Use of Cumulative Assessments in U.S. Schools and Colleges of Pharmacy.

The Accreditation Council of Pharmacy Education (ACPE) has taken a strong stance on assessment in pharmacy education. One available assessment tool is cumulative assessments, which may be administered at various points in the curriculum. This article presents the results of a survey of U.

Antibiotic dosing in cirrhosis.

Purpose: Published evidence regarding the influence of cirrhosis on the clinical pharmacokinetics of antibacterial agents is reviewed; dosing recommendations and a decision algorithm are provided.

Summary: A systematic PubMed search (1960-2013) was conducted to identify literature pertaining to the use of antibacterials with hepatobiliary clearance in adult patients with cirrhosis. Clinical drug databases, conference abstracts, and package inserts were also reviewed for pertinent information.

Managing an outpatient parenteral antibiotic therapy team: challenges and solutions.

Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.

Evaluation of the treatment of vancomycin-resistant enterococcal urinary tract infections in a large academic medical center.

Background: Vancomycin-resistant enterococci (VRE) are a common cause of nosocomial urinary tract infections (UTIs) among hospitalized patients. Clinicians need to differentiate between VRE-associated urinary colonization, asymptomatic bacteriuria, and UTIs to determine the need for treatment and length of therapy.

Objective: To characterize the diagnosis and management of VRE from urinary sources, including compliance with institutional treatment guidelines, and identify risk factors associated with clinical failure.

Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess.

Objective: The objective of this study was to evaluate clinical outcomes and risk factors associated with clinical failure in patients hospitalized with cellulitis with or without abscess.

Methods: We performed a retrospective cohort study among adults admitted for cellulitis/cutaneous abscess from July 1, 2009 through June 30, 2010. Binary univariate and multivariate logistic regression analyses were performed to identify risk factors for clinical failure among evaluable patients.

Impact of a multidisciplinary team review of potential outpatient parenteral antimicrobial therapy prior to discharge from an academic medical center.

Background: Outpatient parenteral antimicrobial therapy (OPAT) is frequently prescribed at hospital discharge, often without infectious diseases (ID) clinician oversight. We developed a multidisciplinary team, including an ID pharmacist, to review OPAT care plans at hospital discharge to improve safety, clinical efficacy, practicality, and appropriateness of the proposed antimicrobial regimen.

Objective: To evaluate the impact of the OPAT team on regimen safety, efficacy, and complexity; calculate the economic benefits of the service by avoiding hospital discharge delay, central venous catheter placement, or need for OPAT; and evaluate the discharge environment among OPAT referrals.

Golimumab: Review of the efficacy and tolerability of a recently approved tumor necrosis factor-α inhibitor.

Background: Golimumab (GLM) is a tumor necrosis factor-α (TNF-α) inhibitor that was approved in the United States in 2009 for use with methotrexate (MTX) in adults with moderate to severe active rheumatoid arthritis (RA), and with or without MTX or other non-biologic disease-modifying antirheumatic drugs in adults with active psoriatic arthritis (PsA) or active ankylosing spondylitis (AS). GLM is administered as a 50-mg subcutaneous injection once a month.

Objectives: The goals of this article were to review the current literature on GLM and to provide recommendations for the use of GLM based on the published information.

Vancomycin-resistant enterococcal urinary tract infections.

Enterococci are a common cause of urinary tract infections (UTIs) among hospitalized patients. The rising prevalence of vancomycin-resistant enterococci (VRE) is of particular concern within many institutions because of its association with increased mortality and health care costs, as well as limited treatment options. Clinicians need to differentiate between VRE-associated urinary colonization, asymptomatic bacteriuria, and UTIs in order to determine the need for treatment, optimal therapeutic options, and length of therapy.

Lessons Learned from Surveillance of Antimicrobial Susceptibilities of Pseudomonas aeruginosa at a Large Academic Medical Center.

This research report assessed the differences in resistance rates and antimicrobial usage-versus-susceptibility relationships of found in various hospital patient care areas. A simplified case control study was also performed to identify patient-specific risk factors associated with cefepime-resistant isolates. Last, we determined the consequence of combining mucoid and non-mucoid derived antimicrobial susceptibilities of into hospital antibiograms.

Pharmacokinetics of mycophenolic acid and metabolites in diabetic kidney transplant recipients.

Mycophenolate mofetil (MMF), the prodrug of mycophenolic acid (MPA), is an immunosuppressive agent commonly used after organ transplantation. Because diabetes mellitus may affect disposition of pharmacologic agents, we investigated the influence of diabetes on the pharmacokinetics of MPA, unbound MPA (fMPA) and its phenyl and acyl glucuronide metabolites (MPAG and AcMPAG respectively). The study included 13 diabetic and 11 nondiabetic, stable, kidney-transplant recipients who were receiving a triple maintenance immunosuppressive regimen.