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Vancomycin is a glycopeptide antibiotic that is active against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Nephrotoxicity, which is usually reversible, is the most serious common adverse effect of vancomycin. Vancomycin-associated nephrotoxicity prolongs hospital stays, imposes a need for additional antibiotics and, in rare circumstances, dialysis treatment, and increases medical costs and mortality. Risk factors for nephrotoxicity include the dose and duration of vancomycin treatment, serum trough concentration, patient characteristics, and concomitant receipt of nephrotoxins. Contemporary guidelines recommend targeting vancomycin trough concentrations of ≥10 mg/L to prevent resistance and trough concentrations of 15–20 mg/L to optimize outcomes. There is significant correlation between vancomycin trough serum concentrations and the incidence of vancomycin-associated nephrotoxicity; however, evidence of an association between trough concentrations and efficacy is less convincing. Routine monitoring of serum vancomycin concentrations consumes time and limited healthcare resources and may not be cost effective. The use of alternative antibacterial agents that do not require monitoring would free up pharmacy resources. This time could then be devoted to initiatives such as pharmacist-led antibiotic stewardship programs that are known to reduce antibiotic use and promote improved patient outcomes.

Among patients with a BL allergy, use of BL antibiotics is associated with a lower rate of clinical failure. The low rate of hypersensitivity provides further evidence about the risk of cross-reactivity between BL classes. These results support the practice of using a BL from an alternative class for patients in need of gram-negative antibiotic coverage.

Pharmacologic VTE prophylaxis was associated with a decreased incidence of VTE in patients with CLD without an increased rate of bleeding and should be routinely considered on admission to the hospital. Patients with CLD and active malignancy, trauma or surgery during hospitalization, or history of VTE appear to be at highest risk of VTE and thus warrant pharmacologic prophylaxis. Prospective studies must validate these findings.

The human airway increases in length and volume during a rapid period of craniofacial growth in patients between the ages of 8 and 18 years, and the site of maximum cross-sectional area constriction can vary.

Integration of AS education in US PharmD curricula is variable and there are considerable differences in the AS activities and topics delivered. PharmD programmes should attempt to expose students to AS education to prepare future pharmacists for AS practice. Efforts should be made to incorporate interprofessional collaboration into AS education.

Objective. To implement and assess the effectiveness of card games to teach pharmacotherapeutic topics to pharmacy students and to determine the relationship between students' assessment scores and their learning styles. Design. Two card games, Cardiology Go Fish and Infectious Diseases Gin Rummy, were created and taught to pharmacy students enrolled in an advanced pharmacy practice experience (APPE). Students were required to play each game for 1 hour, 3 times over a 6-week period. Assessment. Forty-five students completed a 90-question assessment administered prior to and after the 6-week period in which the games were played. Students' cardiology and infectious diseases assessment scores improved significantly as compared with scores on pharmacy practice questions, 19.2% vs. 5.1%, (p , 0.001) and 10.3% vs. 5.1% (p 5 0.006), respectively. Students learned from participating in the games regardless of their learning preference as determined by the VARK (visual, aural, read/write, kinesthetic) questionnaire; however, the cardiology assessment scores of students with a preference for kinetic learning improved the most. Conclusions. Incorporating innovative learning tools such as card games into the curriculum of APPEs can enhance the educational experience of pharmacy students.