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  1. Article ; Online: A survey to describe common practices on antifungal monitoring among Spanish clinicians.

    Gómez-López, Alicia / Martín-Gómez, María Teresa / Salavert Lletí, Miguel

    Enfermedades infecciosas y microbiologia clinica (English ed.)

    2023  Volume 41, Issue 1, Page(s) 18–23

    Abstract: Introduction: We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection.: Methods: The survey included questions relating to methodology and practice ...

    Abstract Introduction: We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection.
    Methods: The survey included questions relating to methodology and practice and was distributed among 137 colleagues of the Study Group of Medical Mycology (GEMICOMED) from July to December 2019.
    Results: Monitoring was routinely carried out by most respondents, mainly for voriconazole, and was more likely used to determine the efficacy of the dose administered and less for minimizing drug toxicity. Most responders did not follow the strategies of voriconazole dosage based on CYP2C19 genotyping. Monitoring of posaconazole, itraconazole, or other azole metabolites was not carried out or scarcely demanded. Most responders rarely used flucytosine in their clinical practice nor did they monitor it. According to the answers given by some responders, monitoring isavuconazole, amphotericin B, caspofungin and fluconazole exposure would be also interesting in daily clinical practice in selected patient populations.
    Conclusions: The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.
    MeSH term(s) Humans ; Antifungal Agents/therapeutic use ; Voriconazole/therapeutic use ; Itraconazole/therapeutic use ; Mycoses/drug therapy ; Mycoses/microbiology ; Fluconazole/therapeutic use
    Chemical Substances Antifungal Agents ; Voriconazole (JFU09I87TR) ; Itraconazole (304NUG5GF4) ; Fluconazole (8VZV102JFY)
    Language English
    Publishing date 2023-01-02
    Publishing country Spain
    Document type Journal Article
    ISSN 2529-993X
    ISSN (online) 2529-993X
    DOI 10.1016/j.eimce.2021.05.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mucormicosis: perspectiva de manejo actual y de futuro.

    Martín Gómez, María Teresa / Salavert Lletí, Miguel

    Revista iberoamericana de micologia

    2021  Volume 38, Issue 2, Page(s) 91–100

    Abstract: Infections caused by mucorales, with an increasing incidence after candidiasis and aspergillosis, are characterized by the fast angioinvasion of blood vessels and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, ... ...

    Title translation Mucormycosis: Current and future management perspective.
    Abstract Infections caused by mucorales, with an increasing incidence after candidiasis and aspergillosis, are characterized by the fast angioinvasion of blood vessels and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous, digestive or disseminated infections, and their spread is favored by certain underlying diseases (diabetes, kidney failure) and risk factors (neutropenia, immunosuppression, iron overload). These infections have a high mortality rate, over 40% in many series, and the key to their cure depends on both an early diagnosis and an antifungal treatment, associated in most cases with extensive surgical debridement and other adjunctive therapies. Currently, there are international guidelines, not only local ones, for the management of mucormycosis, in which it is considered by consensus and with a strong recommendation that first-line treatment with high-dose liposomal amphotericin B is the best choice. The combined antifungal treatment of polyene agents with triazoles or candins remains in open debate.
    MeSH term(s) Antifungal Agents/therapeutic use ; Aspergillosis/drug therapy ; Humans ; Mucorales ; Mucormycosis/diagnosis ; Mucormycosis/drug therapy ; Triazoles/therapeutic use
    Chemical Substances Antifungal Agents ; Triazoles
    Language Spanish
    Publishing date 2021-06-16
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-9188
    ISSN (online) 2173-9188
    DOI 10.1016/j.riam.2021.04.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Choice of treatment in Clostridium difficile-associated diarrhoea: Clinical practice guidelines or risk classifications.

    Salavert Lletí, Miguel

    Enfermedades infecciosas y microbiologia clinica

    2017  Volume 35, Issue 10, Page(s) 613–616

    Title translation Elección del tratamiento en la diarrea asociada a Clostridium difficile: guías de práctica clínica o clasificaciones de riesgo.
    MeSH term(s) Clostridium Infections ; Clostridium difficile ; Diarrhea ; Fidaxomicin ; Humans
    Chemical Substances Fidaxomicin (Z5N076G8YQ)
    Language Spanish
    Publishing date 2017-11-26
    Publishing country Spain
    Document type Editorial ; Comment
    ZDB-ID 1070941-1
    ISSN 1578-1852 ; 0213-005X
    ISSN (online) 1578-1852
    ISSN 0213-005X
    DOI 10.1016/j.eimc.2017.11.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Mucormicosis: perspectiva de manejo actual y de futuro

    Martín Gómez, María Teresa / Salavert Lletí, Miguel

    Asociación Española de Micología Revista iberoamericana de micología. 2021 Apr., June, v. 38, no. 2

    2021  

    Abstract: Infections caused by mucorales, with an increasing incidence after candidiasis and aspergillosis, are characterized by the fast angioinvasion of blood vessels and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, ... ...

    Abstract Infections caused by mucorales, with an increasing incidence after candidiasis and aspergillosis, are characterized by the fast angioinvasion of blood vessels and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous, digestive or disseminated infections, and their spread is favored by certain underlying diseases (diabetes, kidney failure) and risk factors (neutropenia, immunosuppression, iron overload). These infections have a high mortality rate, over 40% in many series, and the key to their cure depends on both an early diagnosis and an antifungal treatment, associated in most cases with extensive surgical debridement and other adjunctive therapies. Currently, there are international guidelines, not only local ones, for the management of mucormycosis, in which it is considered by consensus and with a strong recommendation that first-line treatment with high-dose liposomal amphotericin B is the best choice. The combined antifungal treatment of polyene agents with triazoles or candins remains in open debate.
    Keywords Mucorales ; amphotericin B ; aspergillosis ; blood ; candidiasis ; debridement ; diabetes ; early diagnosis ; immunosuppression ; iron overload ; mortality ; neutropenia ; renal failure ; triazoles ; zygomycosis
    Language English
    Dates of publication 2021-04
    Size p. 91-100.
    Publishing place Elsevier España, S.L.U.
    Document type Article
    ISSN 1130-1406
    DOI 10.1016/j.riam.2021.04.003
    Database NAL-Catalogue (AGRICOLA)

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  5. Article ; Online: Probable cutaneous loxoscelism with mild systemic symptoms: A case report from Spain.

    Jerusalem, Koen / Salavert Lletí, Miguel

    Toxicon : official journal of the International Society on Toxinology

    2018  Volume 156, Page(s) 7–12

    Abstract: We present a case from Valencia, Spain, of a 25-year-old woman who presented with a painful erythematous skin lesion, initially diagnosed as cellulitis. The lesion was unresponsive to antibiotic treatments and progressed into a hemorrhagic blister with ... ...

    Abstract We present a case from Valencia, Spain, of a 25-year-old woman who presented with a painful erythematous skin lesion, initially diagnosed as cellulitis. The lesion was unresponsive to antibiotic treatments and progressed into a hemorrhagic blister with necrotic ulcer formation. Posterior collection of a spider from the patient's home and expert identification of the spider as Loxosceles rufescens was achieved, establishing the diagnosis of probable cutaneous loxoscelism. Symptomatic treatment, general wound care and ultimately surgery, resulted in complete recovery with minor residual scarring. This case illustrates some of the difficulties encountered in the diagnosis and treatment of loxoscelism and adds to the increasing reports of loxoscelism in the Mediterranean Basin.
    MeSH term(s) Adult ; Animals ; Erythema/etiology ; Erythema/pathology ; Female ; Humans ; Necrosis/pathology ; Phosphoric Diester Hydrolases/poisoning ; Skin/pathology ; Spain ; Spider Bites/pathology ; Spider Venoms/poisoning ; Spiders
    Chemical Substances Spider Venoms ; loxosceles venom ; Phosphoric Diester Hydrolases (EC 3.1.4.-)
    Language English
    Publishing date 2018-11-02
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 204479-1
    ISSN 1879-3150 ; 0041-0101
    ISSN (online) 1879-3150
    ISSN 0041-0101
    DOI 10.1016/j.toxicon.2018.10.304
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A survey to describe common practices on antifungal monitoring among Spanish clinicians.

    Gómez-López, Alicia / Martín-Gómez, María Teresa / Salavert Lletí, Miguel

    Enfermedades infecciosas y microbiologia clinica (English ed.)

    2021  

    Abstract: Introduction: We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection.: Methods: The survey included questions relating to methodology and practice ...

    Abstract Introduction: We developed a survey to obtain information on the monitoring practices of major systemic antifungals for treatment and prevention of serious fungal infection.
    Methods: The survey included questions relating to methodology and practice and was distributed among 137 colleagues of the Study Group of Medical Mycology (GEMICOMED) from July to December 2019.
    Results: Monitoring was routinely carried out by most respondents, mainly for voriconazole, and was more likely used to determine the efficacy of the dose administered and less for minimizing drug toxicity. Most responders did not follow the strategies of voriconazole dosage based on CYP2C19 genotyping. Monitoring of posaconazole, itraconazole, or other azole metabolites was not carried out or scarcely demanded. Most responders rarely used flucytosine in their clinical practice nor did they monitor it. According to the answers given by some responders, monitoring isavuconazole, amphotericin B, caspofungin and fluconazole exposure would be also interesting in daily clinical practice in selected patient populations.
    Conclusions: The survey reveals common practices and attitudes towards antifungal monitoring, sometimes not performed as per best recommendations, offering an opportunity for education and research. Appropriate use of therapeutic drug monitoring may be an objective of antifungal stewardship programmes.
    Language Spanish
    Publishing date 2021-07-05
    Publishing country Spain
    Document type Journal Article
    ISSN 2529-993X
    ISSN (online) 2529-993X
    DOI 10.1016/j.eimc.2021.05.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The positioning of ceftobiprole in Staphylococcus aureus bacteremia.

    Membrillo de Novales, Francisco Javier / Bravo de Pablo, Olga / Estella García, Ángel / Morata Ruiz, Laura / Oltra Sempere, Maria Rosa / Salavert Lleti, Miguel / Estébanez Muñoz, Miriam / Hidalgo-Tenorio, Carmen

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2024  

    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciae123
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: El tratamiento de la mucormicosis (cigomicosis) en el siglo xxi.

    Ruiz Camps, Isabel / Salavert Lletí, Miguel

    Revista iberoamericana de micologia

    2018  Volume 35, Issue 4, Page(s) 217–221

    Abstract: Infections due to zygomycetes, caused by mucorales and entomophthorales, are characterized by angioinvasion and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous or disseminated infection and ... ...

    Title translation The treatment of mucormycosis (zygomycosis) in the 21st century.
    Abstract Infections due to zygomycetes, caused by mucorales and entomophthorales, are characterized by angioinvasion and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous or disseminated infection and its spread is favored by several diseases (such as diabetes or chronic kidney disease) and risk factors (neutropenia, immunosuppression, iron overload). They have a high mortality rate, and the key to success in their treatment are early diagnosis, prompt administration of antifungal treatment, and extensive surgical debridement. Currently, isavuconazole constitutes an option for the treatment of those mucormycosis refractory to liposomal amphotericin B. Due to its pharmacokinetic and pharmacodynamic characteristics and its low toxicity, it is also the best choice for maintenance therapy.
    MeSH term(s) Humans ; Mucormycosis/diagnosis ; Mucormycosis/therapy
    Language Spanish
    Publishing date 2018-11-22
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 2173-9188
    ISSN (online) 2173-9188
    DOI 10.1016/j.riam.2018.09.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: El tratamiento de la mucormicosis (cigomicosis) en el siglo xxi

    Ruiz Camps, Isabel / Salavert Lletí, Miguel

    Asociación Española de Micología Revista iberoamericana de micología. 2018 Oct., Dec., v. 35, no. 4

    2018  

    Abstract: Infections due to zygomycetes, caused by mucorales and entomophthorales, are characterized by angioinvasion and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous or disseminated infection and ... ...

    Abstract Infections due to zygomycetes, caused by mucorales and entomophthorales, are characterized by angioinvasion and invasion of neighboring organs or structures. Mucorales most commonly cause rhinocerebral, pulmonary, cutaneous or disseminated infection and its spread is favored by several diseases (such as diabetes or chronic kidney disease) and risk factors (neutropenia, immunosuppression, iron overload). They have a high mortality rate, and the key to success in their treatment are early diagnosis, prompt administration of antifungal treatment, and extensive surgical debridement. Currently, isavuconazole constitutes an option for the treatment of those mucormycosis refractory to liposomal amphotericin B. Due to its pharmacokinetic and pharmacodynamic characteristics and its low toxicity, it is also the best choice for maintenance therapy.
    Keywords amphotericin B ; debridement ; diabetes ; early diagnosis ; Entomophthorales ; immunosuppression ; iron overload ; kidney diseases ; mortality ; Mucorales ; neutropenia ; pharmacodynamics ; pharmacokinetics ; risk factors ; toxicity
    Language English
    Dates of publication 2018-10
    Size p. 217-221.
    Publishing place Elsevier España, S.L.U.
    Document type Article
    ISSN 1130-1406
    DOI 10.1016/j.riam.2018.09.001
    Database NAL-Catalogue (AGRICOLA)

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  10. Article ; Online: CT-Guided Needle Biopsy in Vertebral Osteomyelitis: Study of Factors That Could Influence in Culture Yield.

    Fragío Gil, Jorge Juan / González Mazarío, Roxana / Ivorra Cortés, José / Cañada Martínez, Antonio José / Salavert Lleti, Miguel / Román Ivorra, José Andrés

    Reumatologia clinica

    2022  Volume 18, Issue 1, Page(s) 20–24

    Abstract: Objective: The aim of this study was to analyze which are the main factors that could influence the result of a CT guided biopsy in vertebral osteomyelitis (VO) patients.: Methods: A single center retrospective observational study was performed ... ...

    Abstract Objective: The aim of this study was to analyze which are the main factors that could influence the result of a CT guided biopsy in vertebral osteomyelitis (VO) patients.
    Methods: A single center retrospective observational study was performed including adult patients who had been diagnosed with VO and undergone CT guided needle biopsy from January 2010 to January 2020. Demographical features, concurrent diseases, laboratory findings, microbiological diagnosis, radiological data, medical complications, antibiotic exposure were compiled. Multivariate analysis was performed with a logistic regression comparing the patients depending on the culture result.
    Results: Seventy-seven patients were included in the study. Baseline characteristics were comparable between groups. Sample culture was positive in 43 cases (56%). Microorganism isolated were gram+(72%), gram-(14%), mycobacteria (7%) and fungi (7%). Delay in the procedure, antibiotic exposure and blood culture positivity were also similar among both groups. The biopsy results were not influenced by the CRP value, the presence of fever nor antibiotic exposure. The longer duration of back pain was associated to a lower probability of a positive culture.
    Conclusions: In conclusion, our study displays an acceptable reliability of CT guided needle biopsy in VO patients, even in cases under antibiotic treatment. The presence of fever or CRP values did not predict a positive culture. Delay in diagnosis could impact negatively on culture yield.
    MeSH term(s) Adult ; Biopsy, Needle ; Humans ; Image-Guided Biopsy ; Osteomyelitis/diagnosis ; Reproducibility of Results ; Tomography, X-Ray Computed
    Language English
    Publishing date 2022-01-11
    Publishing country Spain
    Document type Journal Article ; Observational Study
    ISSN 2173-5743
    ISSN (online) 2173-5743
    DOI 10.1016/j.reumae.2020.08.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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