Since late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, better known as COVID-19) has rapidly spread worldwide. The primary pathophysiology by which COVID-19 leads to severe lung damage is cytokine releasing syndrome (CRS), which can cause death. Therefore, removing cytokines via therapeutic plasma exchange or hemoperfusion could be a therapeutic approach to treat CRS. However, hemoperfusion or therapeutic plasma exchange could alter the effectiveness of concomitant medications. Thus, concomitant medication doses might need to be adjusted to prevent their elimination via therapeutic plasma exchange or hemoperfusion, thus ensuring that these medications remain effective. This narrative review investigates the elimination status of current medications used to manage COVID-19 during hemoperfusion and therapeutic plasma exchange, with a focus on their pharmacokinetic profiles.

Context: Community-acquired pneumonia (CAP) refers to pneumonia attained outside the hospital or less than 48 hours before admission, which is a significant cause of mortality and morbidity, especially in major comorbidities and older age. Several microorganisms contribute to developing CAP, primarily Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis, and atypical pathogens, e.g., Mycoplasma pneumonia. The incidence of these microorganisms depends on outpatient or inpatient settings. Administering appropriate treatment among available antibiotics is a critical issue affecting patient survival. Methods: With a multidisciplinary panel expert, this document offers evidence-based recommendations for managing CAP in Iran. Results: The document evaluated the availability of antimicrobial agents and local antibiotic resistance patterns based on 94 relevant published studies from Google Scholar, Scopus, PubMed, Scientific Information Database (SID), Iran Medex, Iran doc, Mag Iran, PubMed, and expert opinions. Conclusions: The panel addressed two main parts of rational recommendations for managing outpatients or hospitalized patients with CAP.

BackgroundThe intensive care unit (ICU) is the most important department for critically ill patients. Different scoring systems are used to assess the severity of the disease and evaluate organ failure during the patient's stay in ICU.AimsOur purpose was to evaluate the C‐reactive protein/Albumin (CRP/Alb) ratio and SOFA score as indicators of 28‐day mortality in ICU patients.Materials and MethodA total of 55 patients were enrolled in this study. CRP and CRP/Alb rates, SOFA scores, and demographic data were used to evaluate 28‐day mortality in a referral hospital.ResultsSurvived and dead patients were significantly different in the CRP, CRP/Alb rates, and SOFA scores. However, in the adjusted model, the SOFA score was the predictor of 28‐day mortality in ICU patients.ConclusionSOFA score was also confirmed as a predictor of mortality in ICU patients. Besides, the role of CRP and CRP/Alb in the prediction of disease prognosis or mortality requires further studies.

Introduction: Haemophilus. influenzae and Moraxella. catarrhalis are two common pathogens in respiratory tract infections. Antimicrobial resistance to these pathogens occurs over years. Therefore, we decided to carry out a systematic review to investigate the antibiotic resistance and sensitivity of these pathogens in Iran.Material and method: All recent original articles and studies related to the antimicrobial resistance in H. influenza and M. cattarhalis in Iran up to 2022 were investigated in English and Persian databases. Result: The prevalence of antibiotic susceptibility in H. influenza to levofloxacin (100%), cefotaxim (78.8%), clarithromycin (71.4%) and ceftriaxone (71.4-80%) was upmost. Resistances to ciprofloxacin were varied. In addition, about 50% of isolated had resistant to ampicillin. The prevalence of M. cattarhalis resistance in Iran including penicillin was 70-100%, erythromycin was 0%, and in three of our study of our studies, the resistance rate of ciprofloxacin was 0% whereas in one study 70% of isolated M.cattarhalis had resistance to ciprofloxacin also, resistances to amoxicillin/clavulanate were varied.Conclusion: According to the study, most isolates of H. influenzae are sensitive to levofloxacin, but resistance to macrolides and third generation cephalosporins are increasing; and the majority of M. cattarhalis was resistant to penicillin.