Background : We report the long-term outcomes, changes in laboratory parameters, the incidence of secondary nosocomial infections and treatment cost of a Spanish cohort of patients with severe COVID-19 that received tocilizumab (TCZ). Methods : Retrospective cohort of PCR confirmed adult patients who received TCZ from March 1 to 24, 2020 in a tertiary hospital was analyzed. Patients were followed up until 10 May 2020. Results : We included 162 patients (median age 64 years; 70.4% male). At time of TCZ administration, 48.1% of patients were on invasive mechanical ventilation (IMV). Over a median follow-up of 53 days, 46.9% of patients were discharge in good conditions and 19.8% were still hospitalized. The overall mortality was 33.3%, being higher in patients on IMV than those who did not (46.2% vs 26.7%, P < 0.001). A significant improvement in the lymphocyte count, C-reactive protein, lactate dehydrogenase, and D-dimer was observed. Overall, 43.2% patients presented nosocomial infections, causing death in 8%. Infections were more prevalent in ICU units (63.0% vs 17.1%, P < 0.001). The total cost of TCZ was €371,784. Conclusions : Among the patients who used TCZ, one third died, regardless the improvement in some inflammatory biomarkers. The incidence of secondary nosocomial infections was high.

Because of possible INR abnormalities during the concomitant use of acenocoumarol, ombitasvir/paritaprevir/ritonavir and dasabuvir, clinicians should closely monitor INR values.

The multidisciplinary programme has been effective in reducing bleeding episodes. The interventions were effective in reducing antithrombotic drugs overdosage, incorporating the use of fondaparinux to the NSTE-ACS therapeutic arsenal, limiting the use of bivalirudin with abciximab and obtaining body weight for most patients.

The simplified regimen of OBV/PTV/r+DSV administered for 12 weeks is effective and safe in patients with chronic HCV genotype 1b infection and compensated cirrhosis. No adverse reactions related to drug-drug interactions were recorded.

Background Abciximab (ABX) is indicated as an adjunctive to percutaneous coronary intervention in patients with acute coronary syndrome (ACS). It is considered a high-alert medicine with heightened risk of causing significant patient harm when used in error. Evidence-based guidelines recommend an intravenous administration of a 0.25 mg/kg bolus dose followed by continuous infusion of a weight-adjusted infusion of 0.125 mcg/kg/min (<80 kg) to a maximum of 10 mcg/min for 12 h (≥80 Kg). Purpose The purpose of this study was to investigate dosing of ABX and its association with bleeding events in patients with ACS. Materials and methods A retrospective chart review was performed in all patients hospitalised between January and July 2010 at our hospital. Inclusion criteria were: patients >18 years of age, diagnosed with ACS and treated with ABX during their hospitalisation. A database was designed to record patient demographics (age, sex) weight, loading dose, maintenance dose, duration of prescribed ABX and bleeding events. Results 73 patients diagnosed with ACS were treated with ABX. Median age was 65 (55–73) years old and 78.1% were male. 24.7% of patients were not weighed before ABX administration. All patients who received ABX infusion were treated with a fixed, body weight-independent, dose of 10 mcg/min infused for 12 h (maximum dose) meaning that 28.8% of patients received an overdose of ABX. 66.7% of them developed a bleeding event compared with 32.8% of patients receiving the correct dose (p=0.016). Conclusions Overdose of ABX seems to be associated with high risk of developing bleeding events in patients with ACS. Some new procedures have been brought in such as hoists with weighing scales and a table made available containing the appropriate dose and infusion rate for each weight. These facilities could be perfectly applicable to other hospitals. Further analysis should be carried out to determine the effect of other potential risk factors.