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  1. Article: Y-site simulation compatibility study of 10% calcium salts with various injectable solutions during toxicological resuscitation.

    Hamelin, Arianne / Thompson-Desormeaux, Félix / Elliott, Audrée / Friciu, Mihaela / Forest, Jean-Marc / Leclair, Gregoire

    European journal of hospital pharmacy : science and practice

    2023  

    Abstract: Purpose: To determine the physical compatibility of 10% calcium chloride and 10% calcium gluconate in combination with injectable solutions, administered in the paediatric and adult intensive care unit setting during toxicological resuscitation ... ...

    Abstract Purpose: To determine the physical compatibility of 10% calcium chloride and 10% calcium gluconate in combination with injectable solutions, administered in the paediatric and adult intensive care unit setting during toxicological resuscitation involving calcium channel blockers and beta-blockers.
    Methods: Forty-eight combinations were prepared at room temperature, including the following products: calcium chloride, calcium gluconate, insulin, epinephrine, norepinephrine, highly concentrated dextrose solution, sodium chloride, Plasma-Lyte A and Ringer's lactate. A visual evaluation at times 0, 1, 4, 24, 48 and 72 hours and a particle count test with the LS-20 particle counter at times 0, 4, 24 and 72 hours were performed. The admixtures were considered incompatible if there was a precipitate, a colour change, turbidity, viscosity or a gas formation. The stability of calcium salts was also tested in empty IV bags and syringes by the particle count test.
    Results: All drug mixtures were found to be compatible by visual evaluation and using the particle counter based on United States Pharmacopoeia chapter 788 (USP<788>) specifications. Calcium salts were compatible with insulin and vasopressors in the tested combinations. The stability of 10% calcium salts in empty IV bags and polypropylene syringes was demonstrated for up to 48 hours at room temperature.
    Conclusion: All the combinations tested were physically compatible for up to 72 hours at room temperature. Clinical use of calcium salt infusions, at an undiluted concentration, in combination with these injectable solutions in a toxicological resuscitation context is considered clinically acceptable.
    Language English
    Publishing date 2023-07-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2650179-X
    ISSN 2047-9964 ; 2047-9956
    ISSN (online) 2047-9964
    ISSN 2047-9956
    DOI 10.1136/ejhpharm-2023-003689
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Vancomycin drug monitoring in infants with CoNS sepsis-target attainment, microbiological response and nephrotoxicity.

    Viel-Thériault, Isabelle / Martin, Brigitte / Thompson-Desormeaux, Félix / Blackburn, Julie / Moussa, Ahmed / Autmizguine, Julie

    Journal of perinatology : official journal of the California Perinatal Association

    2019  Volume 40, Issue 1, Page(s) 97–104

    Abstract: Objectives: To characterize residual vancomycin concentrations (Cmin) and assess the relationships between Cmin, the risk of nephrotoxicity and persistent CoNS sepsis.: Methods: In this 5-year retrospective study among infants treated with vancomycin, ...

    Abstract Objectives: To characterize residual vancomycin concentrations (Cmin) and assess the relationships between Cmin, the risk of nephrotoxicity and persistent CoNS sepsis.
    Methods: In this 5-year retrospective study among infants treated with vancomycin, the primary outcome was the proportion of those with a steady state Cmin between 10 and 20 mg/L. The secondary outcomes were nephrotoxicity and persistent CoNS sepsis.
    Results: Of 120 infants included, the median first steady state Cmin was 12.4 mg/L and 77 (64%) had a Cmin between 10 and 20 mg/L. Six percent developed nephrotoxicity. This risk was not associated with Cmin. Of the 30 infants with CoNS sepsis, 17 (57%) had persistent bacteremia, and this risk did not correlate significantly with Cmin, CoNS minimal inhibitory concentration (MIC) for vancomycin, or Cmin/MIC.
    Conclusions: The majority of infants achieved targeted levels of vancomycin, but persistent bacteremia was common. We did not identify a Cmin threshold associated with nephrotoxicity, nor with microbiological clearance.
    MeSH term(s) Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/blood ; Anti-Bacterial Agents/pharmacokinetics ; Area Under Curve ; Bacteremia/drug therapy ; Bacteremia/microbiology ; Drug Monitoring ; Humans ; Infant, Newborn ; Retrospective Studies ; Staphylococcal Infections/drug therapy ; Staphylococcus/isolation & purification ; Staphylococcus aureus/isolation & purification ; Vancomycin/administration & dosage ; Vancomycin/blood ; Vancomycin/pharmacokinetics
    Chemical Substances Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
    Language English
    Publishing date 2019-10-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645021-0
    ISSN 1476-5543 ; 0743-8346
    ISSN (online) 1476-5543
    ISSN 0743-8346
    DOI 10.1038/s41372-019-0519-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Assessment of Surgical Antibiotic Prophylaxis Compliance in Pediatrics: A Pre-post Quasi-experimental Study.

    Lombardi, Juliana / Nguy, Philippe / Robichaud Ducharme, Antoine / Thompson-Desormeaux, Félix / Ruo, Ni / Girard, Gabrielle / Schnitzer, Mireille E / Thirion, Daniel J G / Papenburg, Jesse / Longpré, Audrey-Anne

    The Pediatric infectious disease journal

    2019  Volume 39, Issue 1, Page(s) 48–53

    Abstract: Objective: Data from rigorous evaluations of the impact of interventions on improving surgical antibiotic prophylaxis (SAP) compliance in pediatrics are lacking. Our objective was to assess the impact of a multifaceted intervention on improving ... ...

    Abstract Objective: Data from rigorous evaluations of the impact of interventions on improving surgical antibiotic prophylaxis (SAP) compliance in pediatrics are lacking. Our objective was to assess the impact of a multifaceted intervention on improving pediatric SAP compliance in a hospital without an ongoing antimicrobial stewardship program.
    Study design: A multidisciplinary team at the Montreal Children's Hospital performed a series of interventions designed to improve pediatric SAP compliance in June 2015. A retrospective, quasi-experimental study was performed to assess SAP compliance before and following the interventions. Our study included patients under 18 years old undergoing surgery between April and September in 2013 (preintervention) and in 2016 (postintervention). A 10-week washout period was included to rigorously assess the persistence of compliance without ongoing interventions. SAP, when indicated, was qualified as noncompliant, partially compliant (adequate agent and timing) or totally compliant (adequate agent, dose, timing, readministration, duration).
    Results: A total of 982 surgical cases requiring SAP were included in our primary analysis. The composite partial and total compliance increased from 51.4% to 55.8% [adjusted odds ratio 1.3; 95% confidence interval: 1.0-1.8; P = 0.06]. Although improvements in correct dose and readministration were significant, there was no significant improvement in correct timing, agent selection or duration.
    Conclusion: Our study demonstrated that overall SAP compliance did not significantly improve following a washout period, illustrating the importance of ongoing surveillance and feedback from an antimicrobial stewardship program. Our strict approach in evaluating the timing criterion may also explain the lack of a significant impact on SAP compliance.
    MeSH term(s) Adolescent ; Age Factors ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; Antimicrobial Stewardship ; Child ; Child, Preschool ; Female ; Guideline Adherence ; Humans ; Male ; Medication Adherence ; Pediatrics ; Perioperative Care ; Retrospective Studies ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2019-10-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392481-6
    ISSN 1532-0987 ; 0891-3668
    ISSN (online) 1532-0987
    ISSN 0891-3668
    DOI 10.1097/INF.0000000000002490
    Database MEDical Literature Analysis and Retrieval System OnLINE

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