The Impact of Clinical Pharmacist-Driven Weekend Antimicrobial Stewardship Coverage at a Quaternary Hospital.

Background And Objective: Extending a consistent pharmacy antimicrobial stewardship weekend service was a newly implemented initiative. We sought to evaluate the impact of incorporating an Infectious Diseases (ID)-trained clinical pharmacist into an antimicrobial stewardship program (AMS) during weekends.

Results: The number of documented interventions was 451 on 362 patients compared to 115 interventions on 108 patients during the pre-implementation period ( = 0.

Towards artificial intelligence-based disease prediction algorithms that comprehensively leverage and continuously learn from real-world clinical tabular data systems.

This manuscript presents a proof-of-concept for a generalizable strategy, the full algorithm, designed to estimate disease risk using real-world clinical tabular data systems, such as electronic health records (EHR) or claims databases. By integrating classic statistical methods and modern artificial intelligence techniques, this strategy automates the production of a disease prediction model that comprehensively reflects the dynamics contained within the underlying data system. Specifically, the full algorithm parses through every facet of the data (e.

Efficacy and safety of ertapenem dosing in patients with ESBL producing infections utilizing renal replacement therapies.

Purpose: The clinical efficacy and safety of ertapenem use in patients undergoing renal replacement therapies (RRT) are not well-documented. Therefore, we aimed to investigate the safety and efficacy of ertapenem in patients with sepsis secondary to Enterobacterales who are undergoing RRT.

Methods: A retrospective cohort study was conducted on patients who met the inclusion criteria at our hospital between May 2015 and December 2021.

The Safety and Effectiveness of Apixaban in Patients with End-Stage Kidney Disease on Dialysis: A Retrospective Observational Study.

Apixaban has been increasingly utilized for various FDA-approved indications, including stroke prevention and venous thromboembolism (VTE) treatment in patients with end stage kidney disease (ESKD) on hemodialysis. However, the safety and efficacy of its use in this population is not well established. Hence, the purpose of this study is to evaluate the safety and effectiveness of apixaban by examining outcomes in this population.

Racial differences in P2Y12 inhibitor responsiveness in patients undergoing neuro-endovascular procedures: A cohort from the Middle East.

Background: Data on P2Y12 inhibitors responsiveness from the middle east is scarce. We sought to investigate patient responsiveness to P2Y12 inhibitors within a cohort of major races that characterize the UAE population. The secondary objective was to assess risk factors for hyper and hypo-responsiveness in this population.

The prevalence of cardiorenal anemia syndrome among patients with heart failure and its association with all-cause hospitalizations: a retrospective single-center study from the Middle East.

Background And Aim: Little is known about the burden of cardiorenal syndrome (CRS) and cardiorenal anemia syndrome (CRAS) in the Middle East Region. Furthermore, whether the occurrence rates of CRAS differ across heart failure (HF) phenotypes is not widely investigated. We aimed to examine the prevalence of CRS and CRAS in patients with HF, compare characteristics of patients with CRAS-HFrEF vs.

A Case of Hemorrhagic Cholecystitis in a Patient on Apixaban After COVID-19 Infection.

BACKGROUND Hemorrhagic cholecystitis is a rare cause of abdominal pain, which can result from malignancy, bleeding, or trauma. The presentation, which includes right upper-quadrant pain, nausea, and vomiting, can overlap with other disease states, thereby rendering the diagnosis challenging. CASE REPORT We describe a patient taking apixaban wo had paroxysmal atrial fibrillation with history of joint pain on long-term steroids who developed hemorrhagic cholecystitis following an episode of pneumonia secondary to SARS-CoV-2 virus (COVID-19) infection.

Clinical outcomes of ceftolozane-tazobactam dosing in patients with sepsis undergoing renal replacement therapies.

Unlabelled: Ceftolozane-tazobactam (C/T) recommended dosing in patients undergoing renal replacement therapies (RRT) is lacking evidence. The objective of this study was to evaluate the clinical outcomes of C/T dosing in patients on RRT.

Materials And Methods: A retrospective descriptive study conducted at our institution between May 1, 2017, and March 15, 2022.

Sustaining Life versus Altering Life-Saving Drugs: Insights to Explain the Paradoxical Effect of Extracorporeal Membrane Oxygenation on Drugs.

There has been a substantial increase in the use of extracorporeal membrane oxygenation (ECMO) support in critically ill adults. Understanding the complex changes that could affect drugs' pharmacokinetics (PK) and pharmacodynamics (PD) is of suitable need. Therefore, critically ill patients on ECMO represent a challenging clinical situation to manage pharmacotherapy.

Microbiologic outcomes of ceftazidime-avibactam dosing in patients with sepsis utilizing renal replacement therapies.

Introduction: The suggested dose of ceftazidime-avibactam (CEF/AVI) in patient with multidrug resistant organisms and utilizing renal replacement therapies (RRTs) is not validated in clinical studies. The objective of this study was to evaluate the microbiologic cure of bacteremia and pneumonia using the recommended CEF/AVI dosing in patients utilizing RRT.

Methods: A retrospective observational study conducted at our institution between September 15, 2018 and March 15, 2022.

Polypharmacy in cardiorenal syndrome patients.

Cardiorenal syndrome (CRS) is a term defined as complex interactions between concomitant cardiac and renal dysfunction in which disease of one organ initiates, perpetuates, and/or accelerates the decline in the other. It accounts for a third of presentations with heart failure and is associated with poor clinical outcomes. Polypharmacy (defined as using five or more medications) is common in CRS patients and is associated with worst clinical outcomes.

Urinary tract infections in hemodialysis patients-The controversy of antimicrobial drug urine concentrations.

Background: Major infectious diseases societies recommend the use of antimicrobials that achieve high-urinary concentrations to treat urinary tract infection (UTI), which is a concept of little relevance to the oliguric and anuric hemodialysis (HD) dependent population. Outcome studies in this population are more relevant, but unfortunately scarce. We sought to investigate the impact of different antimicrobials on clinical and microbiologic outcomes in HD dependent population.

Is Cefoxitin a Carbapenem Sparing Agent in the Management of Urinary Tract Infections Caused by ESBL Producing ?

Cefoxitin has shown in vitro activity against Extended-Spectrum β-Lactamase (ESBL) producing . Outcome data regarding cefoxitin as a carbapenem sparing agent in the management of urinary tract infections (UTI) are scarce. We sought to evaluate the clinical and microbiologic efficacy of cefoxitin as compared to ertapenem.

Assessment of antibiotic appropriateness at discharge: experience from a quaternary care hospital setting.

Background: There is a gap in antimicrobial stewardship in transitions of care.

Objectives: To assess the appropriateness of antibiotics utilized and prescribing habits at hospital discharge.

Methods: A retrospective, observational study was conducted at our quaternary care hospital between January 2021 and March 2021.

Outcomes of caspofungin use in the treatment of -related urinary tract infections, a case series.

Echinocandins are generally excluded in the treatment of related urinary tract infections due to their poor urinary concentration. In the presence of fluconazole resistant species, such as and , alternative therapies are needed. We herein report the use of caspofungin for the treatment of 10 patients with candiduria, including .

Tocilizumab and COVID-19: Timing of Administration and Efficacy.

Elevated concentrations of interleukin-6 have been demonstrated to be an important key factor in COVID-19 host immune impairment. It represents an important prognostic factor of harm associated with COVID-19 infection by stimulating a vigorous proinflammatory response, leading to the so-called "cytokine storm". Therefore, immunomodulatory interventions targeting interleukin-6 receptor antagonism have been investigated as potential treatments to counterbalance the host immune dysregulation and to support the advantageous effects of corticosteroids.

QT Prolongation in Critically Ill Patients With SARS-CoV-2 Infection.

Background: Several reports linked the use of repurposed drugs such as hydroxychloroquine (HCQ), azithromycin, lopinavir/ritonavir, and favipiravir with QT interval prolongation in patients with SARS-CoV2 infection. Little is known about the risk factors for QT interval prolongation in this population. We sought to describe the prevalence and identify the main risk factors associated with clinically significant corrected QT (QTc) prolongation in this population.

Practical considerations for vancomycin dosing in hemodialysis patients: Perspectives from the nephrology stewardship pharmacist.

Background: Vancomycin remains the principal antibiotic used to treat methicillin-resistant in patients with chronic kidney disease stage 5 utilizing hemodialysis (CKD-5D). The recent guidelines have added comprehensive dosing guidance to assist clinicians optimize vancomycin dosing in this population. The purpose of this review was to elaborate on additional practical and stewardship considerations which clinicians may apply in this unique patient population.

Clinical Pharmacokinetics and Pharmacodynamics of Desmoteplase.

Desmoteplase is a bat (Desmodus rotundus) saliva-derived fibrinolytic enzyme resembling a urokinase and tissue plasminogen activator. It is highly dependent on fibrin and has some neuroprotective attributes. Intravenous administration of desmoteplase is safe and well tolerated in healthy subjects.

Risk Factors for Recurrence of Clostridioides difficile in Hospitalized Patients.

Background: Diarrhea and pseudomembranous colitis associated with Clostridioides difficile - a spore-forming anaerobic Gram-positive bacillus - is a major infection in hospitalized patients with a profound impact on clinical and economic outcomes. Recurrence (rCDI) is common and predisposes to further episodes with poor outcomes.

Method: We aimed to identify a wide range of risk factors for recurrence to guide stewardship initiatives.

Hypertriglyceridemia in Critically Ill Patients With SARS-CoV-2 Infection.

Background: Patients with SARS-CoV-2 infection could develop severe disease requiring critical care admission. Case reports indicated high incidence of hypertriglyceridemia (HTG) in critically ill patients infected with SARS-CoV-2, which might be related to the drugs.

Objective: We sought to determine the risk factors associated with HTG in this population and to investigate the relationship between HTG and lipase.