No abstract

No abstract

A prospective, randomized, double-blind trial was conducted on 124 febrile patients with hematological malignancies to compare teicoplanin with vancomycin as an addition to the initial empiric amikacin-ceftazidime regimen after documented bacteremia due to gram-positive cocci. At enrolment, patients in both groups were comparable with respect to age, sex, underlying hematologic disorders and duration of neutropenia. Rates of therapeutic success were 55/63 (87.3%) in the teicoplanin group and 56/61 (91.8%) in the vancomycin group (p = 0.560). The mean duration of treatment was similar, being 12.2 and 11.4 days, respectively (p = 0.216). Patients treated with teicoplanin remained febrile for slightly longer than those treated with vancomycin (4.9 vs. 4.0 days) (p = 0.013). Thirteen patients experienced an adverse drug reaction, but without any significant difference in the two arms. Isolated staphylococci showed a progressive and significant decrease in susceptibility to both glycopeptides during the 8 study years. The economic analysis performed showed that the addition of vancomycin is cost-saving.

BACKGROUND As a result of the COVID-19 pandemic, institutions needed innovative solutions to provide care. With implementation of telehealth, the cystic fibrosis pharmacist was able to incorporate a virtual medication tour during appointments. OBJECTIVE The purpose of our study was to describe the uptake and impact of pharmacist-led virtual medication tours during telehealth visits in the CF clinic setting. PRACTICE DESCRIPTION Prior to the COVID-19 pandemic, the cystic fibrosis pharmacist participated in in-person multidisciplinary team visits to complete medication history reconciliation, assess adherence, assess efficacy and address possible side effects of medications, and work collaboratively with the CF care team and patient to create therapeutic plans. The virtual medication tour described in this study was completed in addition or as a complement to these pre-existing pharmacist roles and responsibilities. PRACTICE INNOVATION Patients seen via telehealth visit were asked to provide a virtual tour of their medications. The pharmacist completed medication history and evaluated whether or not storage conditions were appropriate in regards to temperature, humidity, light exposure, and accessibility to children. EVALUATION METHODS The pharmacist recorded findings from the virtual medication tours, and made interventions when appropriate. Descriptive statistics were used for analysis. RESULTS Of 20 patients seen via telehealth for a quarterly visit during the first 3 months after implementation, 13 were willing to participate in a virtual medication tour. Prior to the visit, 25% had information missing from their medication list. Virtual medication tour allowed for resolution of this information 80% of the time. Three of the four participating patients with a child under 12 years old had medications stored in a location accessible to children. PRACTICE IMPLICATIONS AND CONCLUSION A virtual medication tour led by a pharmacist can be successfully incorporated into telehealth visits, and was accepted by a majority of patients. Most patients stored medications appropriately, but might benefit from education on poison prevention practices.

Biologic agents, including anti-immunoglobulin E (omalizumab) and anti-interleukin 5 (mepolizumab), target different mediators involved in the inflammatory process and may work synergistically to decrease symptoms in patients with severe asthma. Here we describe a 12-year-old female on 2 biologic agents, omalizumab and mepolizumab, to control severe persistent asthma. Omalizumab was started years earlier with an initial response; however, her asthma again became uncontrolled and mepolizumab was added. Both biologics were administered concomitantly for over 6 months with marked improvement of asthma symptoms without significant side effects. A combination of biologic agents may be a potential therapy for pediatric patients with severe persistent asthma that remains uncontrolled on a single agent.