Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology

A special issue of Pharmacoepidemiology (ISSN 2813-0618).

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 8214

Special Issue Editors


E-Mail Website
Guest Editor
Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, CA, USA
Interests: infectious diseases, and resistance to antimicrobial resistance; antimicrobial stewardship; clinical pharmacy; evidence-based practice; outcomes research; resistance; pharmacy

E-Mail Website
Guest Editor
School of Pharmacy, Chapman University, Irvine, CA 92618, USA
Interests: antimicrobial stewardship; clostridioides difficile; resistance; clinical outcomes

Special Issue Information

Dear Colleagues,

Antibiotics are life-saving medications. Since the inception of the first antibiotic, there have been continuous and growing complexities associated with the application and development of anti-infective agents, much of which is owed to antimicrobial resistance. The pharmacoepidemiology and pharmacovigilance of various antimicrobials tend to differ between institutions, patient populations, and countries due to an innumerable number of factors. However, there is one constant: the ever-changing nature of microorganisms influenced by antimicrobials. This Special Issue aims to collect articles that consider and foreground various aspects of anti-infectives, including resistance, adverse events, epidemiology, disparities in healthcare, health policy, and best practices. As knowledge regarding antimicrobials is further disseminated, novel frameworks can be developed and compared across various institutions or communities.

Dr. Lee Nguyen
Dr. Jason Yamaki
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacoepidemiology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (5 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Review

Jump to: Other

13 pages, 417 KiB  
Review
Remdesivir and the Liver: A Concise Narrative Review of Remdesivir-Associated Hepatotoxicity in Patients Hospitalized Due to COVID-19
by Alireza FakhriRavari and Mazyar Malakouti
Pharmacoepidemiology 2024, 3(1), 69-81; https://doi.org/10.3390/pharma3010005 - 13 Feb 2024
Viewed by 1906
Abstract
Severe acute respiratory syndrome coronavirus 2 has infected millions of people, but about 20% of infected individuals do not develop symptoms. COVID-19 is an inflammatory disease that affects a portion of individuals infected with the virus and it is associated with liver injury [...] Read more.
Severe acute respiratory syndrome coronavirus 2 has infected millions of people, but about 20% of infected individuals do not develop symptoms. COVID-19 is an inflammatory disease that affects a portion of individuals infected with the virus and it is associated with liver injury and other complications, leading to hospitalization, critical illness, and death. Remdesivir is an antiviral agent used for the treatment of hospitalized patients with COVID-19 to improve the time to recovery, reduce the duration of mechanical ventilation, decrease the need for supplemental oxygen, and decrease the risk of mortality. Remdesivir-associated hepatotoxicity has been observed as increased transaminases more than five times the upper limit of normal in hospitalized patients with COVID-19, but causality has not been proven. It is generally difficult to distinguish between remdesivir-associated hepatotoxicity and COVID-19-induced hepatotoxicity. The purpose of this review is to evaluate the evidence for remdesivir-associated hepatotoxicity. Current evidence suggests that elevated liver enzymes in hospitalized COVID-19 patients are more likely to be due to the infection than remdesivir, and a 5-day course of remdesivir seems to be safe in regard to hepatotoxicity. Full article
(This article belongs to the Special Issue Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology)
Show Figures

Figure 1

Other

Jump to: Review

7 pages, 911 KiB  
Case Report
Off-Label Use of Dalbavancin in Enterococcus spp. Abscess and Streptococcus pneumoniae Bacteremia Secondary to Septic Arthritis: A Retrospective Case Report
by Miriam Banoub Morkos, Giovani Leon, Mai-Chi Hong, Joshua Allan Garcia, Martin J. Breen, Bhanu Sud and Lee Nguyen
Pharmacoepidemiology 2024, 3(4), 307-313; https://doi.org/10.3390/pharma3040021 - 29 Sep 2024
Viewed by 525
Abstract
Dalbavancin, a semi-synthetic lipoglycopeptide with an extended half-life that allows for weekly dosing, is currently approved for the treatment of bacterial skin and soft tissue infections caused by susceptible gram-positive organisms. This case report discusses the successful treatment of septic arthritis with dalbavancin [...] Read more.
Dalbavancin, a semi-synthetic lipoglycopeptide with an extended half-life that allows for weekly dosing, is currently approved for the treatment of bacterial skin and soft tissue infections caused by susceptible gram-positive organisms. This case report discusses the successful treatment of septic arthritis with dalbavancin in a 38-year-old obese male. Septic arthritis, commonly caused by Staphylococcus aureus and Streptococcus species, was diagnosed in this patient following a mechanical fall that led to worsening shoulder pain. Given the patient’s morbid obesity and concerns about antibiotic penetration, dalbavancin 1500 mg IV biweekly was chosen for its extended half-life and ease of administration. This case underscores dalbavancin’s efficacy in managing septic arthritis in obese patients, offering a convenient alternative to traditional therapies that require a peripherally inserted central catheter (PICC line), frequent dosing, therapeutic monitoring, and prolonged hospital stays. Despite its higher cost, dalbavancin’s advantages include reduced need for PICC lines, additional staff and resources to monitor therapeutic drug levels, and fewer complications, which can offset some expenses. To our knowledge, this is the first documented case investigating the use of dalbavancin for enterococcal septic arthritis with a biweekly dosing regimen. Full article
(This article belongs to the Special Issue Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology)
Show Figures

Figure 1

10 pages, 585 KiB  
Brief Report
A Retrospective Analysis of the Clinical Effectiveness of Tigecycline in the Treatment of Clostridioides difficile-Associated Diarrhea
by Herman Joseph Johannesmeyer, Luiza Baloyan and Kristica Kolyouthapong
Pharmacoepidemiology 2024, 3(2), 231-240; https://doi.org/10.3390/pharma3020015 - 13 Jun 2024
Viewed by 843
Abstract
Clostridioides difficile infection (CDI) is the leading cause of nosocomial diarrhea in the United States. Tigecycline has been proposed as a potential treatment for CDI, though limited clinical data exist to support this practice. The objective of this study was to determine if [...] Read more.
Clostridioides difficile infection (CDI) is the leading cause of nosocomial diarrhea in the United States. Tigecycline has been proposed as a potential treatment for CDI, though limited clinical data exist to support this practice. The objective of this study was to determine if the provision of tigecycline provides a clinically meaningful benefit to inpatients with CDI. This study was a retrospective chart review enrolling inpatients receiving treatment for CDI. Patients were divided into cohorts depending on whether they received a standard antibiotic therapy regimen for CDI or an antibiotic treatment regimen that included tigecycline. The primary outcome was clinical recovery at the time of hospital discharge. A total of 39 and 22 patients were included in the standard antibiotic therapy and tigecycline groups, respectively. ATLAS (Age, Treatment, Leukocyte, Albumin, Serum creatinine) scores at the time of CDI diagnosis were similar between the two groups, though patients in the tigecycline groups were more likely to represent a recurrent episode of CDI. There was no difference in the rate of clinical recovery at the time of hospital discharge between the standard antibiotic therapy and tigecycline groups (38.5% vs. 36.4%, p = 0.8710). These data do not support the routine use of tigecycline for the treatment of CDI, though interpretation is limited due to baseline differences between groups and the retrospective, observational nature of this study. Full article
(This article belongs to the Special Issue Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology)
Show Figures

Figure 1

18 pages, 1026 KiB  
Systematic Review
Impact of Antibiotic De-Escalation on Antibiotic Consumption, Length of Hospitalization, Mortality, and Cost: A Systematic Review and Meta-Analysis
by Abeer Alanazi, Reem Almuhaya, Mohammad Almohaimeed, Nada Alahmari, Noor Abdulrahim, Marouj Basyouni, Farah Althikrallah, Jumanah Al Badwyi, Abdulrahman Khallaf, Khalid Albalawi, Amal Almalki, Khalid Alsaedi, Fatima Bakarman, Fatimah Alotaibi and Mohammed Kanan
Pharmacoepidemiology 2023, 2(4), 289-306; https://doi.org/10.3390/pharma2040025 - 13 Oct 2023
Viewed by 2343
Abstract
Overuse and misuse of antibiotics have led to the emergence of antibiotic-resistant bacteria and pose a significant threat due to adverse drug reactions, increased healthcare costs, and poor patient outcomes. Antibiotic stewardship programs, including antibiotic de-escalation, aim to optimize antibiotic use and to [...] Read more.
Overuse and misuse of antibiotics have led to the emergence of antibiotic-resistant bacteria and pose a significant threat due to adverse drug reactions, increased healthcare costs, and poor patient outcomes. Antibiotic stewardship programs, including antibiotic de-escalation, aim to optimize antibiotic use and to reduce the development of antibiotic resistance. This systematic review and meta-analysis aim to fill the gap by analyzing the current literature on the implications of antibiotic de-escalation in patients on antibiotic use, duration of hospital stay, mortality, and cost; to update clinical practice recommendations for the proper use of antibiotics; and to offer insightful information about the efficacy of antibiotic de-escalation. Based on the PRISMA 2020 recommendations, a comprehensive literature search was conducted using electronic databases and reference lists of identified studies. Eligible studies were published in English, conducted in humans, and evaluated the impact of antibiotic de-escalation on antibiotic consumption, length of hospitalization, mortality, or cost in hospitalized adult patients. Data were extracted using a standardized form, and the quality of included studies was assessed using the Newcastle–Ottawa Scale. The data from 25 studies were pooled and analyzed using the Revman-5 software, and statistical heterogeneity was evaluated using a chi-square test and I2 statistics. Among the total studies, seven studies were conducted in pediatric patients and the remaining studies were conducted in adults. The studies showed a wide range of de-escalation rates, with most studies reporting a rate above 50%. In some studies, de-escalation was associated with a decrease in antimicrobial utilization and mean length of stay, but the impact on overall cost was mixed. Our pooled analysis for mortality reported that a significant difference was observed between the de-escalation group and the non-de-escalation group in a random effect model (RR = 0.67, 95% CI 0.52–0.86, p = 0.001). The results suggest that de-escalation therapy can be applied in different healthcare settings and patient populations. However, the de-escalation rate varied depending on the study population and definition of de-escalation. Despite this variation, the results of this systematic review support the importance of de-escalation as a strategy to optimize antibiotic therapy and to reduce the development of subsequent antibiotic resistance. Further studies are needed to evaluate the impact of de-escalation on patient outcomes and to standardize the definition of de-escalation to allow for better comparison of studies. Full article
(This article belongs to the Special Issue Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology)
Show Figures

Figure 1

6 pages, 238 KiB  
Brief Report
Detectable Vancomycin Stool Concentrations in Hospitalized Patients with Diarrhea Given Intravenous Vancomycin
by Taryn A. Eubank, Chenlin Hu, Anne J. Gonzales-Luna and Kevin W. Garey
Pharmacoepidemiology 2023, 2(4), 283-288; https://doi.org/10.3390/pharma2040024 - 28 Sep 2023
Viewed by 1460
Abstract
Vancomycin is not appreciably passaged via the colonic membrane to the gastrointestinal (GI) tract in persons with an intact gut epithelium due to its large chemical structure. However; hospitalized patients with diarrhea often have a disrupted GI tract. The aim of this study [...] Read more.
Vancomycin is not appreciably passaged via the colonic membrane to the gastrointestinal (GI) tract in persons with an intact gut epithelium due to its large chemical structure. However; hospitalized patients with diarrhea often have a disrupted GI tract. The aim of this study was to determine the frequency of detectable vancomycin concentrations in the stool of patients with antibiotic-associated diarrhea receiving IV vancomycin. This was a multicenter cohort study of hospitalized patients with stool samples collected for Clostridioides difficile testing. Leftover stool samples were collected from patients who had received at least 3 days of IV vancomycin. Fecal vancomycin was quantified by high-performance liquid chromatography. The study cohort included 33 unique patients, majority female (54.5%) aged 60 years (range 23–84). Eighteen of thirty-three patients (54.5%) tested positive for C. difficile toxins. The average duration of systemic vancomycin administration prior to stool collection was 3.5 (range 2–15) days. Three of 33 (9%) stool samples had a detectable vancomycin concentration (range 1.2–13.2 mcg/mL). These concentrations may promote the development of vancomycin-resistant Enterococcus or van mutations in C. difficile, leading to vancomycin resistance. Further studies on implications are warranted. Full article
(This article belongs to the Special Issue Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology)
Back to TopTop