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Introduction: Methicillin-resistantStaphylococcus aureus(MRSA) is a problematic pathogen in both outpatient and inpatient settings. Research to optimize the dosing of these agents is needed to slow the development of antimicrobial resistance and to decrease the likelihood of clinical failure. Areas covered: This review summarizes the available data for orally administered antimicrobials routinely used as monotherapy for MRSA infections. We make recommendations and highlight the current gaps in the literature. A PubMed (1966 – Present) search was performed to identify relevant literature for this review. Expert commentary: There is a vast divide in the amount of pharmacokinetic/pharmacodynamic data to guide dosing decisions for older MRSA agents compared with the oxazolidenones. Five-year view: Additional retrospective data will become available for the older MRSA agents in severe MRSA infections. [ABSTRACT FROM PUBLISHER]

It is important to assess which dispensed medications remain unused as accumulated home medications serve as a source for poisonings, abuse, and misuse. The objective of this study was to characterize and quantify controlled substances relinquished at community medication take back events. Medications were brought to events from 2011 to 2015 across six states. We analyzed medication classification (over-the counter, controlled, non-controlled), medication name, strength, formulation, original dispensed quantity, collected quantity, and therapeutic class. The top nine controlled therapeutic class categories are reported in this study, excluding liquid formulations. The total number of collected controlled prescriptions and units (tablets/capsules/patches) were calculated. Averages are presented for dispensed and collected quantity, and percent waste (unused) for medication categories. Over 10,270 prescriptions with 280,813 units were collected and logged. With 85 units per prescription, morphine had the greatest average originally dispensed units. Hydrocodone had the greatest quantity of prescriptions (4,717), containing 104,460 units. Pregabalin had the highest waste at 74.8%, followed by fentanyl patches (70.1%) and morphine (68.4%). Of the medications returned, more than half of the originally dispensed prescriptions for all medication categories remained unused. All aspects of controlled substance supply and demand should be scrutinized to address this public health epidemic while ensuring optimal patient care. [ABSTRACT FROM AUTHOR]

Obesity is a worldwide epidemic associated with multiple comorbidities that increase the risk of hospitalization. Very little pharmacokinetic data are available for antifungal agents in obesity, as this population is often excluded from drug development studies and these agents are less commonly used than other antimicrobials. Systemic antifungal therapy for invasive candidiasis continues to have a high failure rate, and dose optimization in obesity provides an opportunity for improvement. Based on currently available data, some antifungals should be dosed based on total body weight (i.e. fluconazole), while others should not be adjusted for increased body weight (i.e. posaconazole). More studies are needed to determine if and when dosing changes are needed for many of the antifungal agents. Therefore, drug therapy regimens should be individually evaluated for dose optimization due to body weight. [ABSTRACT FROM PUBLISHER]