Background Depression is one of the most prevalent health problems, frequently being a medium-and long-term condition, with a high comorbidity rate and with frequent relapses and recurrences. Although numerous studies have compared the effectiveness of specific antidepressant therapy drugs and have assessed relapses, scientific evidence on the relationship between pharmacologic treatments and recurrence is scarce. The objective of this study is to describe depressive episodes in a primary care patient cohort, the percentage of depression recurrences and the administered pharmacologic treatment, from a naturalistic perspective. Methods Retrospective descriptive study. 957 subjects were included. The dependent variable was a depression diagnosis and independent variables were: gender, age at time of data collection; age of onset, first-episode treatment, number of recurrences, age at recurrences, treatment prescribed for recurrences using therapeutic groups categorization. Results Recurrences are frequent, affecting more than 40% of the population. In the first episode, 13.69% of the patients were not prescribed pharmacological treatment, but this percentage decreased over the following depression episodes. 80.9% of the patients who did not receive drug treatment in the first depression episode did not experience subsequent episodes. Monotherapy, and specifically, SSRIs were the most frequently prescribed treatment

El proyecto “Protégete del sol, protégete del Lupus”, emplea la  estrategia metodológica de Aprendizaje Servicio como herramienta de integración curricular en la formación del futuro farmacéutico.  El objetivo  que se pretende alcanzar es aplicar, en un paciente crónico,  un caso de intervención dermofarmacéutica, concretamente, se va a tratar la fotosensibilidad en el paciente de Lupus. En esta iniciativa, van a participar alumnos de 3º y 5º curso del grado de Farmacia de la Universidad San Jorge. Las asignaturas implicadas en el aprendizaje planteado son: Fisiología III (3º), Inmunología(3º), Dermofarmacia (5º), Medicamento Individualizado (5º) y Estancias Clínicas (5º). El objetivo de aprendizaje es la integración horizontal y vertical de asignaturas del grado de farmacia con un enfoque común, que es la salud del paciente crónico, concretamente, el paciente de Lupus;  al cual se le ofrece un servicio: la información, prevención, análisis y dermoconsejo farmacéutico. Se va a trabajar con la Asociación de Pacientes ALADA (Asociación de Enfermos de Lupus y Antifosfolípido de Aragón. El proyecto conlleva una serie de actividades que tratan de compaginar el aprendizaje activo de los alumnos, mediante metodologías novedosas, con un servicio sanitario a la sociedad, representada, en este caso, por esta asociación de pacientes. Palabras clave: aprendizaje servicio, lupus, metodologías educativas innovadoras, educación en farmacia, asociaciones de pacientes, TICs.

BackgroundLinezolid is an antibiotic with a broad spectrum of activity against all clinically important Gram +bacteria, including methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococci. Standard dosing is prescribed for critical patients, regardless of their pharmacokinetic variability.PurposeTo describe the plasma concentrations of linezolid in critical patients and its relationship with antibiotic discontinuation.Material and methodsA prospective, observational study was carried out in a university hospital ICU during June 2017. Patients with linezolid treatment >48 hours that signed the informed consent were included. Two blood samples, Cmin and Cmax, were taken per patient. They were analysed by validated high-performance liquid chromatography assay. General, clinical data and analytic parameters of interest were recorded. Results were expressed in median, interquartile range and percentages. Fischer exact test for dichotomic variables was employed.ResultsTwelve patients were included, 11 males, age 66 (12) years, weight 82.50 (21) kg, body mass index 26.85 (2.88) kg/m2, APACHE II score 22 (11) at admission.Analytical parameters: leukocytes 11.80 (10.80) cells x109/mL, neutrophils 89.10 (19.05)%, creatinine 0.95 (0.73) mg/mL, and PCR 6.77 (28.49) mg/dL.All patients received intravenous linezolid 600 mg b. i. d. Duration of treatment: 7 (5.5) days. Respiratory tract infections were the most prevalent (50%). 91.67% of patients received combination therapy, mostly linezolid +meropenem (66.67%). In 10 cases, linezolid was the empirical antibiotic regimen, only two as targeted therapy.A total of 24 serum samples were obtained at steady state (between 5th and 11th dose). Cmax were 10.49 (range 6.50–19.80) µg/mL and Cmin were 0.7 (0.02–6.10) µg/mL. Eight patients (67%) presented with plasma levels<1 mcg/mL, and two (17%) presented with plasma levels>18 mcg/mL.Factors that might influence linezolid pharmacokinetics: 83.3% patients presented overweight or obese, 72.73% were mechanically ventilated, 58.33% received parenteral nutrition, 50% vasoactive drugs and 33.33% had postsurgical drains. Reasons for therapeutic discontinuation (1_Empirical treatment recommendations 2_Ineffectiveness 3_Toxicity) could be related with Cmin concentrations (p=0.045).ConclusionA high interindividual pharmacokinetic variability of linezolid was observed and it could be related to the discontinuation of this antibiotic.Frequently, pharmacokinetic/pharmacodynamic targets are not achieved with standard dosing (600 mg b. i. d). TDM should be considered for individualised linezolid dosing in ICU patients.No conflict of interest