Journal of pharmacy practice
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Review
Statin Effects on Incidence, Treatment Success, and Mortality of Clostridium difficile Infections.
To review the effects of statin use in patients at risk for or diagnosed with Clostridium difficile infection (CDI) on CDI incidence, treatment success, and mortality. ⋯ Statin use may have a protective effect against the development of CDI and improve CDI treatment success; however, it is unclear if use confers a mortality benefit. Current data remain sparse and larger, prospective studies are needed to confirm current results and identify the specific population that may benefit the most from this intervention.
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The objective of this article is to discuss the pharmacology, side effects, and clinical application of vasoactive therapy in the management of adult septic shock. ⋯ While advances in research, identification, and early implementation of best practices for the treatment of sepsis has reduced mortality, rates remain high. Vasopressors and inotropes remain part of the core therapeutic modalities of sepsis management. Norepinephrine is the first-line vasopressor of choice for septic shock, though secondary vasopressors can be used depending on the patient's circumstances.
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Andexanet alfa is the newly approved factor Xa inhibitor reversal agent for the treatment of life-threatening or uncontrolled bleeding from apixaban or rivaroxaban. This decoy protein directly binds factor Xa inhibitors reversing their action. A systematic and evidence-based evaluation of the available clinical trials is lacking in the literature. ⋯ Another study is unblinded and uncontrolled but presents patient-oriented evidence resulting in a moderate level of evidence. Only one study could score high because the outcome is patient-oriented evidence, and it could achieve follow-up of 80%. There is a need for well-controlled and blinded evaluation to improve the recommendation strength.