Enfermedades infecciosas y microbiología clínica
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Enferm. Infecc. Microbiol. Clin. · Apr 2011
Review[Shedding light on the use of colistin: still gaps to be filled].
Colistin (polymyxin E), an old antibiotic replaced by other less toxic antibiotics in the 1970s, has been increasingly used over the last decade due to multidrug-resistance in Gram-negative bacteria and lack of new antibiotics. However, there is a dearth of information on the pharmacokinetics (PK), pharmacodynamics (PD) and toxicodynamics (TD) of colistin and its non-active prodrug colistimethate sodium (CMS). ⋯ Therefore, it is urgent to conduct prospective studies to optimise CMS/colistin use in patients, in particular the critically ill. This review summarises recent key clinical studies evaluating the efficacy, toxicity and PK/PD of colistin/CMS.
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Enferm. Infecc. Microbiol. Clin. · Apr 2011
[Low adherence to 2009 pandemic influenza A(H1N1) vaccination program among health care workers of a medical centre during the pandemic phase].
Several strategies have been designed to increase adherence to vaccination programs aimed at health professionals, though the results were not always satisfactory. ⋯ Adherence to pandemic influenza vaccination program was very low, which suggests the need to implement new strategies into vaccination programs. The main reason for vaccination was patient protection. The tolerability of the pandemic vaccine was good.
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Enferm. Infecc. Microbiol. Clin. · Mar 2011
Review[Drug interactions in critically-ill patients. An important factor in the use of micafungin?].
Currently there are three main drug groups for the prevention and treatment of fungal infections: polyenes (amphotericin B deoxycholate or its lipid formulations), azoles (fluconazole, itraconazole or posaconazole) and echinocandins (caspofungin, micafungin and anidulafungin). However, a major characteristic to be evaluated when choosing an antifungal agent -apart from antifungal spectrum, pharmacokinetics and adverse effects- is the absence of significant drug interactions. Amphotericin B lacks interactions but may cause renal dysfunction, leading to the accumulation of renally metabolized drugs. ⋯ The echinocandin with the highest number of interactions is caspofungin. Micafungin is an echinocandin lacking in relevant interactions and consequently its dosage requires no adjustment in any of its indications. This drug can be used both in adults and in the pediatric population, including neonates.