BackgroundFampridine is a drug indicated to improve walking in adult patients with multiple sclerosis (MS). Patients should be evaluated after two weeks and treatment should be stopped for those who have not shown any improvement.PurposeTo evaluate walking improvement in multiple sclerosis patients treated with fampridine and compliance with the condition of stopping the drug at two weeks in the absence of improvement.Material and methodsRetrospective study in MS patients treated with fampridine (January/2014–September/2014). Timed 25-Foot Walk (T25FW) and Twelve Item MS Walking Scale (MSWS-12) were used to evaluate drug response. Data recorded were age, gender, and results of T25FW and MSWS-12 at baseline and after two weeks of treatment. Drug discontinuation in non-responders was evaluated. Means were calculated and comparisons were performed by using Wilcoxon Signed Rank test.Results10 adult MS patients were included in the study (40% male; mean age 55 ± 9.7 years). 90% improved their walking tests. Baseline mean time for T25FW was 12.2 ± 5.9 s initially and 8.96 ± 3.8 s after 2 weeks (p = 0.007).MSWS-12 reflected a significant improvement in the following items: balance, time standing, walking speed and distance (p ≤ 0.05). No difference was detected for the following items: ability to run (p = 0.317) and the need for using a walking support outdoors (p = 0.590) or indoors (p = 0.157).There was only one non-responding patient who didn’t stop drug treatment.ConclusionThe walking of most patients on fampridine had improved at two weeks especially regarding balance, distance and time standing. The stopping criterion was not observed in one non-responder.References and/or AcknowledgementsEMA Product information fampridineNo conflict of interest.

BackgroundThe objective of preoperative antibiotic prophylaxis (PAP) is to reduce the incidence of postoperative wound infection. In our centre, the pharmacy service is actively involved in the PAP antibiotic aseptic compounding in the centralised intravenous admixture unit. The PAP is prepared according to the approved infectious disease commission protocol that is reviewed by the pharmacist and applied for each patient the day before elective surgery. A systematic review of documented allergies has also been implemented since April 2015.PurposeTo evaluate the proportion of detected patients who required PAP with no notified antibiotic allergies in the preoperative patient list, the drugs implicated and pharmaceutical interventions.Material and methodsDescriptive, observational and retrospective study. According to the allergy detection programme, a pharmacist reviewed if the allergies had been notified by the surgeon in order to select appropriate alternative, if needed. Also, pharmacists checked previous patient medical records in order to detect documented allergies that were not notified. When detected, the pharmacist proposed an alternative antibiotic regimen.Data regarding the programme results and pharmacist interventions between April 2015 and September 2015 were analysed.Results1929 (33.7%) patients received PAP from 5724 elective surgeries. 64 patients who received PAP (3.3%) were allergic to antibiotics, had not been notified and required pharmaceutical interventions. 82.8% of unnotified allergies were to β-lactams, 4.7% to aminoglycosides, 6.3% to β-lactams and aminoglycosides, and 6.2% to others, including clavulanic acid intolerance. 57 (89.1%) of antibiotic prophylaxis prescriptions were changed due to an unnotified allergy. More frequent proposed alternative regimens were: intravenous vancomycin as an alternative to intravenous cefazolin (40.6%), moxifloxacin ophthalmic solution to intracameral cefuroxime (15.6%) and the combination of intravenous gentamicin and intravenous clindamycin to intravenous amoxicillin-clavulanate (12.5%).ConclusionA significant proportion of unreported allergies in the preoperative patient list, especially to β-lactams, were detected. Pharmaceutical interventions prevented the error and possible collateral damage. Allergies notification is an improvement approach to guarantee patient safety.No conflict of interest.

BackgroundInitial intravenous dosing with vancomycin should be based on actual body weight (ABW) and subsequent dose titration based on renal function and serum trough concentrations. The manufacturer´s labelling recommends 500 mg/6 h or 1000 mg/12 h (the most commonly used dose).PurposeTo analyse the frequency of vancomycin overdose when a standard dose of 1000 mg/12 h is used, and its association with age, gender and creatinine clearance (CrCl).Material and methodsRetrospective observational study between January 2014 and September 2015. All patients treated with at least four doses of vancomycin were included. Age, gender, ClCr and trough level of vancomycin, collected before the fourth dose, were obtained. Patients were classified according to age (65 years), gender and ClCr (50 mL/min). Thereafter, data were related to trough levels of vancomycin (>20 μg/mL was considered an overdose). Bivariate analysis was carried out to identify variables associated with overdosing with χ2 or Fisher exact test.Results75 patients were included, 46 male (61.3%), mean age 68.7 ± 13.8 years. Patients overdosaged were 25 (33.3%). Patients were classified as shown in table 1.Abstract PKP-030 Table 1<20 μg/ml>20 μg/mlMale3313Female1712<65 years183>65 years3222CrCl < 50 mL/min312CrCl > 50 mL/min4713No association between gender and overdose was found (p = 0.241). Statistical analysis suggested a significant relationship between baseline CrCl <50 mL/min and overdose (OR=14.5; 95% CI 3.5 to 59.1; p < 0.01) and age >65 years and overdose (OR=4.1; 95% CI 1.1 to 15.7; p = 0.029).ConclusionA prefixed dose of vancomycin of 1000 mg/12 h, particularly in patients >65 years old and in renal impairment could lead to toxic levels.Although data regarding the optimal initial dose of vancomycin in the elderly are scarce, our results are consistent with those reported by Guay et al .1 The initial vancomycin dose should be individualised according to ABW, age and renal function, and subsequent dosing should be adjusted based on serum trough vancomycin concentrations.References and/or AcknowledgementsGuay DRP, Vance-Bryan K, Gilliland S, et al. Comparison of vancomycin pharmacokinetics in hospitalized elderly and young patients using a Bayesian forecaster. J Clin Pharma 1993;33:918–22No conflict of interest.