UHSP Collections (University of Health Sciences and Pharmacy)
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Ceftaroline as Salvage Monotherapy for Persistent MRSA Bacteremia
No full textObjective: To summarize published data regarding the use of ceftaroline as salvage monotherapy for persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Data Sources: PubMed (January 1980-June 2016) was searched using combinations of the search terms methicillin-resistant Staphylococcus aureus, MRSA, bacteremia, ceftaroline, refractory, and persistent. Supplemental references were generated through review of identified literature citations. Study Selection and Data Extraction: Available English-language, full-text articles pertaining to the use of ceftaroline for persistent MRSA bacteremia (MRSAB) were included. Data Synthesis: The PubMed search yielded 23 articles for evaluation. There are no randomized controlled trials to date—only case series and reports. Four retrospective case series detailing the use of ceftaroline as monotherapy for persistent MRSAB were included. Most patients received at least 4 days of an appropriate anti-MRSA antimicrobial prior to ceftaroline and were able to clear bacteremia within 3 days. The most common rationales for ceftaroline use were progression of disease or nonresponse to current therapy. Higher off-label dosing of ceftaroline is often utilized to achieve optimal pharmacokinetic/pharmacodynamic parameters. Adverse events are not well described due to lack of follow-up; however, neutropenia has been associated with prolonged use. Conclusions: Treatment options for persistent MRSAB remain few and far between. Ceftaroline is an effective agent for the salvage treatment of MRSAB. Off-label doses up to 600 mg every 8 hours are often used to achieve optimal pharmacokinetic/pharmacodynamic parameters. Because of lack of follow-up in these reports, the incidence of adverse effects of prolonged use of ceftaroline is not well defined
Efficacy of Oral Vancomycin in Preventing Recurrent Clostridium difficile Infection in Patients Treated With Systemic Antimicrobial Agents
No full textWe compared rates of recurrent Clostridium difficile infection in patients receiving or not receiving oral vancomycin prophylaxis with systemic antimicrobial therapy. The incidence of C. difficile infection was significantly lower in patients receiving prophylaxis (4.2% vs 26.6% in those without prophylaxis; odds ratio, 0.12; 95% confidence interval,. 04-.4; P \u3c. 001)
Meals and Entertainment Policy - Interim
No full textIt is important that the College utilize its resources to further the mission of the institution and be a thoughtful steward of its funds. This policy provides guidelines and limitations regarding expenditures of resources for the business purpose of entertainment, hospitality, and recognition. Expenditures are expected to be both reasonable and appropriate to the circumstances.
While such expenses are necessary and may benefit the College, funds expended for these purposes are resources that will be unavailable for other important expenditures that could further the mission of the College. Thoughtful utilization of College resources is an obligation of all faculty and staff.
Funds for expenditures of this nature are generally unallowable on grants and should be funded by unrestricted funds of the College.
This policy applies to all individuals expending funds for the purposes of entertainment, hospitality, and recognition on behalf of the College
Current Challenges and Potential Opportunities for the Pharmaceutical Sciences to Make Global Impact: An FIP Perspective
No full textThe chairs of each of the 8 Special Interest Groups of the Board of Pharmaceutical Sciences of the International Pharmaceutical Federation have compiled opinions with regard to major challenges for the pharmaceutical sciences over the next 5-10 years. Areas covered are drug design and discovery, natural products, formulation design and pharmaceutical technology, pharmacokinetics/pharmacodynamics and systems pharmacology, translational and personalized medicine, biotechnology, analytical sciences and quality control, and regulatory science
Ability and use of comparative effectiveness research by P and T committee members and support staff: A 1-year follow-up
No full textBACKGROUND: In recent years, comparative effectiveness tools and methods have evolved to assist health care decision makers in identifying optimal therapies. In-person training programs on comparative effectiveness research may be helpful in understanding and applying this information. OBJECTIVE: To provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P and T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program, in which participants were taught about CER designs and how to access available CER resources through the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program. METHODS: A retrospective, cross-sectional questionnaire was developed and mailed to 2 groups of individuals: CER workshop attendees and interested nonattendees (expressing an interest in attending a workshop but did not attend for unknown reasons). The questionnaire asked respondents to indicate personal and organizational use of CER in the decision-making process. Participants were asked to indicate whether their knowledge, ability, and use of CER studies increased since participating in the program. Data were analyzed using nonparametric tests to compare the responses of attendees and nonattendees, as well as overall reliability of the instrument. RESULTS: A total of 164 respondents completed the questionnaire (63 attendees and 101 nonattendees; overall response rate = 44[%]). The majority of respondents were pharmacists (n = 157, 95.7[%]) and were affiliated with a hospital (n = 106, 64.6[%]). Proportions of attendees and nonattendees differed significantly in the use of EHC research reviews/reports (45[%] and 28[%], respectively; P = 0.02) and EHC executive summaries of research reviews/reports (48[%] and 29[%], respectively; P = 0.01). At 1-year followup, the majority of attendees reported an increase ( somewhat or very much ) in knowledge of CER (91.5[%]), ability to use CER (83.0[%]), and use of CER studies (58.7[%]). CONCLUSIONS: Health professionals attending a continuing education CER program reported higher use of EHC CER materials compared with nonattendees. Additionally, attendees reported increased use of CER in clinical decision making. A continuing education program such as this may provide an effective avenue for introducing CER methods and resources to the P and T committee and clinical decision-making processes
Predictive modeling using a nationally representative database to identify patients at risk of developing microalbuminuria
No full textPurpose: Predictive models allow clinicians to identify higher- and lower-risk patients and make targeted treatment decisions. Microalbuminuria (MA) is a condition whose presence is understood to be an early marker for cardiovascular disease. The aims of this study were to develop a patient data-driven predictive model and a risk-score assessment to improve the identification of MA. Methods: The 2007–2008 National Health and Nutrition Examination Survey (NHANES) was utilized to create a predictive model. The dataset was split into thirds; one-third was used to develop the model, while the other two-thirds were utilized for internal validation. The 2012–2013 NHANES was used as an external validation database. Multivariate logistic regression was performed to create the model. Performance was evaluated using three criteria: (1) receiver operating characteristic curves; (2) pseudo-R2 values; and (3) goodness of fit (Hosmer–Lemeshow). The model was then used to develop a risk-score chart. Results: A model was developed using variables for which there was a significant relationship. Variables included were systolic blood pressure, fasting glucose, C-reactive protein, blood urea nitrogen, and alcohol consumption. The model performed well, and no significant differences were observed when utilized in the validation datasets. A risk score was developed, and the probability of developing MA for each score was calculated. Conclusion: The predictive model provides new evidence about variables related with MA and may be used by clinicians to identify at-risk patients and to tailor treatment. The risk score developed may allow clinicians to measure a patient’s MA risk
University Driving and Vehicle Usage Policy
No full textThe purpose of the University Driving and Vehicle Usage Policy is to ensure employees who are required to drive a University Vehicle or a Personal Vehicle to perform their assigned job duties have appropriate documentation and training to ensure that employee and passenger safety and other risks are mitigated. Additionally, this policy establishes procedures for regular review of these covered employee\u27s driving records, driver screening, and responsibilities. University employees who occasionally use their personal vehicle for University business or activities are not covered by this policy
Critical Personnel and Continuity of Operations COOP Planning Policy
No full textThe University of Health Sciences and Pharmacy in St. Louis is committed to being institutionally resilient to all hazards that may impact its stakeholders and jeopardize its ability to fulfill its mission, and strives to develop innovative solutions to maintain the continuity of Critical Operating Units and preserve Mission Essential Functions for its students, faculty, staff, and visitors. This policy captures that commitment, and provides clarity, guidance, and resources to facilitate comprehensive Continuity of Operations (COOP) for office and department level entities at the University.
This policy applies to faculty and staff personnel working within an office or department designated as a Critical Operating Unit or identified as completing a Mission Essential Function, and employees, based on their normal role or membership on a group or team, determined to be Critical Personnel