S Enners, G Gradl, M Kieble, O Iliescu, L Freudewald, A Said, M Schulz
The current conflict between Russia and Ukraine increased concerns in the German population of a release of radioactive substances, e.g.radioactive iodine. A high dose of potassium iodide (PI) may prevent accumulation of radioactive iodine in the thyroid gland. Therefore, the German government keeps a sufficient quantity of PI in stock for public supply in case of an emergency. We investigated ambulatory drug dispensing rates of PI and found that the total dispensing of PI (statutory health insurance (SHI), private health insurance (PHI), and overthe-counter (OTC)) increased by 106% from February to March 2022. Changes in PI dispensing were mainly due to an increase in OTC sales, where PI as an antidote showed a sevenfold increase from around 930 packages (February 2022) to 6,500 packages (March 2022), while SHI and PHI dispensing remained relatively low. Furthermore, we investigated whether these changes in dispensing raised the number of suspected adverse drug reactions (ADR). We found no increase of ADR reports related to the use of PI-containing medicinal products between February and September 2022, neither in our national pharmacovigilance nor in the European EudraVigilance database. The data suggest that the mere possibility of a nuclear disaster in Ukraine raised the demand of PI in Germany. Thus, timely and proactive information and reassurance of the public of supply reliability by the Government in a case of a nuclear emergency could be helpful in preventing potential drug shortages and unfounded concern.
{"title":"Increased Demand for Pharmaceutical Drugs Containing Potassium Iodide In Connection with the Russia-Ukraine Conflict.","authors":"S Enners, G Gradl, M Kieble, O Iliescu, L Freudewald, A Said, M Schulz","doi":"10.1691/ph.2023.2541","DOIUrl":"https://doi.org/10.1691/ph.2023.2541","url":null,"abstract":"<p><p>The current conflict between Russia and Ukraine increased concerns in the German population of a release of radioactive substances, e.g.radioactive iodine. A high dose of potassium iodide (PI) may prevent accumulation of radioactive iodine in the thyroid gland. Therefore, the German government keeps a sufficient quantity of PI in stock for public supply in case of an emergency. We investigated ambulatory drug dispensing rates of PI and found that the total dispensing of PI (statutory health insurance (SHI), private health insurance (PHI), and overthe-counter (OTC)) increased by 106% from February to March 2022. Changes in PI dispensing were mainly due to an increase in OTC sales, where PI as an antidote showed a sevenfold increase from around 930 packages (February 2022) to 6,500 packages (March 2022), while SHI and PHI dispensing remained relatively low. Furthermore, we investigated whether these changes in dispensing raised the number of suspected adverse drug reactions (ADR). We found no increase of ADR reports related to the use of PI-containing medicinal products between February and September 2022, neither in our national pharmacovigilance nor in the European EudraVigilance database. The data suggest that the mere possibility of a nuclear disaster in Ukraine raised the demand of PI in Germany. Thus, timely and proactive information and reassurance of the public of supply reliability by the Government in a case of a nuclear emergency could be helpful in preventing potential drug shortages and unfounded concern.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"78 1","pages":"17-19"},"PeriodicalIF":1.6,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Town Hall Pharmacy (Raeapteek) in the Town Hall Square of Tallinn, Estonia (N59°26'16.001'' E24°44'45.412'') was first mentioned in historical records on 8 April 1422. To our best knowledge, the Raeapteek is the oldest community pharmacy in Europe which has operated on the same premises since the beginning. There are several hypotheses about the actual opening time of Raeapteek: it is possible that the pharmacy was operating on the square of the Tallinn Town Hall as early as in 1415, 1420, 1392 or even in 1248. In the territory of present-day Estonia, two pharmacies (in Tartu first mentioned in 1430) were already in business in less than 200 kilometres from each other before community pharmacies were opened in Russia, Sweden, Finland, Norway, Denmark, Lithuania, and other cities. The Raeapteek played an essential role in the establishment of the current Estonian History Museum, the Estonian Pharmaceutical Factory, K. C. Fick's faience manufactory and other dignified institutions had their beginning at the pharmacy. Now, the pharmacy functions hand-in-hand with the museum which is supported by the city of Tallinn.
位于爱沙尼亚塔林市政厅广场(N59°26'16.001 " E24°44'45.412 ")的市政厅药房(Raeapteek)于1422年4月8日首次在历史记录中被提及。据我们所知,Raeapteek是欧洲最古老的社区药房,从一开始就在同一场所经营。关于Raeapteek的实际开业时间有几种假设:早在1415年、1420年、1392年甚至1248年,这家药店就可能在塔林市政厅的广场上营业。在今天的爱沙尼亚境内,早在俄罗斯、瑞典、芬兰、挪威、丹麦、立陶宛和其他城市开设社区药店之前,就有两家药店(1430年在塔尔图首次被提及)在相距不到200公里的地方开始营业。Raeapteek在建立目前的爱沙尼亚历史博物馆、爱沙尼亚制药厂、K. C. Fick的瓷器厂和其他有尊严的机构方面发挥了重要作用,它们都是从药房开始的。现在,药房与博物馆携手并进,博物馆由塔林市支持。
{"title":"600 Years of Town Hall Pharmacy (raeapteek) in Tallinn, Estonia.","authors":"A Raal, J Koppel","doi":"10.1691/ph.2023.2065","DOIUrl":"https://doi.org/10.1691/ph.2023.2065","url":null,"abstract":"<p><p>The Town Hall Pharmacy (Raeapteek) in the Town Hall Square of Tallinn, Estonia (N59°26'16.001'' E24°44'45.412'') was first mentioned in historical records on 8 April 1422. To our best knowledge, the Raeapteek is the oldest community pharmacy in Europe which has operated on the same premises since the beginning. There are several hypotheses about the actual opening time of Raeapteek: it is possible that the pharmacy was operating on the square of the Tallinn Town Hall as early as in 1415, 1420, 1392 or even in 1248. In the territory of present-day Estonia, two pharmacies (in Tartu first mentioned in 1430) were already in business in less than 200 kilometres from each other before community pharmacies were opened in Russia, Sweden, Finland, Norway, Denmark, Lithuania, and other cities. The Raeapteek played an essential role in the establishment of the current Estonian History Museum, the Estonian Pharmaceutical Factory, K. C. Fick's faience manufactory and other dignified institutions had their beginning at the pharmacy. Now, the pharmacy functions hand-in-hand with the museum which is supported by the city of Tallinn.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"78 1","pages":"20-25"},"PeriodicalIF":1.6,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bin Sun, Xiaofei Liu, Xiuwei Sun, Yingjie Zhou, Xiaoqing Gong, Longfei Mao, Weichen Shi, Peng Deng, Lin Shi
To explore potential indoleamine 2,3-dioxygenase 1 (IDO1) inhibitors, we designed a series of compounds incorporating urea and 1,2,3-triazole structures. IDO1 enzymatic activity experiments with the synthesized compounds were used to verify their molecular-level activity; for instance, the half maximal inhibitory concentration value of compound 3c was 0.07 μM. Our research has yielded a series of novel IDO1 inhibitors which may be beneficial in the development of drugs targeting IDO1 for cancer treatment.
{"title":"Novel Compounds with Promising IDO1 Inhibitory Activity As New Cancer Drug Candidates: Derivatives Of N, N'-diphenylurea Linked With 1,2,3-triazole.","authors":"Bin Sun, Xiaofei Liu, Xiuwei Sun, Yingjie Zhou, Xiaoqing Gong, Longfei Mao, Weichen Shi, Peng Deng, Lin Shi","doi":"10.1691/2023.2552","DOIUrl":"https://doi.org/10.1691/2023.2552","url":null,"abstract":"<p><p>To explore potential indoleamine 2,3-dioxygenase 1 (IDO1) inhibitors, we designed a series of compounds incorporating urea and 1,2,3-triazole structures. IDO1 enzymatic activity experiments with the synthesized compounds were used to verify their molecular-level activity; for instance, the half maximal inhibitory concentration value of compound 3c was 0.07 μM. Our research has yielded a series of novel IDO1 inhibitors which may be beneficial in the development of drugs targeting IDO1 for cancer treatment.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"78 1","pages":"2-5"},"PeriodicalIF":1.6,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study aimed to investigate the efficacy and safety of flumatinib in patients newly diagnosed with chronic myeloid leukemia in the chronic phase (CML-CP). A retrospective study was conducted using five patients newly diagnosed with CML-CP who received flumatinib (600 mg/day). Results of the present study demonstrated that all five patients with CML-CP that were treated with flumatinib achieved the optimal molecular response within three months. In addition, two patients experienced major molecular response (MMR), and one patient acquired undetectable molecular residual disease, which was maintained for more than one year. Moreover, one patient exhibited grade 3 hematological toxicity, two patients exhibited transient diarrhea, one patient exhibited vomiting and one patient exhibited a rash with pruritus. No second-generation tyrosine kinase inhibitor-specific adverse cardiovascular events occurred in any patients. In conclusion, flumatinib exhibits high efficacy and high early molecular response rate in patients newly diagnosed with CML-CP. The majority of patients obtained MMR within three months, and the adverse reactions experienced were mild and tolerable.
{"title":"Clinical Efficacy and Safety of Flumatinib in Newly Diagnosed Chronic Myelogenous Leukemia.","authors":"Lei Jiang, Mingzhen Yang","doi":"10.1691/ph.2023.2536","DOIUrl":"https://doi.org/10.1691/ph.2023.2536","url":null,"abstract":"<p><p>The present study aimed to investigate the efficacy and safety of flumatinib in patients newly diagnosed with chronic myeloid leukemia in the chronic phase (CML-CP). A retrospective study was conducted using five patients newly diagnosed with CML-CP who received flumatinib (600 mg/day). Results of the present study demonstrated that all five patients with CML-CP that were treated with flumatinib achieved the optimal molecular response within three months. In addition, two patients experienced major molecular response (MMR), and one patient acquired undetectable molecular residual disease, which was maintained for more than one year. Moreover, one patient exhibited grade 3 hematological toxicity, two patients exhibited transient diarrhea, one patient exhibited vomiting and one patient exhibited a rash with pruritus. No second-generation tyrosine kinase inhibitor-specific adverse cardiovascular events occurred in any patients. In conclusion, flumatinib exhibits high efficacy and high early molecular response rate in patients newly diagnosed with CML-CP. The majority of patients obtained MMR within three months, and the adverse reactions experienced were mild and tolerable.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"78 1","pages":"13-16"},"PeriodicalIF":1.6,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9863837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yeahwa Yoon, Seunghee Bae, Tae Jin Kim, Sungkwan An, Jae Ho Lee
The aim of the present study was to investigate the potential inhibitory effects of nodakenin, a coumarin glucoside derivative from the root extract of Angelica gigas Nakai (AGN), on melanogenesis and its underlying mechanisms in B16F10 melanoma cells. The inhibitory effects of nodakenin on melanogenesis were evaluated by determining melanin contents and tyrosinase activity in α -melanocyte stimulating hormone (α-MSH)-treated B16F10 melanoma cells. The mechanisms associated with the anti-pigmentation effect of nodakenin were investigated by quantitative real-time PCR and immunoblotting analysis. Using the UVB-irradiated conditioned media culture system and UVB-irradiated co-cultivation system of HaCaT keratinocytes and B16F10 melanoma cells mimicking in vivo melanin biosynthesis, the effect of nodakenin on melanin production was evaluated. Melanin content analysis showed that nodakenin decreased cellular melanin biosynthesis in α-MSH-treated B16F10 cells. Immunoblotting revealed that CREB phosphorylation, MITF, a mastering transcription factor of melanogenesis and its downstream genes tyrosinase, tyrosinase-related protein 1, and tyrosinase-related protein 2 were downregulated by nodakenin in a dose-dependent manner. Interestingly, nodakenin did not affect the phosphorylation of PKA and p38 MAPK but the phosphorylation of ERK1/2 and MSK1. In addition, the inhibition of melanin accumulation by nodakenin in the UVB-irradiated conditioned media culture system and UVB-irradiated co-cultivation system of HaCaT and B16F10 cells suggests that nodakenin has potential as an anti-pigmentation activity. These data suggest that nodakenin inhibits the melanogenesis in B16F10 cells by interfering the ERK/ MSK1/CREB axis and thus preventing MITF expression.
{"title":"Nodakenin Inhibits Melanogenesis Via the ERK/MSK1 Signaling Pathway.","authors":"Yeahwa Yoon, Seunghee Bae, Tae Jin Kim, Sungkwan An, Jae Ho Lee","doi":"10.1691/ph.2023.2490","DOIUrl":"https://doi.org/10.1691/ph.2023.2490","url":null,"abstract":"<p><p>The aim of the present study was to investigate the potential inhibitory effects of nodakenin, a coumarin glucoside derivative from the root extract of <i>Angelica gigas</i> Nakai (AGN), on melanogenesis and its underlying mechanisms in B16F10 melanoma cells. The inhibitory effects of nodakenin on melanogenesis were evaluated by determining melanin contents and tyrosinase activity in α -melanocyte stimulating hormone (α-MSH)-treated B16F10 melanoma cells. The mechanisms associated with the anti-pigmentation effect of nodakenin were investigated by quantitative real-time PCR and immunoblotting analysis. Using the UVB-irradiated conditioned media culture system and UVB-irradiated co-cultivation system of HaCaT keratinocytes and B16F10 melanoma cells mimicking <i>in vivo</i> melanin biosynthesis, the effect of nodakenin on melanin production was evaluated. Melanin content analysis showed that nodakenin decreased cellular melanin biosynthesis in α-MSH-treated B16F10 cells. Immunoblotting revealed that CREB phosphorylation, MITF, a mastering transcription factor of melanogenesis and its downstream genes tyrosinase, tyrosinase-related protein 1, and tyrosinase-related protein 2 were downregulated by nodakenin in a dose-dependent manner. Interestingly, nodakenin did not affect the phosphorylation of PKA and p38 MAPK but the phosphorylation of ERK1/2 and MSK1. In addition, the inhibition of melanin accumulation by nodakenin in the UVB-irradiated conditioned media culture system and UVB-irradiated co-cultivation system of HaCaT and B16F10 cells suggests that nodakenin has potential as an anti-pigmentation activity. These data suggest that nodakenin inhibits the melanogenesis in B16F10 cells by interfering the ERK/ MSK1/CREB axis and thus preventing MITF expression.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"78 1","pages":"6-12"},"PeriodicalIF":1.6,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9863838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L Sutthapitaksakul, K Thanawuth, K Huanbutta, P Sriamornsak
The disintegration time is critical for characterizing orally disintegrating tablets (ODTs), according to regulatory standards. The current study aimed to assess the effect of superdisintegrants such as sodium starch glycolate, croscarmellose sodium, and crospovidone on the disintegration of ODTs using simulated wetting and in vitro disintegration tests. The results showed that the wetting time of ODTs containing sodium starch glycolate and croscarmellose sodium was 17 - 21 s, but the wetting time of ODTs containing crospovidone was 9 - 12 s. In contrast, there was no significant difference in in vitro disintegration time among ODTs using different disintegrants (ca. 14 to 18 s) The quick wetting time of ODTs with crospovidone may be attributed to strong capillary characteristics of crospovidone. It is suggested that determining the disintegration time of ODTs just through simulated wetting test is insufficient and may lead to biases. As a result of the findings, it is recommended that an additional disintegration test, imitating saliva fluid absorption and tablet breaking, to provide a more precise evaluation of ODTs.
{"title":"Effect of a superdisintegrant on disintegration of orally disintegrating tablets determined by simulated wetting test and <i>in vitro</i>disintegration test.","authors":"L Sutthapitaksakul, K Thanawuth, K Huanbutta, P Sriamornsak","doi":"10.1691/ph.2022.2015","DOIUrl":"https://doi.org/10.1691/ph.2022.2015","url":null,"abstract":"<p><p>The disintegration time is critical for characterizing orally disintegrating tablets (ODTs), according to regulatory standards. The current study aimed to assess the effect of superdisintegrants such as sodium starch glycolate, croscarmellose sodium, and crospovidone on the disintegration of ODTs using simulated wetting and <i>in vitro</i> disintegration tests. The results showed that the wetting time of ODTs containing sodium starch glycolate and croscarmellose sodium was 17 - 21 s, but the wetting time of ODTs containing crospovidone was 9 - 12 s. In contrast, there was no significant difference in <i>in vitro</i> disintegration time among ODTs using different disintegrants (ca. 14 to 18 s) The quick wetting time of ODTs with crospovidone may be attributed to strong capillary characteristics of crospovidone. It is suggested that determining the disintegration time of ODTs just through simulated wetting test is insufficient and may lead to biases. As a result of the findings, it is recommended that an additional disintegration test, imitating saliva fluid absorption and tablet breaking, to provide a more precise evaluation of ODTs.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"287-290"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Xiong, Xinyue Zheng, Yongmei Xie, Youling Gong, Y I Luo
BRAF V600E-mutated colorectal cancer (CRC) is very aggressive and responds poorly to standard treatment. In this study, BRAFV600E-mutant mice with CRC were treated with intragastric cyasterone, a compound commonly used in traditional Chinese herbal medicine, for 21 days. Microbial DNA was extracted from mouse intestinal contents for 16S ribosomal RNA gene amplicon sequencing and analyzed. Our results indicated that cyasterone enhanced the diversity of the gut microbiota. The abundance of beneficial bacteria, such as Prevotellaceae, Muribaculaceae, and Ruminococcaceae was significantly higher in cyasterone-treated mice than controls. The abundance of Erysipelotrichaceae, a family of bacteria that promotes inflammation in the gut, was significantly positively correlated with tumor weight. Cyasterone is a potential inhibitor of BRAFV600E-mutant CRC via its effects on intestinal flora.
{"title":"Effect of cyasterone on intestinal flora in a <i><sup>BRAF</sup></i>V600E-mutant mouse model of colorectal cancer.","authors":"Ying Xiong, Xinyue Zheng, Yongmei Xie, Youling Gong, Y I Luo","doi":"10.1691/ph.2022.2422","DOIUrl":"https://doi.org/10.1691/ph.2022.2422","url":null,"abstract":"<p><p><i>BRAF <sup>V600E</sup></i>-mutated colorectal cancer (CRC) is very aggressive and responds poorly to standard treatment. In this study, <i>BRAF<sup>V600E</sup></i>-mutant mice with CRC were treated with intragastric cyasterone, a compound commonly used in traditional Chinese herbal medicine, for 21 days. Microbial DNA was extracted from mouse intestinal contents for 16S ribosomal RNA gene amplicon sequencing and analyzed. Our results indicated that cyasterone enhanced the diversity of the gut microbiota. The abundance of beneficial bacteria, such as Prevotellaceae, Muribaculaceae, and Ruminococcaceae was significantly higher in cyasterone-treated mice than controls. The abundance of Erysipelotrichaceae, a family of bacteria that promotes inflammation in the gut, was significantly positively correlated with tumor weight. Cyasterone is a potential inhibitor of <i>BRAF<sup>V600E</sup></i>-mutant CRC <i>via</i> its effects on intestinal flora.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"291-294"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antimicrobials should be used appropriately to minimise the risk of resistant strains arising in association with overuse. De-escalation of antimicrobial therapy is one strategy used to ensure appropriate use, but its safety and efficacy in burn patients are unclear. The aim of this study was to evaluate the safety and efficacy of de-escalation therapy for treating infections in burn patients. This retrospective cohort study investigated patients admitted to our intensive care unit with burns and treated for infection between October 1, 2013, and September 30, 2020. Patients were classified into a de-escalation group (Group D) comprising patients treated with empiric antimicrobial therapy followed by de-escalation and a non-de-escalation group (Group ND) comprising patients who did not undergo de-escalation. Characteristics and outcomes were compared between groups. Forty-three patients met the inclusion criteria, including 15 patients in Group D and 28 patients in Group ND. Bacterial species commonly detected in these patients were Corynebacterium spp. (17.3%), Pseudomonas aeruginosa (16.1%), and Staphylococcus aureus (9.6%) . No inter-group difference was seen in 28-day mortality (6.7% vs 21.4%, p =0.391). Multidrug-resistant strains were detected significantly less frequently in Group D (13.0%) than in Group ND (26.1%, p =0.003). De-escalation was associated with use of two or more antimicrobials as empiric antimicrobial therapy. As the use of de-escalation in infection treatment did not impact 28-day mortality, de-escalation might be safe for treating infections in burn patients.
应适当使用抗菌素,以尽量减少因过度使用而产生耐药菌株的风险。抗菌药物治疗的降级是一种确保适当使用的策略,但其在烧伤患者中的安全性和有效性尚不清楚。本研究的目的是评估降级疗法治疗烧伤患者感染的安全性和有效性。这项回顾性队列研究调查了2013年10月1日至2020年9月30日期间因烧伤和感染接受治疗的重症监护病房患者。患者被分为降级组(D组),包括接受经验性抗菌药物治疗的患者,随后降级;非降级组(ND组),包括未接受降级治疗的患者。比较两组间的特征和结果。43例患者符合纳入标准,其中D组15例,ND组28例。检出的细菌种类主要为棒状杆菌(17.3%)、铜绿假单胞菌(16.1%)和金黄色葡萄球菌(9.6%)。28天死亡率组间无差异(6.7% vs 21.4%, p =0.391)。D组多药耐药菌株检出率(13.0%)显著低于ND组(26.1%,p =0.003)。降级与使用两种或两种以上抗菌素作为经验性抗菌素治疗有关。由于在感染治疗中使用降级治疗不会影响28天死亡率,因此降级治疗烧伤患者感染可能是安全的。
{"title":"Evaluating the impact of de-escalating antimicrobial therapy in burn patients: a retrospective cohort study.","authors":"Y Kohama, M Kosugi, M Arakawa, S Hidaka","doi":"10.1691/ph.2022.2455","DOIUrl":"https://doi.org/10.1691/ph.2022.2455","url":null,"abstract":"<p><p>Antimicrobials should be used appropriately to minimise the risk of resistant strains arising in association with overuse. De-escalation of antimicrobial therapy is one strategy used to ensure appropriate use, but its safety and efficacy in burn patients are unclear. The aim of this study was to evaluate the safety and efficacy of de-escalation therapy for treating infections in burn patients. This retrospective cohort study investigated patients admitted to our intensive care unit with burns and treated for infection between October 1, 2013, and September 30, 2020. Patients were classified into a de-escalation group (Group D) comprising patients treated with empiric antimicrobial therapy followed by de-escalation and a non-de-escalation group (Group ND) comprising patients who did not undergo de-escalation. Characteristics and outcomes were compared between groups. Forty-three patients met the inclusion criteria, including 15 patients in Group D and 28 patients in Group ND. Bacterial species commonly detected in these patients were <i>Corynebacterium</i> spp. (17.3%), <i>Pseudomonas aeruginosa</i> (16.1%), and <i>Staphylococcus aureus</i> (9.6%) <i>.</i> No inter-group difference was seen in 28-day mortality (6.7% vs 21.4%, <i>p</i> =0.391). Multidrug-resistant strains were detected significantly less frequently in Group D (13.0%) than in Group ND (26.1%, <i>p</i> =0.003). De-escalation was associated with use of two or more antimicrobials as empiric antimicrobial therapy. As the use of de-escalation in infection treatment did not impact 28-day mortality, de-escalation might be safe for treating infections in burn patients.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"311-315"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V Hindelang, K Dimitriadis, T Saller, K Golla, H Mannell, M J Hug, D Strobach
Structured risk screening for postoperative delirium (POD) considering prehospital medication is not established. We aimed to develop a POD-risk prediction score based on known risk factors and delirium-risk increasing drugs to be used by pharmacists during medication reconciliation at hospital admission, and to test for feasibility in a retrospective cohort of surgical patients. Therefore, established POD-risk factors and drugs were extracted from the literature and a score was generated. Following this, the score was tested for feasibility in a retrospective 3-month-cohort of surgical patients. For patients with higher scores suggesting higher probability of POD, patient charts were screened for documentation of POD. For development of the score, the following POD-risk factors were defined and points assigned for score calculation: age (≥65 years=1 point/≥75 years=2), male sex (1), renal insufficiency (RI; 1), hepatic impairment (HI; Model-of-endstage-liver-disease (MELD) 10-14=1/≥15=2), delirium-risk increasing drugs (1 point per drug class), anticholinergic drug burden (ACB; ≥3=1). In the retrospective test cohort of 1174 surgical patients these factors concerned: age ≥65 years 567 patients (48%)/≥75 years 303 (26%), male 652 (55%), RI 238 (20%), MELD 10-14 106 (9%)/≥15 65 (5%), ≥ 1 delirium-risk increasing drug 418 (36%), ACB ≥3 106 (9%). The median POD-risk prediction score was 2 (range 0-9). Of 146 patients (12%) with a score ≥ 5, POD was documented for 43 (30%), no evidence for POD for 91 (62%) and data inconclusive for 12 (8%). For scores of ≥ 7, POD was documented for 50% of the patients with sufficient POD documentation. Overall, POD documentation was poor. To summarize, we developed and successfully tested the feasibility of a POD-prediction-score assessable by pharmacists at medication reconciliation at hospital admission.
{"title":"A new medication-based prediction score for postoperative delirium in surgical patients: Development and proof of feasibility in a retrospective patient cohort.","authors":"V Hindelang, K Dimitriadis, T Saller, K Golla, H Mannell, M J Hug, D Strobach","doi":"10.1691/ph.2022.2438","DOIUrl":"https://doi.org/10.1691/ph.2022.2438","url":null,"abstract":"<p><p>Structured risk screening for postoperative delirium (POD) considering prehospital medication is not established. We aimed to develop a POD-risk prediction score based on known risk factors and delirium-risk increasing drugs to be used by pharmacists during medication reconciliation at hospital admission, and to test for feasibility in a retrospective cohort of surgical patients. Therefore, established POD-risk factors and drugs were extracted from the literature and a score was generated. Following this, the score was tested for feasibility in a retrospective 3-month-cohort of surgical patients. For patients with higher scores suggesting higher probability of POD, patient charts were screened for documentation of POD. For development of the score, the following POD-risk factors were defined and points assigned for score calculation: age (≥65 years=1 point/≥75 years=2), male sex (1), renal insufficiency (RI; 1), hepatic impairment (HI; Model-of-endstage-liver-disease (MELD) 10-14=1/≥15=2), delirium-risk increasing drugs (1 point per drug class), anticholinergic drug burden (ACB; ≥3=1). In the retrospective test cohort of 1174 surgical patients these factors concerned: age ≥65 years 567 patients (48%)/≥75 years 303 (26%), male 652 (55%), RI 238 (20%), MELD 10-14 106 (9%)/≥15 65 (5%), ≥ 1 delirium-risk increasing drug 418 (36%), ACB ≥3 106 (9%). The median POD-risk prediction score was 2 (range 0-9). Of 146 patients (12%) with a score ≥ 5, POD was documented for 43 (30%), no evidence for POD for 91 (62%) and data inconclusive for 12 (8%). For scores of ≥ 7, POD was documented for 50% of the patients with sufficient POD documentation. Overall, POD documentation was poor. To summarize, we developed and successfully tested the feasibility of a POD-prediction-score assessable by pharmacists at medication reconciliation at hospital admission.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"302-306"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Long-term voriconazole use may increase the risk of cutaneous squamous cell carcinoma (cSCC), especially in immunocompromised patients. However, relatively little is known regarding voriconazole-induced cSCC in Japan. Thus, the purpose of this study was to evaluate the association between voriconazole use and cSCC in Japan using different national pharmacovigilance databases. First, using the Japanese Adverse Drug Event Report (JADER) database, we evaluated the association between voriconazole use and cSCC in Japan. Second, using the U. S. Food and Drug Administration Adverse Event Reporting System (FAERS) database, we examined regional differences in the occurrence of voriconazole-induced cSCC between Japan and other countries. We calculated reporting odds ratios (RORs) as disproportionality analysis to evaluate voriconazole-induced cSCC. In this study, cases in which one or more of "Bowen's disease", "Carcinoma in situ of skin", "Keratoacanthoma", "Squamous cell carcinoma in skin", or "Squamous cell carcinoma" were reported as adverse events were considered to be cSCC cases. The analysis based on the JADER database showed an association between voriconazole use and cSCC in Japan, with a ROR (95% confidence interval) of 35.37 (25.60-48.87). Further, the analysis based on the FAERS database revealed that signals were detected in Japan as well as in Western countries and Australia. This study is the first in which the association between voriconazole use and cSCC in Japan is assessed using national pharmacovigilance databases. Healthcare providers need to be fully aware of the potential for cSCC development owing to voriconazole use and in all countries, including Japan, ensure careful follow-up of patients' skin.
{"title":"Occurrence of voriconazole-induced cutaneous squamous cell carcinoma in Japan: data mining from different national pharmacovigilance databases.","authors":"H Tanaka, M Okuma, T Ishii","doi":"10.1691/ph.2022.2453","DOIUrl":"https://doi.org/10.1691/ph.2022.2453","url":null,"abstract":"<p><p>Long-term voriconazole use may increase the risk of cutaneous squamous cell carcinoma (cSCC), especially in immunocompromised patients. However, relatively little is known regarding voriconazole-induced cSCC in Japan. Thus, the purpose of this study was to evaluate the association between voriconazole use and cSCC in Japan using different national pharmacovigilance databases. First, using the Japanese Adverse Drug Event Report (JADER) database, we evaluated the association between voriconazole use and cSCC in Japan. Second, using the U. S. Food and Drug Administration Adverse Event Reporting System (FAERS) database, we examined regional differences in the occurrence of voriconazole-induced cSCC between Japan and other countries. We calculated reporting odds ratios (RORs) as disproportionality analysis to evaluate voriconazole-induced cSCC. In this study, cases in which one or more of \"Bowen's disease\", \"Carcinoma in situ of skin\", \"Keratoacanthoma\", \"Squamous cell carcinoma in skin\", or \"Squamous cell carcinoma\" were reported as adverse events were considered to be cSCC cases. The analysis based on the JADER database showed an association between voriconazole use and cSCC in Japan, with a ROR (95% confidence interval) of 35.37 (25.60-48.87). Further, the analysis based on the FAERS database revealed that signals were detected in Japan as well as in Western countries and Australia. This study is the first in which the association between voriconazole use and cSCC in Japan is assessed using national pharmacovigilance databases. Healthcare providers need to be fully aware of the potential for cSCC development owing to voriconazole use and in all countries, including Japan, ensure careful follow-up of patients' skin.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"307-310"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}