scholarly journals Impact of Colistin Dosing on the Incidence of Nephrotoxicity in a Tertiary Care Hospital in Saudi Arabia

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 485 ◽  
Author(s):  
Reem Almutairy ◽  
Waad Aljrarri ◽  
Afnan Noor ◽  
Pansy Elsamadisi ◽  
Nour Shamas ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Clinical Cure ◽  
Clinical Cure Rate ◽  
Serum Albumin Level ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Severity Of Illness ◽  
Albumin Level ◽  
Care Hospital ◽  
Cure Rate

Colistin therapy is associated with the development of nephrotoxicity. We examined the incidence and risk factors of nephrotoxicity associated with colistin dosing. We included adult hospitalized patients who received intravenous (IV) colistin for >72 h between January 2014 and December 2015. The primary endpoint was the incidence of colistin-associated acute kidney injury (AKI). The secondary analyses were predictors of nephrotoxicity, proportions of patients inappropriately dosed with colistin according to the Food and Drug Administration (FDA), European Medicines Agency (EMA), and Garonzik formula and clinical cure rate. We enrolled 198 patients with a mean age of 55.67 ± 19.35 years, 62% were men, and 60% were infected with multidrug-resistant organisms. AKI occurred in 44.4% (95% CI: 37.4–51.7). Multivariable analysis demonstrated that daily colistin dose per body weight (kg) was associated with AKI (OR: 1.57, 95% CI: 1.08–2.30; p = 0.02). Other significant predictors included serum albumin level, body mass index (BMI), and severity of illness. None of the patients received loading doses, however FDA-recommended dosing was achieved in 70.2% and the clinical cure rate was 13%. The incidence of colistin-associated AKI is high. Daily colistin dose, BMI, serum albumin level, and severity of illness are independent predictors of nephrotoxicity.

scholarly journals Prospective Study of the Wilson Severity-of-Illness Scoring System for Complicated Skin and Skin Structure Infections

2012 ◽  
Vol 57 (1) ◽  
pp. 647-650 ◽  
Author(s):  
George H. Talbot ◽  
Tanya O'Neal ◽  
Anita F. Das ◽  
Dirk Thye
Keyword(s):  
Clinical Cure ◽  
Clinical Cure Rate ◽  
Severity Of Illness ◽  
Cure Rate ◽  
Two Phase ◽  
Ceftaroline Fosamil ◽  
Risk Class ◽  
Skin Structure ◽  
Complicated Skin ◽  
Cure Rates

ABSTRACTWilson et al. (Am. J. Surg.185:369–375, 2003) developed a disease severity classification system for use in complicated skin and skin structure infections (cSSSI). Two phase 3 trials of ceftaroline fosamil in cSSSI provided the opportunity to evaluate the association between Wilson Severity Risk Class and clinical cure rates. Our analyses did not confirm that an association exists between Wilson Severity Risk Class and clinical cure rate and, thus, did not validate its predictive utility.

scholarly journals Preoperative serum albumin level as a predictor of surgical complications after emergency abdominal surgery

2019 ◽  
Vol 6 (2) ◽  
pp. 361
Author(s):  
Sharath Kumar V. ◽  
Dhruva G. Prakash ◽  
Venkatasiva Krishna Pottendla
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Tertiary Care ◽  
Total Mortality ◽  
Albumin Level ◽  
Morbidity And Mortality ◽  
Preoperative Serum ◽  
Emergency Abdominal Surgery

Background: Hypoalbumenia has been shown to be associated with increased morbidity and mortality in acute surgical patients due to increased catabolism. This study intends to correlate between hypoalbumenia and postoperative complications in patients undergoing emergency abdominal surgery.Methods: A prospective study is done in a rural tertiary care centre in a total of 190 patients undergoing emergency abdominal surgery after obtaining ethical clearance. In this study preoperative serum albumin and postoperative complications including death up to postoperative day thirty were recorded and gathered using a checklist designed for the study and analysed. Serum albumin less than 3.5g/dl is considered as hypoalbumenia in this study. The correlation between preoperative serum albumin and postoperative morbidity and mortality is assessed.Results: In a total of 190 patients, 93 (48.9%) patients had morbidity and 27 (14.2%) patients had mortality. Preoperative serum albumin less than 3.5g/dl is found in 120 (63.1%) cases and 70 (36.9%) patients has same or more than 3.5g/dl. Patients with preoperative serum albumin less than 3.5g/dl has morbidity in 87 (45.8%) patients than that of normal preoperative serum albumin level which is 6 (3.1%) cases (p= <0.0001, chi-square =72.31). The total mortality is 27 (14.2%) in which all mortality is found in low albumin group compared to no mortality in patients with normal serum albumin. As the albumin level decreases the risk of morbidity and mortality increases with majority of complication in this study occurring in patients with albumin group less than 2.5g/dl to 3g/dl.Conclusions: Preoperative serum albumin is a good predictor of surgical outcome after emergency abdominal surgery.

scholarly journals Predictive value of pre-arrest albumin level with GO-FAR score in patients with in-hospital cardiac arrest

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seok-In Hong ◽  
Youn-Jung Kim ◽  
Yeon Joo Cho ◽  
Jin Won Huh ◽  
Sang-Bum Hong ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Serum Albumin ◽  
Characteristic Curve ◽  
Tertiary Care ◽  
Predictive Performance ◽  
Albumin Level ◽  
Ordinal Scale ◽  
Care Hospital ◽  
Neurologic Outcomes ◽  
Hospital Cardiac Arrest

AbstractWe investigated whether combining the pre-arrest serum albumin level could improve the performance of the Good Outcome Following Attempted Resuscitation (GO-FAR) score for predicting neurologic outcomes in in-hospital cardiac arrest patients. Adult patients who were admitted to a tertiary care hospital between 2013 and 2017 were assessed. Their pre-arrest serum albumin levels were measured within 24 h before the cardiac arrest. According to albumin levels, the patients were divided into quartiles and were assigned 1, 0, 0, and, − 2 points. Patients were allocated to the derivation (n = 419) and validation (n = 444) cohorts. The proportion of favorable outcome increased in a stepwise manner across increasing quartiles (p for trend < 0.018). Area under receiver operating characteristic curve (AUROC) of the albumin-added model was significantly higher than that of the original GO-FAR model (0.848 vs. 0.839; p = 0.033). The results were consistent in the validation cohort (AUROC 0.799 vs. 0.791; p = 0.034). Net reclassification indices of the albumin-added model were 0.059 (95% confidence interval [CI] − 0.037 to 0.094) and 0.072 (95% CI 0.013–0.132) in the derivation and validation cohorts, respectively. An improvement in predictive performance was found by adding the ordinal scale of pre-arrest albumin levels to the original GO-FAR score.

scholarly journals Serum albumin level as prognostic indicator of acute ischemic stroke in tertiary care hospital admitted patients

2020 ◽  
Vol 7 (6) ◽  
pp. 948
Author(s):  
Prafulla Kumar Dash ◽  
Smrutiranjan Behera ◽  
Nirmal Chandra Sahoo ◽  
Roma Rattan ◽  
Saroj Kumar Tripathy
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Serum Albumin ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Osmotic Gradient ◽  
Care Hospital

Background: Serum Albumin level is an important multifunctional protein in the blood for maintaining the normal permeability across vessel wall by osmotic gradient, in inhibiting platelet aggregation and in reducing blood viscosity.  Serum albumin level as a novel parameter for predicting outcome and assessment of severity of coronary artery disease is established. Keeping in mind the scarcity of studies regarding albumin level in ischemic Cerebrovascular Accident (CVA), present study was undertaken to correlate serum albumin level with clinical outcome in acute ischemic stroke (AIS) patients.Methods: One hundred patients of diagnosed AIS were included in the study. Thorough clinical examination and risk factor profile assessment was done. Severity of stroke was assessed using National Institute of Health Stroke Scale (NIHSS) Score and then followed up to 1 week and 3 months post-admission with serum albumin level and assessment was done using modified Rankin Scale (mRS) score. Institutional ethics committee cleared the study.Results: In 100 patients with AIS, 58% were male and 42% were female. Mean age was 65±8.160. Motor weakness (85%) was the commonest presenting symptom. Around 75% of patients revealed infarction in middle cerebral artery (MCA) territory. Hypertension (HTN) (74%) was the most frequently associated comorbid condition. Patients with low serum albumin level at admission time were directly proportional to severity of stroke at presentation and poor clinical outcome. 1 week and 3 months follow up mean albumin level (g/dl) was 3.8±0.25 and 3.7±0.23 in patients with poor functional outcome respectively. Significant co-relation between mean serum albumin level and clinical outcome was observed.Conclusions: Serum albumin level is inversely correlated with severity of stroke at presentation and functional outcome in patients on follow up.

scholarly journals Low Serum Albumin Level is Risk Factor for Patients with Percutaneous Endoscopic Gastrostomy

2010 ◽  
Vol 49 (21) ◽  
pp. 2283-2288 ◽  
Author(s):  
Naoyuki Tominaga ◽  
Ryo Shimoda ◽  
Ryuichi Iwakiri ◽  
Nanae Tsuruoka ◽  
Yasuhisa Sakata ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Endoscopic Gastrostomy ◽  
Low Serum

scholarly journals 1692. Retrospective Review on the Safety and Efficacy of Nitrofurantoin for the Treatment of Cystitis in the Veteran Population With or Without Renal Insufficiency

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S829-S830
Author(s):  
Elwyn W Welch ◽  
Shaila Sheth ◽  
Chester Ashong ◽  
Caroline Pham
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Clinical Cure ◽  
Clinical Cure Rate ◽  
Retrospective Chart Review ◽  
Outpatient Setting ◽  
Secondary Outcome ◽  
Cure Rate ◽  
Acute Cystitis ◽  
Significant Difference

Abstract Background Nitrofurantoin has been used to treat cystitis in women; however, data supporting its use in men is lacking. In addition, recent retrospective studies have challenged the manufacturer’s recommendation to avoid nitrofurantoin with creatinine clearances (CrCl) less than 60 mL/min. The purpose of this study is to compare the efficacy and safety of nitrofurantoin for the treatment of acute cystitis in male and female veterans with variable degrees of renal dysfunction. Methods A retrospective chart review was conducted in adult patients who received nitrofurantoin for acute cystitis in the outpatient setting between May 1, 2018 and May 1, 2019. The primary outcomes were rates of clinical cure as compared between males and females, and across various renal function groups (CrCl greater than 60 mL/min, 30 to 60 mL/min, and less than 30 mL/min) following treatment with nitrofurantoin. The secondary outcome was adverse event rates. Results A total of 446 patients were included with 278 females and 168 males. Overall clinical cure rate was 86.5% (n=386). Clinical cure rate did not vary between genders (p=0.0851) or CrCl ranges (p=1.0) as shown in the tables. Benign prostatic hyperplasia (BPH) was associated with decreased odds of clinical cure (OR 0.50 [95% CI 0.26-0.97], p=0.0404) in addition to cirrhosis (OR 0.22 [95% CI 0.06-0.91], p=0.0357). Adverse events occurred in 2% of patients and did not vary based on gender or renal function. RATES OF CLINICAL CURE Conclusion There was no statistically significant difference in clinical cure with nitrofurantoin between genders and various renal impairments. However, history of BPH and cirrhosis were associated with decreased efficacy. Subgroup analysis also revealed lower efficacy in males with CrCl greater than 60 mL/min versus females with similar renal function. This study adds to the growing body of literature suggesting that renal dysfunction with CrCl of 30 to 60 mL/min may not carry the risk of treatment failure and adverse effects previously associated with nitrofurantoin, but large randomized trials are needed to confirm these results. Disclosures All Authors: No reported disclosures

scholarly journals A Japanese traditional medicine Hochuekkito promotes negative conversion of vancomycin-resistant Enterococci

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junko Kohno ◽  
Tsuyoshi Kawamura ◽  
Akiko Kikuchi ◽  
Tetsuya Akaishi ◽  
Shin Takayama ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care ◽  
Albumin Level ◽  
Kampo Medicine ◽  
Care Hospital ◽  
Intestinal Immunity ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Japanese Traditional Medicine ◽  
Negative Conversion

AbstractVancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p = .0003). Administration of probiotics (p = .0065) and Kampo medicines with probiotics (p = .0002), especially of the Kampo medicine hochuekkito (p = .0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p = 0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

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