daily were prescribed. At 5.5-year and 5-year followup, respectively, both patients were asymptomatic and free of infection with well-integrated implants. As the Brucella pathogen is highly susceptible to antibiotics, standard 2-stage revision arthroplasty for loosened implant or debridement and antibiotic treatment for well-fixed implant should suffice.

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Background Renal insufficiency may affect up to 10% of HIV patients as a result of HIV-associated nephropathy (HIVAN), a consequence of HIV replication in the kidney, AIDS-related kidney disease or drug treatment. Tenofovir, atazanavir and abacavir are mainly used, and it is important to consider the potential impact of kidney disease on antiretroviral therapy.1 2 The increasing number of older patients with HIV coupled with the prevalence of chronic kidney disease (CKD) in this age group and the side effects of antiretrovirals leads us to select them as an at-risk population for clinical drug monitoring. Purpose Assessment of kidney function in older patients infected by HIV treated with antiretrovirals. Materials and methods Retrospective study (2010) of HIV-infected older patients (≥65 years) followed at the infectious disease unit of the author's hospital to identify those with CKD. Data were obtained from patient clinical files, pharmacy drug database and laboratory test results. CKD is defined as either GFR <60 ml/min/1.73 m2 for ≥3 months or presence of kidney damage (KD) for ≥3 months, with or without decreased GFR, manifest by either pathological abnormalities or markers of KD. Proteinuria (>30 mg/dl) is an early and sensitive marker of KD.3 The Modification of Diet in Renal Disease equation was used to estimate the GFR (eGFR).3 The stages (1–5) of CKD are defined based on the level of kidney function. Results Of 63 patients (48 men) with mean age 70.6 (65–84) and mean serum creatinine 0.99±0.31 mg/dl, 15 were diabetic, 19 had CKD at different levels of kidney function: stage 1=3, stage 2=3, stage 3=11, stage 4=1, stage 5=1. Of this nineteen, 14 were men, mean age 70.9 (65–79), 18 with mean serum creatinine 1.25±0.39 mg/dl and 1 with 10.92 mg/dl on haemodialysis, 12 were being treated with tenofovir, 3 with abacavir and 1 with atazanavir+abacavir. Conclusions A significant number of this population had a decreased eGFR and had CKD probably due to age, HIVAN, but also to the use of tenofovir, abacavir or atazanavir.

Background Linezolid is an antimicrobial agent to treat infections of Gram-positive pathogens. While effective, linezolid treatment is frequently associated with haematological side effects. This adverse event does not seem to be of abrupt onset and consequently close monitoring for the blood test abnormalities is important. Purpose To analyse the incidence of thrombocytopenia, to determine the degree of thrombocytopenia and to decide whether the difference between initial values and final platelet values after linezolid (LZ) treatment is significant. Materials and methods Prospective study in a 2nd-level hospital, we included all patients treated with LZ, from January 2012 to August 2013, who did not have TCP pre-treatment. Thrombocytopenia was defined as a decrease in the platelet count to <150,000 cells/mcL (mild: 150,000–1,000,000, moderate: 100,000–50,000 and severe: <50,000). The data collected were: number of patients, sex, age, days of LZ therapy, platelets at the beginning and at the end of LZ treatment. We performed the Kolmogorov-Smirnov test to check whether the data fitted a normal test and U-Mann Whitney to analyse the differences. Results 167 patients were included (57.5% men) with a mean age of 68 (interquartile range (IQR): 21); Median days of linezolid therapy were 9 (IQR: 7). The incidence of thrombocytopenia incidence was 13.27% (28 cases). TCP was mild in 19 cases (9%), moderate in 8 (3.79%) and severe in 1 (0.47%). 71.5% of patients presented a reduction in the platelet values, and the difference between initial values and final platelet values after linezolid treatment was significant. Conclusions The incidence of thrombocytopenia observed in our study was similar to that described in the literature (2.4–64.7%). The thrombocytopenia was severe in 1 case. Other factors that could have been causing thrombocytopenia in patients treated with linezolid were not assessed. Pharmaceutical validation must incorporate an assessment of the platelet count, as it may contribute to early identification of thrombocytopenia. No conflict of interest.

Background Medicines errors are a major cause of adverse events in hospitalised elderly patients and increase morbidity, mortality and healthcare costs. Purpose To improve the reconciliation process in these patients, to establish the degree of risk of the discrepancies, to analyse potentially inappropriate prescriptions (STOPP criteria) and to identify drug interactions. Materials and methods Retrospective and descriptive study conducted at a general hospital from January to December 2012 on patients aged over 75. The patient’s usual medicines were recorded by HORUS (software application of outpatient clinic medicines records), medical history and interview with the patient. The patient’s chronic medicines were compared with the prescribed at admission to identify discrepancies classified according to the ‘Consensus Document on Terminology and Classification in Medication Reconciliation’. The potential risk of reconciliation errors (REs) was evaluated based on the NCCMERP index. We reviewed potentially inappropriate prescriptions (STOPP criteria) and drug interactions. Results Medicines reconciliation was performed in 1,530 patients, 59.71% were women. 13,117 drugs were evaluated (8.64/patient) and 2,722 discrepancies were detected (1.78/patient). More frequently justified discrepancies were not to prescribe a drug due to clinical and medical decisions (33.73%), and change of dose or route of administration of a drug based on new clinical situation (28.04%). Most common causes of REs were: omission of chronic medicines (73.53%) and incorrect dose, route or frequency (17.35%). The risk associated with REs was category C (71.76%), category D (25%), and category E (2.35%). There were 80 inappropriate prescriptions according to STOPP criteria (6.92% of patients). 187 clinically significant drug interactions were found (15.56% of patients). Conclusions The incorporation of the reconciliation process in the hospital has enabled us to detect and intercept REs. Before any prescriptions are written it is necessary to consider all aspects of elderly patients’ conditions that may affect the efficacy, safety and success of pharmacotherapy. No conflict of interest.