BackgroundSince antibiotic resistance has become a worldwide public health concern and is in part related to physicians’ lack of knowledge, it is essential to focus our attention on healthcare profession students. The present study aims at evaluating the knowledge and attitudes of the School of Medicine’s students towards antibiotic usage and antibiotic resistance.MethodsIn December 2013, a cross sectional study was conducted amongst medical, dental, nursing and other health care profession students of the School of Medicine at the University of Torino. Students of all the academic years took part in this study. Questionnaires were submitted during regular lectures (only students who attended courses on one specific day were surveyed) and the data collected was analyzed using StataMP11 statistical software.ResultsOverall, 1,050 students were interviewed. The response rate was 100%. Around 20% of the sample stated that antibiotics are appropriate for viral infections and 15% of the students that they stop taking those drugs when symptoms decrease. Results of the multivariate analyses showed that females were more likely than males to take antibiotics only when prescribed (OR 1.43, 95% CI 1.04–1.98). Interestingly, students with a relative working in a health-related field, as well as those who took at least one course of antibiotics in the last year, had a lower probability of taking those drugs only under prescription (OR = 0.69 95% CI: 0.49–0.97 and OR = 0.38 95% CI: 0.27–0.53, respectively).ConclusionThe present paper shows how healthcare profession students do not practice what they know. Since those students will be a behavioral model for citizens and patients, it is important to generate more awareness around this issue throughout their studies. It would be advisable to introduce a specific course and training on antibiotics in the core curriculum of the School of Medicine.

No abstract

Nivolumab is approved and reimbursed by Italian Drug Agency (AIFA) in several tumors, including non-small cell lung cancer, head & neck cancer and renal cell cancer. In May 2018, the original schedule (3 mg/kg every 2 weeks) -used in pivotal clinical trials demonstrating treatment efficacy -was replaced by a flat dose (240 mg every 2 weeks). Aim of this study was to identify the most cost-effective dosing strategy of nivolumab in a real-world setting. The primary endpoint of this analysis was the difference of nivolumab costs between the real scenario based on data from our hospital, and the hypothetical expenditure according to different simulated strategies of nivolumab dosing. The secondary endpoint was to report the economic savings associated with "drug day" and dose rounding

Hospital pharmacy services had to implement a telepharmacy programme in record time, to bring drugs closer to patients. Aim and objectives To measure the impact of a telepharmacy programme in terms of direct and indirect costs and benefits for patients. Material and methods A retrospective observational study was conducted in a tertiary level hospital between March and September 2020. The following variables were collected: number of remote dispensings, number of patients enrolled in the telepharmacy programme, population characteristics, drugs and storage conditions, average distance, and direct and indirect costs. Results 13 216 remote dispensings were made relating to 4090 active patients within the telepharmacy programme. This represented 51.21% of the total number of our outpatients (7986). 50.81% (2078) of the patients were women and median age was 57 (±23) years. 44.59% (5894) of the total drugs sent were thermolabile drugs. The mean distance of the shipments was 41.7 (0.2-208) km. Establishing the ratio 0.226C ¼ /km, and 1 visit every 2 months to the hospital pharmacy service, direct costs would mean an average of 113.04C ¼ per year for patients. Establishing the 1 km/2 min relationship, the annual indirect costs represent 10.5 working hours: 7.7 hours as the average travel time and 2.8 hours as the average waiting time for face-to-face dispensings. Conclusion and relevance Telepharmacy has become one more tool for dispensing treatments to outpatients with savings for the patient in terms of travel and waiting times. The time of confinement due to the pandemic has accelerated the inclusion of patients in this programme, reaching more than 50% in 6 months.

versus IFX-B, as well as the prevalence of immunogenicity between both. Material and methods We conducted a retrospective observational study (March 2017-September 2018. We included all patients with IBD who received maintenance therapy with IFX and underwent pharmacokinetic monitoring.The variables studied were: sex, age, diagnosis, type of drug (IFX-O or IFX-B), number of serum samples collected, serum trough levels IFX and the presences of antibodies. Blood extraction was performed in trough levels and determined by sandwich ELISA (Promonitor). The IFX therapeutic range was defined as between 3-10 mcg/mL. We used the X 2 test to compare the association between categorical variables and the student t-test for quantitative variables. All tests were performed using SPSS v.23.0. Results We included 70 patients (65.7% were males). The average age of the study population was 41.8 (DE: 14.8) years. 74.4% had Crohn's disease.Concerning treatment, 49.3% were treated with IFX-O and 50.7% with IFX-B. We analysed 174 serum samples (61.5% IFX-O), 2.9 (SD: 1.1) and 1.8 (SD: 1.0) samples per patient of IFX-O and IFX-B respectively. Mean serum trough levels of IFX-O were 7.2 (SD: 4.5) mcg/mL versus 8.3 (SD: 7.8) mcg/ mL with IFX-B (p=0.790), of which 61.9% and 47.8% (p=0.137) were in the therapeutic range respectively. In terms of immunogenicity, 13.1% patients presented antibodies anti-IFX (11.6% IFX-O and 15.4% IFX-B, p=0.43). Conclusion In our study there was no significant difference in the mean concentration of drugs between IFX-O and IFX-B, and neither in immunogenicity, with IFX-B as a cost-effective alternative to the originator product. Pharmacokinetic monitoring represents a fundamental mainstay in the optimisation of these treatments. REFERENCE AND/OR ACKNOWLEDGEMENTSMitchell RA, et al. The utility of infliximab therapeutic drug monitoring among patients with inflammatory bowel disease and concerns for loss of response: a retrospective analysis of a real-world experience. Can J Gastroent Hepatol 2016.No conflict of interest.