Optimizing Medication Therapy & Improving Outcomes

April 29, 2016

Urinary Tract Infections: Causes and Treatment Update

Urinary tract infections (UTIs) are very common in women and may be classified as acute (uncomplicated), recurrent, or complicated. Due to increasing antibiotic resistance, beta-lactam therapy has become less effective. There have also been recent reports of drug-induced UTIs related to sodium-glucose cotransporter 2 (SGLT2) inhibitors. Treatment of complicated UTIs (cUTIs) has become increasingly complex because of the rising prevalence of multidrug-resistant gram-negative bacteria. Two new IV antibiotics (Zerbaxa, Avycaz) have the potential to overcome some of the antibiotic resistance noted with oral medications. Both of these drugs combine an antibiotic with novel beta-lactamase inhibitors and have shown promise in eradicating gram-negative resistant infections. Read more.

Lyme Disease: The Pharmacist’s Role in Treatment and Prevention

Lyme disease, the most common tick-borne infection in the United States, is usually caused by the bacteriumBorrelia burgdorferi. While the typical manifestation of early disease is a skin lesion called erythema migrans, progression to more severe neurologic and cardiac sequelae can occur. When symptoms are identified early, there is a high cure rate with antimicrobial treatment. Most important, the disease is preventable with prompt identification and removal of all ticks and with other measures such as appropriate clothing and use of insecticides. Pharmacists can play a role in assisting in prevention and treatment of early disease. Read more.

Management of Invasive Aspergillosis

Invasive aspergillosis (IA) is a rare, serious fungal infection commonly affecting immunocompromised patients. The precise incidence of IA has not been documented, and reported incidence rates vary widely. Some typical risk factors for IA include hematopoietic stem-cell transplants, long-term corticosteroid therapy, hematologic malignancies, and HIV. The lungs are the most frequent site of IA; consequently, symptoms and clinical manifestations are typically pulmonary. Because of the high risk of fatality, IA management with the appropriate agents must commence as quickly as possible. Voriconazole is the first-line empirical therapy recommended by Infectious Diseases Society of America guidelines; if there is no clinical response, then salvage therapy with other azoles, echinocandins, or amphotericin B lipid formulations should be administered. Read more.

Medication Therapy Management in the News

Patients Often Don’t Reveal Complementary, Alternative Therapy Usage

While customers primarily purchasing herbs or supplements from a pharmacy or elsewhere are a bit more likely to tell their physicians than those practicing yoga or meditation, many patients don’t disclose use of CAM, according to a research letter published in JAMA Internal Medicine. Read more.

Beta-Blockers Appear to Reduce Risk of COPD Exacerbations

A common cardiology drug is showing promise in reducing the risk of chronic obstructive pulmonary disease exacerbations, although they are suspected of tightening airway muscles. Read more

Increased Risk of Bladder Cancer With Pioglitazone Confirmed in Study

The risk of bladder cancer is increased with use of the diabetes drug pioglitazone, and that risk appears to increase with duration of use and dosage. Read more.

Determining How Long to Continue Dual Antiplatelet Therapy

Nearly all of the 1 million stent patients in the United States are prescribed dual antiplatelet therapy (DAPT), but there have been questions about how long patients should receive DAPT. Now, a study published recently in JAMA describes a new tool to help determine a personalized treatment strategy. Read more.