Stability of Ampicillin plus Ceftriaxone Combined in Elastomeric Infusion Devices for Outpatient Parenteral Antimicrobial Therapy

Ampicillin; Infective endocarditis; Outpatient parenteral antimicrobial therapyAmpicil·lina; Endocarditis infecciosa; Teràpia antimicrobiana parenteral ambulatòriaAmpicilina; Endocarditis infecciosa; Terapia antimicrobiana parenteral ambulatoriaCurrently, ampicillin plus ceftriaxone (AC) is one of the preferred treatments for Enterococcus faecalis infective endocarditis. However, there is a lack of stability data for the combination of both drugs in elastomeric devices, so the inclusion of AC in Outpatient Parenteral Antimicrobial Therapy (OPAT) programs is challenging. The objective of the study was to determine the stability of AC in elastomeric pumps when stored at 8 ± 2 °C, 25 ± 2 °C, 30 ± 2 °C and 37 ± 2 °C using LC-MS/MS. The combination was diluted in 0.9% sodium chloride and the final concentrations were ampicillin 24 g/L plus ceftriaxone 8 g/L. Physical and chemical stability were evaluated at 12, 20, 24, 36 and 48 h after preparation. Stability was met at each time point if the percentage of intact drug was ≥90% of its respective baseline concentration and color and clearness remained unchanged. The drug combination was stable for 48 h when it was kept at 8 ± 2 °C. At 25 ± 2 °C and 30 ± 2 °C, they were stable for 24 h of storage. At 37 ± 2 °C, the stability criterion was not met at any time point. These results prove that AC could be included in OPAT programs using elastomeric infusion devices for the treatment of E. faecalis infections.This work was supported by the Sociedad Española de Farmacia Hospitalaria and the AFinf Working Group for the project “Stability study of antimicrobials under conditions analogous to the outpatient parenteral antibiotic therapy program (OPAT)”. A.G.-V. was supported by the Instituto de Salud Carlos III, co-financed by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Miguel Servet (grant CP19/00159). L.H.-H. was supported by the Instituto de Salud Carlos III, co-financed by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Juan Rodés (grant JR22/00049)

Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review

Antimicrobials; Elastomer; Systematic reviewAntimicrobianos; Elastómero; Revisión sistemáticaAntimicrobians; Elastòmer; Revisió sistemàticaOutpatient parenteral antimicrobial therapy (OPAThttp) programs have become an important healthcare tool around the world. Portable elastomeric infusion pumps are functional devices for ambulatory delivery of antimicrobial drugs, and their stability is an essential point to guarantee an appropriate infusion administration. We conducted a systematic review to provide a synthesis and a critical evaluation of the current evidence regarding antimicrobial stability in elastomeric pumps. Data sources were PubMed, EMBASE, and Web of Sciences. The review protocol was registered on the Center for Open Science, and it was carried out following the PRISMA guidelines. Studies were eligible if the aim was the evaluation of the physicochemical stability of an antimicrobial agent stored in an elastomeric device. Of the 613 papers identified, 33 met the inclusion criteria. The most studied group of antimicrobials was penicillins, followed by cephalosporins and carbapenems. In general, the stability results of the antimicrobials that have been studied in more than one article agree with each other, with the exception of ampicillin, flucloxacillin, and ceftazidime. The antibiotics that displayed a longer stability were glycopeptides and clindamycin. Regarding the stability of antifungals and antivirals, only caspofungin, voriconazole, and ganciclovir have been investigated. The information provided in this article should be considered in patient treatments within the OPAT setting. Further stability studies are needed to confirm the appropriate use of the antimicrobials included in this program to ensure optimal patient outcomes.This work was supported by the Sociedad Española de Farmacia Hospitalaria and the AFinf Working Group for the project “Stability study of antimicrobials under conditions analogous to the outpatient parenteral antibiotic therapy program (OPAT)”. A.G.-V. was supported by the Instituto de Salud Carlos III, co-financed by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Miguel Servet (grant CP19/00159). L.H.-H. was supported by the Instituto de Salud Carlos III, Subprograma Rio Hortega (grant CM19/00152)

Retos institucionales de la formación del profesorado universitario

El Grupo Interuniversitario de Formación Docente (GIFD) está formado por las unidades y centros de formación (ICE-UB, IDES-UAB, ICE-UPC, CQUID-UPF, ICE-UdG, ICE-UdL, ICE-URV y eLC-UOC) de las ocho universidades públicas catalanas. Estas unidades actualmente se encuentran en un proceso de reformulación de las actividades y planes de formación que están ofreciendo al profesorado universitario para facilitar el desarrollo de su actividad docente. El replanteamiento de sus actuacions nace de un interés común vinculado a la calidad de la formación docente del profesorado universitario, coherente con los planteamientos promulgados por el Espacio Europeo de Educación Superior (EEES). Este interés y preocupación conduce al desarrollo de un estudio de identificación de las competencias docentes que debe poseer el profesorado universitario para abordar con éxito el desarrollo de las nuevas titulaciones de grado acordes con el EEES. Además este trabajo recoge un cuestionamiento y reflexión en relación a las principales características que deberían tener las actividades y programas de formación dirigidas al profesorado para facilitar su tarea docente; apelando a la labor que, tanto las unidades o centros de formación, las instituciones universitarias a las que pertenecen y los organismos vinculados a la acción docente, deberían replantearse para dar respuesta a las nuevas exigències docentes requeridas al profesorado. El objetivo del trabajo es provocar la reflexión y generar el debate sobre el camino que debe seguir la formación docente del profesorado universitario, como elemento estratégico de la institución, para contribuir a alcanzar los objetivos de calidad a los que las universidades se han comprometido en el proceso de verificación de los nuevos títulosPostprint (published version

Retos institucionales de la formación del profesorado universitario

El Grupo Interuniversitario de Formación Docente (GIFD) está formado por las unidades y centros de formación (ICE-UB, IDES-UAB, ICE-UPC, CQUID-UPF, ICE-UdG, ICE-UdL, ICE-URV y eLC-UOC) de las ocho universidades públicas catalanas. Estas unidades actualmente se encuentran en un proceso de reformulación de las actividades y planes de formación que están ofreciendo al profesorado universitario para facilitar el desarrollo de su actividad docente. El replanteamiento de sus actuacions nace de un interés común vinculado a la calidad de la formación docente del profesorado universitario, coherente con los planteamientos promulgados por el Espacio Europeo de Educación Superior (EEES). Este interés y preocupación conduce al desarrollo de un estudio de identificación de las competencias docentes que debe poseer el profesorado universitario para abordar con éxito el desarrollo de las nuevas titulaciones de grado acordes con el EEES. Además este trabajo recoge un cuestionamiento y reflexión en relación a las principales características que deberían tener las actividades y programas de formación dirigidas al profesorado para facilitar su tarea docente; apelando a la labor que, tanto las unidades o centros de formación, las instituciones universitarias a las que pertenecen y los organismos vinculados a la acción docente, deberían replantearse para dar respuesta a las nuevas exigències docentes requeridas al profesorado. El objetivo del trabajo es provocar la reflexión y generar el debate sobre el camino que debe seguir la formación docente del profesorado universitario, como elemento estratégico de la institución, para contribuir a alcanzar los objetivos de calidad a los que las universidades se han comprometido en el proceso de verificación de los nuevos título

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Venous thromboembolism risk and prophylaxis in hospitalised medically ill patients The ENDORSE Global Survey

Limited data are available regarding the risk for venous thromboembolism (VIE) and VIE prophylaxis use in hospitalised medically ill patients. We analysed data from the global ENDORSE survey to evaluate VTE risk and prophylaxis use in this population according to diagnosis, baseline characteristics, and country. Data on patient characteristics, VIE risk, and prophylaxis use were abstracted from hospital charts. VTE risk and prophylaxis use were evaluated according to the 2004 American College of Chest Physicians (ACCP) guidelines. Multivariable analysis was performed to identify factors associated with use of ACCP-recommended prophylaxis. Data were evaluated for 37,356 hospitalised medical patients across 32 countries. VIE risk varied according to medical diagnosis, from 31.2% of patients with gastrointestinal/hepatobiliary diseases to 100% of patients with acute heart failure, active noninfectious respiratory disease, or pulmonary infection (global rate, 41.5%). Among those at risk for VTE, ACCP-recommended prophylaxis was used in 24.4% haemorrhagic stroke patients and 40-45% of cardiopulmonary disease patients (global rate, 39.5%). Large differences in prophylaxis use were observed among countries. Markers of disease severity, including central venous catheters, mechanical ventilation, and admission to intensive care units, were strongly associated with use of ACCP-recommended prophylaxis. In conclusion, VIE risk varies according to medical diagnosis. Less than 40% of at-risk hospitalised medical patients receive ACCP-recommended prophylaxis. Prophylaxis use appears to be associated with disease severity rather than medical diagnosis. These data support the necessity to improve implementation of available guidelines for evaluating VIE risk and providing prophylaxis to hospitalised medical patients

Venous Thromboembolism Risk and Prophylaxis in the Acute Care Hospital Setting (ENDORSE Survey) Findings in Surgical Patients

Objective: To evaluate venous thromboembolism (VTE) risk in patients who underwent a major operation, including the use of, and factors influencing, American College of Chest Physicians-recommended types of VTE prophylaxis

Chasing Gravitational Waves with the Chereknov Telescope Array

Presented at the 38th International Cosmic Ray Conference (ICRC 2023), 2023 (arXiv:2309.08219)2310.07413International audienceThe detection of gravitational waves from a binary neutron star merger by Advanced LIGO and Advanced Virgo (GW170817), along with the discovery of the electromagnetic counterparts of this gravitational wave event, ushered in a new era of multimessenger astronomy, providing the first direct evidence that BNS mergers are progenitors of short gamma-ray bursts (GRBs). Such events may also produce very-high-energy (VHE, > 100GeV) photons which have yet to be detected in coincidence with a gravitational wave signal. The Cherenkov Telescope Array (CTA) is a next-generation VHE observatory which aims to be indispensable in this search, with an unparalleled sensitivity and ability to slew anywhere on the sky within a few tens of seconds. New observing modes and follow-up strategies are being developed for CTA to rapidly cover localization areas of gravitational wave events that are typically larger than the CTA field of view. This work will evaluate and provide estimations on the expected number of of gravitational wave events that will be observable with CTA, considering both on- and off-axis emission. In addition, we will present and discuss the prospects of potential follow-up strategies with CTA