the mortality risk is being assessed but not registered in clinical charts.

Background After evaluation of ranibizumab and bevacizumab by the Pharmacy and Therapeutics Committee of a tertiary hospital, for the treatment of macular oedema secondary to retinal vein occlusion (RVO), based on the available evidence, both drugs were considered equivalent therapeutic alternatives and ‘off label’ use of bevacizumab was approved. 1.25 mg intravitreal prefilled syringes are prepared by the Pharmacy department, administered every 6 weeks for four doses and repeated as required. Purpose To evaluate the efficacy and safety of bevacizumab as an antiangiogenic drug in the treatment of macular oedema secondary to RVO. Materials and methods Data were collected from patients diagnosed with macular oedema secondary to RVO from November 2012 to April 2013. For each patient, the following data were collected: age and gender, type of occlusion and adverse reactions detected. The variable used to evaluate the efficacy of the treatment was the improvement in the visual acuity, measured by the Snellen fraction adapted to decimal between 0.05 and 1. Results 18 patients with macular oedema secondary to RVO were treated, with a total of 46 doses, and an average of 2.5 (1–5) doses/patient. The average age was 67 and 61% were women. In all cases we used intravitreal bevacizumab as the antiangiogenic drug. 14 cases were branch RVO and 4 cases were central RVO. 14 patients showed great improvement after being given the drug, 2 patients showed a slight improvement and the other 2 patients maintained the same visual acuity and continue with the treatment. No loss of visual acuity has been recorded in any patients. No adverse reactions have been reported. Conclusions In our group of patients, intravitreal bevacizumab was an effective and safe treatment of macular oedema secondary to RVO. The efficacy data obtained are consistent with the reported bibliography. No conflict of interest.

Background Vancomycin is an antibiotic against Gram positive bacteria. Vancomycin is useful in treating infections caused by foreign materials, such as catheters used in haemodialysis. It is eliminated mainly through the renal system, so any renal system alteration affects the concentration of vancomycin. Purpose To assess the effectiveness of vancomycin monitoring in patients undergoing haemodialysis and the effectiveness of the interventions made by the pharmacy service to reach the target concentration. Materials and methods Patients undergoing haemodialysis whose vancomycin levels had been monitored by the pharmacy service between May 2012 to April 2013 at a tertiary level hospital. The variables collected were: age, sex, weight, residual renal function, type of infection, type of microorganism, target level, type of dialysis membrane, initial dose, recommended dose, trough levels and effectiveness of treatment. The target serum concentration was between 15–20 µg/ml in serious infections, and 10–15 µg/ml in milder cases. Results 26 patients undergoing haemodialysis were selected but just 24 were included. 15 men and 9 women, with an average age of 62.5 years and weight between 50 and 119 kg. Of all patients, just 10 had residual renal function. 6 patients used a low flow membrane, 8 patients used an intermediate membrane, 6 patients used a high flow membrane and no data were available from 3 patients. The initial dose varied between 5 mg/kg and 23.8 mg/kg. Recommended doses varied between 0.5–2 g. The target was never reached in 4 patients. The goal was achieved after the initial dose in 4 cases, after <2 recommendations in 2 cases and after <5 recommendations in 6 cases. Conclusions The infection was eradicated in 86% of cases, and the target concentration was reached in 79% of them. These results justify a broader analysis to establish a treatment guide for vancomycin in patients undergoing haemodialysis. No conflict of interest.

Background Axitinib is a new oral cytostatic VEGFR-1,-2 and -3 inhibitor, used in the treatment of renal cell carcinoma (RCC), available through an expanded access programme. Purpose To analyse the effectiveness and safety of axitinib treatment in patients with RCC in a tertiary hospital. Materials and methods A retrospective descriptive study of patients taking axitinib from November 2012 to April 2013. The following information was collected: demographics (gender and age), diagnosis, basal situation (ECOG performance status (PS) and staging), dose of axitinib, pre-treatments, effectiveness (response rate and overall survival after four months) and adverse reactions. The information source was the electronic health record. Results 7 patients were recruited. 3 (42.8%) were women. The mean age was 57.8 (32–71). 6 patients were diagnosed with clear cell carcinoma and the other one with papillary carcinoma. The PSs were: 0 (n = 2), 1 (n = 4) and 2 (n = 1). All patients had metastatic disease (stage IV). All patients received axitinib 5 mg/12 h. A total of 5 (71.4%) patients had been treated once already, and 2 (28.6%) patients had been treated with at least two prior regimens. Pre-treatments: the majority of patients 4 (57.1%) received sunitinib before starting axitinib treatment, 2 (28.6%) received pazopanib and everolimus and 1 (14.3%) received only pazopanib. Effectiveness: the response rates were stable disease (n = 3; 48.8%), partial response (n = 2; 28.6%) and no response (n = 2, 28.6%). The global survival rate after 4 months was 57.1%. Safety: the most frequent adverse reactions were: mucositis (n = 5; 71%), diarrhoea (n = 3; 43%), asthenia (n = 3; 43%), hypertension (n = 2; 29%) and rash (n = 2; 29%). One patient had a reduction to 5 mg/24 h. Conclusions The number of patients included in the expanded access, and therefore in this study, was very low, so that the effectiveness of the treatment cannot be demonstrated. Nevertheless, it is important to highlight that 2 out of 7 patients had a partial response and 3 out of 7 have stable disease. Gastrointestinal problems were the most frequent adverse reactions. No conflict of interest.

Background After the Pharmacy and Therapeutics Committee of a tertiary hospital had evaluated ranibizumab and bevacizumab for the treatment of macular oedema secondary to retinal vein occlusion (RVO) based on the available evidence, the two drugs were considered equivalent therapeutic alternatives and ‘off label’ bevacizumab use was approved (1.25 mg intravitreal prefilled syringe prepared by the Pharmacy department, administered every 6 weeks for four doses and subsequently as required). Purpose To quantify the financial impact of the use of bevacizumab as anti-VEGF of choice in the treatment of macular oedema secondary to RVO. Materials and methods Data were collected from patients diagnosed with macular oedema secondary to RVO from November 2012 to April 2013, and from the treatment given. In order to calculate the savings generated by using bevacizumab, rather than ranibizumab, during this period, the direct cost difference between the two alternatives was used. Results 18 patients with macular oedema secondary to RVO were treated, with a total of 46 doses. In all the cases, we used intravitreal bevacizumab as the antiangiogenic drug. The saving generated by using a dose of intravitreal bevacizumab rather than intravitreal ranibizumab was 1,291 €. The impact of cost savings for the hospital during the six months studied was 11,626 €. According to the established protocol, the incremental cost of one year’s treatment is 7,767–15,534 € (depending on the number of injections). Therefore, the annual impact on the hospital budget (assuming 36 patients/year) would be around 280,000–560,000 €. Conclusions Selecting bevacizumab as the antiangiogenic drug in patients with macular oedema secondary to RVO generates significant cost savings for the healthcare system. No conflict of interest.