9 results on '"Esteve-Pitarch, Erika"'
Search Results
2. A Real-World Data Observational Analysis of the Impact of Liposomal Amphotericin B on Renal Function Using Machine Learning in Critically Ill Patients.
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Sacanella, Ignasi, Esteve-Pitarch, Erika, Guevara-Chaux, Jessica, Berrueta, Julen, García-Martínez, Alejandro, Gómez, Josep, Casarino, Cecilia, Alés, Florencia, Canadell, Laura, Martín-Loeches, Ignacio, Grau, Santiago, Candel, Francisco Javier, Bodí, María, and Rodríguez, Alejandro
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ANTIFUNGAL agents ,AMPHOTERICIN B ,ACUTE kidney failure ,RANDOM forest algorithms ,ELECTRONIC health records - Abstract
Background: Liposomal amphotericin B (L-AmB) has become the mainstay of treatment for severe invasive fungal infections. However, the potential for renal toxicity must be considered. Aims: To evaluate the incidence of acute kidney injury (AKI) in critically ill patients receiving L-AmB for more than 48 h. Methods: Retrospective, observational, single-center study. Clinical, demographic and laboratory variables were obtained automatically from the electronic medical record. AKI incidence was analyzed in the entire population and in patients with a "low" or "high" risk of AKI based on their creatinine levels at the outset of the study. Factors associated with the development of AKI were studied using random forest models. Results: Finally, 67 patients with a median age of 61 (53–71) years, 67% male, a median SOFA of 4 (3–6.5) and a crude mortality of 34.3% were included. No variations in serum creatinine were observed during the observation period, except for a decrease in the high-risk subgroup. A total of 26.8% (total population), 25% (low risk) and 13% (high risk) of patients developed AKI. Norepinephrine, the SOFA score, furosemide (general model), potassium, C-reactive protein and procalcitonin (low-risk subgroup) were the variables identified by the random forest models as important contributing factors to the development of AKI other than L-AmB administration. Conclusions: The development of AKI is multifactorial and the administration of L-AmB appears to be safe in this group of patients. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Clinical and Microbiological Impact of Implementing a Decision Support Algorithm Through Microbiologic Rapid Diagnosis in Critically Ill Patients. An Epidemiological Retrospective Pre/Post Intervention Study
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Rodriguez, Alejandro H, primary, Gomez, Frederic, additional, Sarvisé, Carolina, additional, Gutierrez, Cristina, additional, Galofre-Giralt, Montserrat, additional, Guerrero-Torres, María Dolores, additional, Pardo-Granell, Sergio, additional, Benavent-Bofill, Clara, additional, Trefler, Sandra, additional, Berrueta, Julen, additional, Canadell, Laura, additional, Claverias, Laura, additional, Esteve-Pitarch, Erika, additional, Olona, Montserrat, additional, García-Pardo, Graciano, additional, Teixido, Xavier, additional, Bordonado, Laura, additional, Sans-Mateu, María Teresa, additional, and Bodí, María, additional
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- 2023
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4. Clinical and Microbiological Impact of Implementing a Decision Support Algorithm through Microbiologic Rapid Diagnosis in Critically Ill Patients: An Epidemiological Retrospective Pre-/Post-Intervention Study.
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Rodríguez, Alejandro, Gómez, Frederic, Sarvisé, Carolina, Gutiérrez, Cristina, Giralt, Montserrat Galofre, Guerrero-Torres, María Dolores, Pardo-Granell, Sergio, Picó-Plana, Ester, Benavent-Bofill, Clara, Trefler, Sandra, Berrueta, Julen, Canadell, Laura, Claverias, Laura, Esteve Pitarch, Erika, Olona, Montserrat, García Pardo, Graciano, Teixidó, Xavier, Bordonado, Laura, Sans, María Teresa, and Bodí, María
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CRITICALLY ill ,MICROBIOLOGICAL techniques ,VENTILATOR-associated pneumonia ,RESPIRATORY infections ,NOSOCOMIAL infections - Abstract
Background: Data on the benefits of rapid microbiological testing on antimicrobial consumption (AC) and antimicrobial resistance patterns (ARPs) are scarce. We evaluated the impact of a protocol based on rapid techniques on AC and ARP in intensive care (ICU) patients. Methods: A retrospective pre- (2018) and post-intervention (2019–2021) study was conducted in ICU patients. A rapid diagnostic algorithm was applied starting in 2019 in patients with a lower respiratory tract infection. The incidence of nosocomial infections, ARPs, and AC as DDDs (defined daily doses) were monitored. Results: A total of 3635 patients were included: 987 in the pre-intervention group and 2648 in the post-intervention group. The median age was 60 years, the sample was 64% male, and the average APACHE II and SOFA scores were 19 points and 3 points. The overall ICU mortality was 17.2% without any differences between the groups. An increase in the number of infections was observed in the post-intervention group (44.5% vs. 17.9%, p < 0.01), especially due to an increase in the incidence of ventilator-associated pneumonia (44.6% vs. 25%, p < 0.001). AC decreased from 128.7 DDD in 2018 to 66.0 DDD in 2021 (rate ratio = 0.51). An increase in Pseudomonas aeruginosa susceptibility of 23% for Piperacillin/tazobactam and 31% for Meropenem was observed. Conclusion: The implementation of an algorithm based on rapid microbiological diagnostic techniques allowed for a significant reduction in AC and ARPs without affecting the prognosis of critically ill patients. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
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Martínez-Casanova, Javier, primary, Esteve-Pitarch, Erika, additional, Colom-Codina, Helena, additional, Gumucio-Sanguino, Víctor Daniel, additional, Cobo-Sacristán, Sara, additional, Shaw, Evelyn, additional, Maisterra-Santos, Kristel, additional, Sabater-Riera, Joan, additional, Pérez-Fernandez, Xosé L., additional, Rigo-Bonnin, Raül, additional, Tubau-Quintano, Fe, additional, Carratalà, Jordi, additional, and Padullés-Zamora, Ariadna, additional
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- 2023
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6. Infección grave por coronavirus SARS-CoV-2: experiencia en un hospital de tercer nivel con pacientes afectados por COVID-19 durante la pandemia 2020
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Rodríguez, A., primary, Moreno, G., additional, Gómez, J., additional, Carbonell, R., additional, Picó-Plana, E., additional, Benavent Bofill, C., additional, Sánchez Parrilla, R., additional, Trefler, S., additional, Esteve Pitarch, E., additional, Canadell, L., additional, Teixido, X., additional, Claverias, L., additional, Bodí, M., additional, Bastón Paz, Natalia, additional, Sarvisé Buil, Carolina, additional, Gómez Bertomeu, Frederic, additional, Recio Comi, Gemma, additional, Martin Grau, Carla, additional, Montolio Breva, Silvia, additional, Rivera Moreno, Victoria, additional, Sabaté Piñol, Modest, additional, Molina Clavero, Carmen, additional, Serrat Orús, Nuria, additional, Teresa Sans Mateu, Maria, additional, Gutiérrez Fornes, Cristina, additional, Montserrat Olona Cabases, M., additional, Teixidó, Xavier, additional, Gil Castillejos, Diana, additional, Burló Arévalo, Nuria, additional, Canadell, Laura, additional, Esteve Pitarch, Erika, additional, Bodi, María, additional, Rodríguez, Alejandro, additional, Moreno, Gerard, additional, Villavicencio, Christian, additional, Carmen Gilavert, Mari, additional, Rosich, Sara, additional, Pobo, Ángel, additional, Magret, Mónica, additional, Sirgo, Gonzalo, additional, Blázquez, Vanessa, additional, Esteban, Federico, additional, Leache, Iulen, additional, Perello, Paula, additional, Oliva, Iban, additional, Samper, Manuel, additional, Plans, Oriol, additional, Cartanyá, Marc, additional, Canelles, Sandra, additional, Carbonell, Raquel, additional, Guasch, Neus, additional, Ferré, Cristina, additional, Manrique, Sara, additional, Daniel, Xavier, additional, Urgeles, Silvia, additional, David, Ivan, additional, Roure, Marina, additional, Murillo, Natalia, additional, Sánchez, Marina, additional, Salgado, Melina, additional, Gómez, Josep, additional, Ruiz-Botella, Manuel, additional, Albiol, Jordi, additional, and Mayol, Eduard, additional
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- 2020
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7. OTAC: Optimization of Antibiotic Therapy in Critically ill Patients. Using beta-lactam antibiotics by continuous infusion
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Esteve Pitarch, Erika, Padullés Zamora, Ariadna, Maisterra-Santos, Kristel, Colom Codina, Helena, and Cobo Sacristán, Sara
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Adult ,Male ,Critical Illness ,lcsh:Medicine ,lcsh:RS1-441 ,Microbial Sensitivity Tests ,lcsh:Pharmacy and materia medica ,Hospitals, University ,Tertiary Care Centers ,Medicina intensiva ,polycyclic compounds ,Humans ,Antibiòtics betalactàmics ,Beta-lactams ,Pseudomonas Infections ,Critical care medicine ,Pharmacokinetics ,Prospective Studies ,Infusions, Intravenous ,Aged ,Piperacillin ,Cross Infection ,Farmacocinètica ,lcsh:R ,Clinical Studies as Topic ,Enterobacteriaceae Infections ,Meropenem ,biochemical phenomena, metabolism, and nutrition ,Middle Aged ,bacterial infections and mycoses ,Drug monitoring ,Anti-Bacterial Agents ,Critical care ,Intensive Care Units ,Piperacillin, Tazobactam Drug Combination ,bacteria ,Female ,Beta lactam antibiotics - Abstract
To determine the percentage of patients given standard doses of piperacillin/tazobactam or meropenem by continuous infusion who achieved the target pharmacokinetic/pharmacodynamic (PK/PD) index, which was defined as free concentrations four times more than the minimum inhibitory concentration (CMI) for 100% of the dosing interval (100% fT≥ 4 x MIC).Preliminary data from a larger prospective clinical study analysing the PK/PD behaviour of β-lactams antibiotics continuous infusion (CI) in critical patients. The study was conducted in the intensive care units of a tertiary university hospital for adults (June 2015-May 2017). Inclusion criteria: normal renal function (glomerular renal function (GFR) CKD-EPI formula ≥ 60 mL/min/1.73 m2) and treatment with standard dose β-lactams CI. Concentrations at steady state (Css) conditions were determined using UHPLC-MS/MS. We selected the highest susceptible MIC for all likely organisms according to European Commitee on Antimicrobial Susceptibility Testing's (i.e. piperacillin/tazobactam: 8 mg/L for enterobacteriaceae and 16 mg/L for Pseudomonas aeruginosa; meropenem: 2 mg/L for any microorganism). In addition, a subanalysis of patients was conducted using actual MIC values.61 patients were enrolled (25 to meropenem and 36 to piperacillin/tazobactam). Average age was 59 (15) years and median GFR rate was 95 mL/min/1.73 m2 (83-115). Median meropenem and piperacillin free concentrations were 16 mg/L (11-29) and 40 mg/L (21- 51), respectively. 88% of patients treated with meropenem reached the PK/PD target, without differences between both microorganisms. For piperacillin/tazobactam, 61% and 11% of patients reached the target, with enterobacteriaceae and Pseudomonas as suspected microorganisms, respectively. The pathogen was isolated in 35 (57%) patients: 94% reached the target PK/PD, without differences between both antibiotic therapies.Standard doses of meropenem CI are sufficient to achieve a PK/PD target of 100% fT≥ 4 x MIC in suspected infections with high MICs (Pseudomonas aeruginosa or enterobacteriaceae). However, higher doses of piperacillin/tazobactam could be considered to achieve this goal. In patients with isolated microorganisms, a standard dose of both antibiotic therapies would be sufficient to achieve the target. Therapeutic drug monitoring is highly recommended for therapeutic optimization.Objetivo: Determinar el porcentaje de pacientes, a los que se les administró dosis estándar de piperacilina/tazobactam o meropenem en perfusión continua, que alcanzaban el índice farmacocinético/farmacodinámico diana definido como el 100% del intervalo de administración en que las concentraciones de antibiótico libre fueron cuatro veces iguales o superiores a la concentración mínima inhibitoria (100% fT ≥ 4 x CMI).Método: Datos preliminares obtenidos de un estudio clínico prospectivo que analiza el comportamiento farmacocinético/farmacodinámico de los antibióticos betalactámicos administrados en perfusión continua en pacientes críticos. Se realizó en unidades de cuidados intensivos de un hospital universitario de tercer nivel, desde junio de 2015 a mayo de 2017. Criterios de inclusión: adultos con función renal correcta (filtrado glomerular según la fórmula CKD-EPI ≥ 60 ml/min/1,73 m2) y tratados con dosis estándar de antibióticos betalactámicos en perfusión continua. Las concentraciones en estado de equilibrio estacionario fueron determinadas mediante cromatografía líquida acoplada a espectrometría de masas (UHPLC- MS/MS). Se utilizaron valores de concentración mínima inhibitoria teóricos para microorganismos más resistentes (piperacilina/ tazobactam: 16 mg/l para Pseudomonas aeruginosa y 8 mg/l para Enterobacteriaceae; meropenem: 2 mg/l, independientemente del microorganismo). Además, se realizó un subanálisis de los pacientes con aislamiento microbiológico (concentraciones mínimas inhibitorias reales).Resultados: Se incluyeron 61 pacientes (25 meropenem y 36 piperacilina/ tazobactam). Edad media 59 años (15), mediana de filtrado glomerular 95 ml/min/1,73 m2 (83-115). Mediana de concentraciones en estado de equilibrio estacionario libre: 16 mg/l (11- 29) meropenem y 40 mg/l (21-51) piperacilina. El 88% de los pacientes tratados con meropenem alcanzaron el objetivo farmacocinético/farmacodinámico, sin diferencias entre Enterobacteriaceae y Pseudomonas. En el caso de piperacilina/tazobactam, el 61% y el 11% de los pacientes alcanzaron la diana, considerando Enterobacteriaceae y Pseudomonas como microorganismo sospechoso. Un total de 35 (57%) pacientes presentaron aislamiento microbiológico. El 94% de ellos alcanzaron la diana, sin diferencias entre los dos antibióticos.Conclusiones: Ante la sospecha de infecciones por microorganismos con concentraciones mínimas inhibitorias elevadas (Pseudomonas aeruginosa o enterobacterias), se observa que dosis convencionales de meropenem en perfusión continua son suficientes para lograr la diana 100% fT≥ 4 x MIC. Sin embargo, se requerirían dosis superiores de piperacilina/tazobactam. En casos de aislamiento microbiológico, dosis estándar de ambos antibióticos fueron suficientes para lograr la diana. La monitorización farmacocinética es altamente recomendable para la optimización terapéutica.
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- 2019
8. OTAC: Optimización de la Terapia Antibiótica en el paciente Crítico. Antibióticos betalactámicos en perfusión continua.
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Esteve-Pitarch, Erika, Padullés-Zamora, Ariadna, Maisterra-Santos, Kristel, Colom-Codina, Helena, and Cobo-Sacristán, Sara
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- 2019
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9. OTAC: Optimization of Antibiotic Therapy in Critically ill Patients. Using beta-lactam antibiotics by continuous infusion
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Esteve-Pitarch, Erika, Padullés-Zamora, Ariadna, Maisterra-Santos, Kristel, Colom-Codina, Helena, and Cobo-Sacristán, Sara
- Abstract
To determine the percentage of patients given standard doses of piperacillin/tazobactam or meropenem by continuous infusion who achieved the target pharmacokinetic/pharmacodynamic (PK/PD) index, which was defined as free concentrations four times more than the minimum inhibitory concentration (CMI) for 100% of the dosing interval (100% fT ≥ 4 x MIC).
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- 2019
- Full Text
- View/download PDF
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