effectiveness over a longer period.References and/or AcknowledgementsNo conflict of interest.
BackgroundOur Hospital Pharmacy Service (HPS) participates in the process of authorising off-label indications (OLIs) of drugs. Immunosuppressants are often used in OLIs.PurposeTo analyse prescriptions for oral immunosuppressants dispensed as OLI in our HPS Outpatient Unit (HPSOU) to identify points in the system that could be improved.Material and methodsRetrospective study of oral immunosuppressants dispensed at our centre between March 2012 and March 2014.Variables collected were age, sex, drug, prescribing service and indication; obtained from the HPSOU database and the electronic medical history.Results269 patients (median age 52 years (5–92), 135 women (50%) and 134 men (50%)) were evaluated.6 drugs were dispensed in 8 different medicinal products: tacrolimus 94 patients (35%), mycophenolate mofetil 78 (29%), mycophenolic acid 56 (21%), ciclosporin 34 (17%), everolimus 6 (2%) and sirolimus 1 (0.3%).11 services were involved: Haematology (89 patients: 33%), Rheumatology (61: 23%), Nephrology (56: 21%), Ophthalmology (15: 6%), Digestive (14: 5%), Pneumology (10: 4%), Paediatrics (9: 3%), Neurology (8: 3%), Internal Medicine (4: 1%), Dermatology (2: 0.7%) and Oncology (1: 0.3%).Immunosuppressants were dispensed for 35 different indications. Main indications and their treatments were: Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) for 75 patients (28%), with tacrolimus (71%), mycophenolate mofetil (17%) and ciclosporin (12%); Systemic Lupus Erythematosus (SLE) for 46 (17%), with mycophenolate mofetil (62%), mycophenolic acid (30%) and tacrolimus (8%) and Membranous Glomerulonephritis (MGN) for 20 (7%), with mycophenolic acid (50%) and tacrolimus.ConclusionThe use of oral immunosuppressants as OLI is an established treatment for various indications, specially, allo-HSCT, SLE and GMN. The creation of multidisciplinary groups to develop protocols for the management of these drugs is required.References and/or AcknowledgementsSummaries of product characteristics of the evaluated medicinal products.No conflict of interest.
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