Clinical therapeutics
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Clinical therapeutics · Nov 2009
Multicenter StudyIn vitro activity and pharmacodynamics of commonly used antibiotics against adult systemic isolates of Escherichia coli and Pseudomonas aeruginosa at Forty US Hospitals.
Treatment of infections caused by gram-negative bacilli is increasingly challenging because of emerging resistance. Current surveillance data are informative, but may not discern differences by infection site and clinical setting, and do not incorporate pharmacodynamic (PD) characteristics when determining susceptibility. ⋯ These data suggest that susceptibility of E coli to commonly used antibiotics remains high (>90% for most drug classes), with the important exception of the fluoroquinolones; however, susceptibility of P aeruginosa is low enough to warrant concern. Attention to the source of the organism and the patient's location in an ICU or a ward-combined with knowledge of local epidemiology and PD principles--should prove valuable in empiric agent selection. Additionally, reassessment of breakpoints employing PD principles is recommended, particularly for fluoroquinolones and piperacillin/tazobactam.
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Clinical therapeutics · Nov 2009
Comparative StudyEconomic outcomes in patients diagnosed with systemic lupus erythematosus with versus without nephritis: results from an analysis of data from a US claims database.
Based on a literature search, there are limited data on the economic burden of systemic lupus erythematosus (SLE), particularly in patients with lupus nephritis. ⋯ The present data analysis found that patients with SLE with nephritis consumed significantly more health care resources, with >2.5-fold the costs, compared with those without nephritis. The majority (84%) of added costs were attributable to inpatient hospitalizations and outpatient services, and 16% were attributable to pharmacy services.
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Clinical therapeutics · Nov 2009
Randomized Controlled Trial Comparative StudyPharmacokinetics and bioequivalence of two formulations of rebamipide 100-mg tablets: a randomized, single-dose, two-period, two-sequence crossover study in healthy Korean male volunteers.
Rebamipide is a quinolinone-derived gastroprotective agent approved in Korea for the treatment of gastric ulcers, acute gastritis, and exacerbated chronic gastritis. ⋯ The results of this study in healthy Korean male volunteers suggest that the 2 rebamipide 100-mg tablet formulations administered in the fasted state met the regulatory criterion for bioequivalence. There was no evidence that rebamipide pharmacokinetic parameters were influenced by genetic polymorphisms in the ABCB1 gene (exons 21 and 26). ClinicalTrials.gov identifier: .
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Clinical therapeutics · Nov 2009
Validity of the adherence estimator in the prediction of 9-month persistence with medications prescribed for chronic diseases: a prospective analysis of data from pharmacy claims.
The aim of this article was to assess the predictive validity of the Adherence Estimator--a 3-item instrument designed to estimate a patient's propensity to adhere to medications prescribed for chronic disease. ⋯ In the present analysis of the validity of the Adherence Estimator in predicting adherence, baseline propensity to adhere to medications prescribed for chronic diseases was statistically associated with several measures of adherence and persistence, as derived from pharmacy claims data, over a 9-month period.
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Clinical therapeutics · Nov 2009
Association between previous health care use and initiation of inhaled corticosteroid and long-acting beta2-adrenergic agonist combination therapy among US patients with asthma.
Combination inhaled corticosteroid and long-acting beta(2)-adrenergic agonist (ICS/LABA) therapy is recommended for patients whose asthma is not adequately controlled by other maintenance therapies and for those with moderate to severe asthma. ⋯ Just under 40% of patients met the criteria for appropriate initiation of ICS/LABA therapy, with significantly greater proportions of BFC than FSC users meeting the overall and individual criteria for appropriate use. Patients with appropriate initiation of ICS/LABA therapy were significantly more likely to be treated by pulmonologists and allergists than by family medicine/general practitioners.