Impact of a remdesivir formulary restriction by antimicrobial stewardship on drug utilization and cost at a safety-net community hospital during the COVID-19 pandemic.

Deploying novel COVID-19 therapies proved challenging amid rapidly evolving data, drug shortages, and conflicting guidelines. We established a remdesivir formulary restriction remdesivir to promote its evidence-based use. This intervention led to changes in remdesivir utilization patterns and cost savings.

Levees for a hundred-year flood: impact of a syndrome-based antimicrobial stewardship intervention for coronavirus disease 2019 on antimicrobial use and resistance.

Coronavirus disease 2019 can be indistinguishable from lower respiratory tract infections (LRTIs) caused by other viral and bacterial agents. This likely contributed to antimicrobial use (AU) and antimicrobial resistance (AMR) during the pandemic. Our antimicrobial stewardship program targeted the selection and duration of therapy for LRTIs and led to a reduction in AU and AMR.

Real-world prevalence of integrase inhibitor resistance and virological failure since adoption as guideline-preferred therapy.

Background: Limited data reporting real-world prevalence of integrase strand transfer inhibitor resistance (INSTI-R) in the USA are available because their recommendation as first-line treatment in 2017. Reported national surveillance data in the USA estimated INSTI-R to be 6.3% as of 2018.

Evaluation of the P-Δ (P-Delta) effect in columns and frames using the two-cycle method based on the solution of the beam-column differential equation.

P-Delta is a nonlinear phenomenon that results from the consideration of axial loads acting on the deformed configuration of a member of the structure, usually a beam-column. This effect is especially significant in slender members, which can undergo large transversal displacements which tend to increase the bending moment caused by an axial load P acting upon them. The P-delta effect can be computed through a geometrically nonlinear analysis, usually employing the Finite Element Method, which subdivides each bar of the frame in finite segments known as elements.

Feasibility and impact of a monoclonal antibody infusion program in reaching vulnerable underserved communities.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted Black, indigenous, and people of color (BIPOC). Equitable access to therapeutics is key to addressing health disparities. We established a monoclonal infusion program in the emergency department of a safety-net hospital.

Antimicrobial stewardship and drug formulary restrictions during COVID-19: what is restricted and who decides?

COVID-19 therapies were challenging to deploy due to evolving literature and conflicting guidelines. Antimicrobial stewardship can help optimize drug use. We conducted a survey to understand the role of stewardship and formulary restrictions during the pandemic.

Remdesivir use and antimicrobial stewardship restrictions during the coronavirus disease 2019 (COVID-19) pandemic in the United States: A cross-sectional survey.

Deploying therapeutics for coronavirus disease 2019 (COVID-19) has proved challenging due to evolving evidence, supply shortages, and conflicting guideline recommendations. We conducted a survey on remdesivir use and the role of stewardship. Use differs significantly from guidelines.

Commonly Reported Mosquito-Borne Viruses in the United States: A Primer for Pharmacists.

Mosquito-borne diseases are a public health concern. Pharmacists are often a patient's first stop for health information and may be asked questions regarding transmission, symptoms, and treatment of mosquito borne viruses (MBVs). The objective of this paper is to review transmission, geographic location, symptoms, diagnosis and treatment of MBVs.

Clinical Evaluation of Meropenem-Vaborbactam Combination for the Treatment of Urinary Tract Infection: Evidence to Date.

As antimicrobial resistance continues to grow, one of the biggest threats includes the members of the Enterobacterales order presenting with carbapenem resistance (CRE). Meropenem-vaborbactam, along with other beta-lactam/beta-lactamase agents, has been developed to help combat this growing concern and is currently approved to treat complicated urinary tract infections (cUTI), as well as acute pyelonephritis (AP), in the USA. Vaborbactam is a novel beta-lactamase inhibitor designed specifically to optimize and restore the activity of meropenem against resistant Enterobacterales.

Influence of different Lachancea thermotolerans strains in the wine profile in the era of climate challenge.

The study performed sequential fermentations of red grape juice using several strains of Lachancea thermotolerans and one strain of Saccharomyces cerevisiae. Due to the new conditions imposed by climate change, wine acidity must be affected as well as the volatile profile. Non-Saccharomyces yeasts such as L.

Complete tangent stiffness matrix considering higher-order terms in the strain tensor and large rotations for a Euler Bernoulli - Timoshenko space beam-column element.

This paper presents a unified method developed by Rodrigues et al. [1] to obtain a complete tangent stiffness matrix for spatial geometric nonlinear analysis using minimal discretization. The formulation presents four distinct important aspects to a complete analysis: interpolation (shape) functions, higher-order terms in the strain tensor and in the finite rotations, an updated Lagrangian kinematic description, and shear deformation effect (Timoshenko beam theory).

Real-world impact of switching from tenofovir disoproxil fumarate to tenofovir alafenamide.

Although tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) have been evaluated in various clinical trials, limited safety and efficacy data exist in real-world settings. The goal of this retrospective analysis is to assess changes in virological suppression, immunological status, renal function, weight and body mass index (BMI) amongst people living with HIV who switched from a TDF-based to a TAF-based regimen. Of 130 patients included in the final analysis, 53 patients experienced an increase in their viral load upon switching from TDF to TAF therapy whilst 62 patients remained undetectable.

The race to a COVID-19 vaccine: opportunities and challenges in development and distribution.

The unprecedented toll of severe acute respiratory syndrome coronavirus 2, the virus responsible for coronavirus 2019 disease (COVID-19), jumpstarted the race towards the development and distribution of effective treatment and prevention options. With an urgent need to slow viral transmission, lessen disease severity, and reduce mortality, biopharmaceutical companies rapidly began investigating potential COVID-19 vaccinations. While typical vaccine development can take upwards of 10-15 years, COVID-19 vaccines were developed in less than a year after the identification of COVID-19.

Impact of Pharmacist-Driven Antiretroviral Stewardship and Transitions of Care Interventions on Persons With Human Immunodeficiency Virus.

Background: Persons with human immunodeficiency virus (HIV) experience high rates of medication-related errors when admitted to the inpatient setting. Data are lacking on the impact of a combined antiretroviral (ARV) stewardship and transitions of care (TOC) program. We investigated the impact of a pharmacist-driven ARV stewardship and TOC program in persons with HIV.

Trimethoprim-Sulfamethoxazole Associated Drug-Induced Liver Injury in Pediatrics: A Systematic Review.

Background: Drug-induced liver injury (DILI) is a rare but known adverse event associated with trimethoprim-sulfamethoxazole (TMP-SMX) in adults. No studies to date have looked at the risk of this association in children. We systematically reviewed the evidence for a potential association between TMP-SMX and DILI in the pediatric population.

Omadacycline: A Review of the Clinical Pharmacokinetics and Pharmacodynamics.

Omadacycline is a novel aminomethylcycline antibiotic (antibacterial). Omadacycline has had chemical structure modifications at the C9 and C7 positions of the core tetracycline rings that allow stability in the efflux pump and ribosomal protection protein mechanisms of tetracycline resistance. The systemic exposure (i.

Mycobacterium conceptionense Pneumonitis in Patient with HIV/AIDS.

Approximately 21 human cases of infection with Mycobacterium conceptionense have been reported. However, most cases were outside the United States, and optimal treatment remains uncertain. We report a case of M.

Omadacycline: a novel aminomethylcycline.

Tetracyclines have come a long way since they became available almost seven decades ago, with numerous enhancements allowing new agents to overcome bacterial mechanisms of resistance. However, these enhancements come with toxicities and pharmacokinetic disadvantages such as the gastrointestinal side-effects and poor oral bioavailability seen with the glycylcylcines. Omadacycline, a new and improved tetracycline, has demonstrated a broad spectrum of in vitro activity, has oral and intravenous formulations, improved safety compared to glycylcyclines, as well as clinical efficacy and safety for two types of infections: acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia.

ZTI-01 (fosfomycin for injection) in the treatment of hospitalized patients with complicated urinary tract infections.

Fosfomycin is a bactericidal antibiotic available since the 1970s whose intravenous formulation has been available in many countries outside the USA. Given the rise in drug-resistant bacteria, its introduction into the US market has become a necessity for addressing these organisms. This review provides an overview of the microbiology, clinical pharmacology and initial clinical experiences of the intravenous fosfomycin product (ZTI-01) that is undergoing clinical development in the USA for the treatment of complicated urinary tract infections and acute pyelonephritis.

Pharmacokinetic evaluation of meropenem and vaborbactam for the treatment of urinary tract infection.

Meropenem/vaborbactam (M/V) represents the first carbapenem and β-lactamase inhibitor combination approved for treatment of complicated urinary tract infections (cUTIs), including pyelonephritis. Vaborbactam is a novel boronic acid, β-lactamase inhibitor with a high affinity for serine β-lactamases, including Klebsiella pneumoniae carbapenemase (KPC). This combination, Vabomere™, was approved in August 2017 by the United States Food and Drug Administration for the treatment of cUTIs in patients 18 years or older, including pyelonephritis, caused by the following susceptible microorganisms: Escherichia coli, K.

Severe dyslipidaemia after the addition of raltegravir to a lopinavir/ritonavir-containing regimen.

We describe a 55-year-old HIV-1-infected male who developed severe dyslipidaemia (total cholesterol 600 mg/dl, triglycerides >5,000 mg/dl, high density lipoprotein <5 mg/dl) after raltegravir was added to his lopinavir/ritonavir-containing regimen. To our knowledge, this is the first reported case of severe dyslipidaemia associated with the addition of raltegravir to a lopinavir/ritonavir-based regimen, suggestive of a possible drug interaction. The lipid profile quickly normalized following discontinuation of lopinavir/ritonavir and continuation of raltegravir, suggesting that lopinavir/ritonavir was the primary driver for the adverse event.