Enfermedades infecciosas y microbiología clínica
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Enferm. Infecc. Microbiol. Clin. · Apr 2011
Review[Shedding light on the use of colistin: still gaps to be filled].
Colistin (polymyxin E), an old antibiotic replaced by other less toxic antibiotics in the 1970s, has been increasingly used over the last decade due to multidrug-resistance in Gram-negative bacteria and lack of new antibiotics. However, there is a dearth of information on the pharmacokinetics (PK), pharmacodynamics (PD) and toxicodynamics (TD) of colistin and its non-active prodrug colistimethate sodium (CMS). ⋯ Therefore, it is urgent to conduct prospective studies to optimise CMS/colistin use in patients, in particular the critically ill. This review summarises recent key clinical studies evaluating the efficacy, toxicity and PK/PD of colistin/CMS.
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Enferm. Infecc. Microbiol. Clin. · Apr 2011
[Low adherence to 2009 pandemic influenza A(H1N1) vaccination program among health care workers of a medical centre during the pandemic phase].
Several strategies have been designed to increase adherence to vaccination programs aimed at health professionals, though the results were not always satisfactory. ⋯ Adherence to pandemic influenza vaccination program was very low, which suggests the need to implement new strategies into vaccination programs. The main reason for vaccination was patient protection. The tolerability of the pandemic vaccine was good.
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Enferm. Infecc. Microbiol. Clin. · Mar 2011
Review[Why might micafungin be the drug of choice in pediatric patients?].
Micafungin is an echinocandin approved by the European Medicines Evaluation Agency for the treatment of invasive candidiasis in children, including premature infants born before 29 weeks of pregnancy, and as prophylaxis in children undergoing hematopoietic stem-cell transplantation or patients at risk of prolonged neutropenia. This drug has good activity in several Candida spp., including those resistant to fluconazole. Although micafungin is active against Aspergillus spp., it has been used mainly in combination therapy for invasive aspergillosis. ⋯ In premature infants, the most appropriate doses to achieve levels in the brain parenchyma are 7 mg/kg/day and 10 mg/kg/day in those weighing more and less than 1,000 g, respectively. Micafungin has few drug-drug interactions and an acceptable safety profile. Withdrawal of this drug due to adverse effects is rare, although transaminase monitoring is recommended during treatment, as well as evaluation of the risk-benefit balance in patients with liver disease or concomitant administration of hepatotoxic drugs.