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Ferry T, Conrad A, Senneville E, Roux S, Dupieux-Chabert C, Dinh A, Lustig S, Goutelle S, Pham T, Valour F. Sécurité du tédizolide en tant que thérapie antimicrobienne suppressive pour les patients souffrant d’une infection ostéo-articulaire complexe sur implant à Gram-positif multirésistants : résultats de l’étude de cohorte TediSAT. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Triffault-Fillit C, Mabrut E, Corbin K, Braun E, Becker A, Goutelle S, Chaudier P, Fessy MH, Dupieux C, Laurent F, Gunst S, Lustig S, Chidiac C, Ferry T, Valour F. Tolerance and microbiological efficacy of cefepime or piperacillin/tazobactam in combination with vancomycin as empirical antimicrobial therapy of prosthetic joint infection: a propensity-matched cohort study. J Antimicrob Chemother 2021; 75:2299-2306. [PMID: 32407512 DOI: 10.1093/jac/dkaa166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The use of piperacillin/tazobactam with vancomycin as empirical antimicrobial therapy (EAT) for prosthetic joint infection (PJI) has been associated with an increased risk of acute kidney injury (AKI), leading us to propose cefepime as an alternative since 2017 in our reference centre. OBJECTIVES To compare microbiological efficacy and tolerance of these two EAT strategies. METHODS All adult patients with PJI empirically treated with vancomycin+cefepime (n = 89) were enrolled in a prospective observational study and matched with vancomycin+piperacillin/tazobactam-treated historical controls (n = 89) according to a propensity score including age, baseline renal function and concomitant use of other nephrotoxic agents. The two groups were compared using Kaplan-Meier curve analysis, and non-parametric tests regarding the proportion of efficacious empirical regimen and the incidence of empirical therapy-related adverse events (AE). RESULTS Among 146 (82.0%) documented infections, the EAT was considered efficacious in 77 (98.7%) and 65 (98.5%) of the piperacillin/tazobactam- and cefepime-treated patients, respectively (P = 1.000). The rate of AE, particularly AKI, was significantly higher in the vancomycin+piperacillin/tazobactam group [n = 27 (30.3%) for all AE and 23 (25.8%) for AKI] compared with the vancomycin+cefepime [n = 13 (14.6%) and 6 (6.7%)] group (P = 0.019 and <0.001, respectively), leading to premature EAT discontinuation in 20 (22.5%) and 5 (5.6%) patients (P = 0.002). The two groups were not significantly different regarding their comorbidities, and AKI incidence was not related to vancomycin plasma overexposure. CONCLUSIONS Based on the susceptibility profile of bacterial isolates from included patients, microbiological efficacy of both strategies was expected to be similar, but vancomycin + cefepime was associated with a significantly lower incidence of AKI.
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Affiliation(s)
- C Triffault-Fillit
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - E Mabrut
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - K Corbin
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - E Braun
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - A Becker
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - S Goutelle
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service pharmaceutique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, ISPB Faculté de Pharmacie de Lyon, UMR CNRS 5558, Laboratoire de Biométrie et Biologie Évolutive, Lyon, France
| | - P Chaudier
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de chirurgie orthopédique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - M H Fessy
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de chirurgie orthopédique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - C Dupieux
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France.,Institut des agents infectieux, Laboratoire de bactériologie, Centre National de référence des staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - F Laurent
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France.,Institut des agents infectieux, Laboratoire de bactériologie, Centre National de référence des staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Gunst
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Lustig
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - C Chidiac
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - T Ferry
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France
| | - F Valour
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France
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Goutelle S, Bleyzac N, Mioux L, de la Gastine B, Bourguignon L. Estimating renal function when adjusting the dosage of antibiotics: Facts and fables. Infect Dis Now 2021; 51:635-637. [PMID: 33870894 DOI: 10.1016/j.idnow.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 11/30/2022]
Affiliation(s)
- S Goutelle
- Service de pharmacie, Hospices Civils de Lyon, groupement hospitalier Nord, Lyon, France; Laboratoire de Biométrie et Biologie Evolutive UMR CNRS 5558 & ISPB, faculté de pharmacie de Lyon, université Lyon, université Lyon 1, Lyon, France.
| | - N Bleyzac
- Service de pharmacie, Hospices Civils de Lyon, groupement hospitalier Nord, Lyon, France
| | - L Mioux
- Service de pharmacie, Hospices Civils de Lyon, groupement hospitalier Nord, Lyon, France
| | - B de la Gastine
- Service de gériatrie, Hospices Civils de Lyon, groupement hospitalier Nord, hôpital Pierre-Garraud, Lyon, France
| | - L Bourguignon
- Service de pharmacie, Hospices Civils de Lyon, groupement hospitalier Nord, Lyon, France; Laboratoire de Biométrie et Biologie Evolutive UMR CNRS 5558 & ISPB, faculté de pharmacie de Lyon, université Lyon, université Lyon 1, Lyon, France
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Gervais F, Novais T, Goutelle S, Chappuy M, Parat S, Cabelguenne D, Mouchoux C. Drug-related problems among older patients: Analysis of 8 years of pharmacist's interventions. Ann Pharm Fr 2021; 79:511-521. [PMID: 33587921 DOI: 10.1016/j.pharma.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/18/2020] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To analyse the most frequent DRP over time and pharmacists' interventions made among older patients aged over 75 years old. DRP between older patients and younger patients aged 18 to 74 years and between older patients treated in geriatric wards or not were also compared. METHODS A cross-sectional observational study conducted on DRP detected by pharmacists at the university hospital centre of Lyon and prospectively recorded in the Act-IP© database from January 2008 to December 2015. RESULTS A total of 56,223 DRP were investigated - 19,056 in older patients and 37,167 in younger patients. A supratherapeutic dosage was mainly reported (22.4% in older patients vs. 19.0% in younger patient) and pharmacists made interventions mostly to adjust dosage (27.3% vs. 24.2%). Physicians' acceptance was significantly lower in older patients (57.1% vs. 64.3%). DRP associated to a drug included a supratherapeutic use of acetaminophen (5.2% vs. 3.8%) and hypnotics (4.0% vs. 1.4%), medication in cardiology used without indication (1.4% vs. 0.2%) and underuse of vitamin D (1.2% vs. 0.1%). Supratherapeutic dosages were more significantly detected with a lower overall physicians' acceptance in older patients treated in general wards. CONCLUSIONS This study highlights the specificity of DRP among older patients and encourages health care professionals to remain especially alert regarding older patients treated in general wards. These findings can contribute to define or adjust training needs and quality indicators to improve the daily practices of health care professionals.
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Affiliation(s)
- F Gervais
- Pharmacie, Groupement hospitalier centre, Hospices civils de Lyon, Lyon, France.
| | - T Novais
- Pharmacie, Groupement hospitalier centre, Hospices civils de Lyon, Lyon, France; ISPB - Facultés de pharmacie de Lyon, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Université de Lyon, EA-7425 HESPER, Health Services and Performance Research, 69003 Lyon, France
| | - S Goutelle
- Pharmacie, Groupement hospitalier Nord, Hospices civils de Lyon, Lyon, France; ISPB - Facultés de pharmacie de Lyon, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Université de Lyon, Université Claude-Bernard Lyon 1, UMR CNRS 5558, Laboratoire de biométrie et biologie évolutive, Villeurbanne, France
| | - M Chappuy
- Pharmacie, Groupement hospitalier centre, Hospices civils de Lyon, Lyon, France; Pharmacie, Groupement hospitalier Nord, Hospices civils de Lyon, Lyon, France
| | - S Parat
- Pharmacie, Groupement hospitalier Sud, Hospices civils de Lyon, Lyon, France
| | - D Cabelguenne
- Pharmacie, Groupement hospitalier Sud, Hospices civils de Lyon, Lyon, France
| | - C Mouchoux
- Pharmacie, Groupement hospitalier centre, Hospices civils de Lyon, Lyon, France; ISPB - Facultés de pharmacie de Lyon, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; INSERM U1028; CNRS UMR5292; Lyon Neuroscience Research Centre, Brain Dynamics and Cognition Team, 69000 Lyon, France
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Praet A, Vételé F, Bréant V, Dumitrescu O, Doléans-Jordheim A, Reix P, Bourguignon L, Goutelle S. P153 Population PK analysis and dosing simulation of tobramycin in paediatric patients with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30488-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bretagnolle C, Lalande L, Mabrut E, Ferry T, Goutelle S. Observance au traitement antibiotique par voie orale dans les infections ostéo-articulaires : étude pilote. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bosch A, Valour F, Dumitrescu O, Dumortier J, Radenne S, Pages-Ecochard M, Chidiac C, Ferry T, Perpoint T, Miailhes P, Conrad A, Goutelle S, Ader F. A practical approach to tuberculosis diagnosis and treatment in liver transplant recipients in a low-prevalence area. Med Mal Infect 2018; 49:231-240. [PMID: 30591271 DOI: 10.1016/j.medmal.2018.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/11/2018] [Accepted: 11/26/2018] [Indexed: 01/30/2023]
Abstract
Solid organ transplant candidates/recipients are at risk of mycobacterial infections. Although guidelines on the management of latent tuberculosis infection and active tuberculosis are available for solid organ transplant recipients, limited guidance focuses on end-stage liver disease or liver transplant recipients who require management in a referral center. Therapeutic challenges arise from direct antituberculosis drug-related hepatotoxicity, and substantial metabolic interactions between immunosuppressive and antituberculosis drugs. Another issue is the optimal timing of therapy with regards to the time of transplantation. This review focuses on the importance of tuberculosis screening with immunological tests, challenges in the diagnosis, management, and treatment of latent tuberculosis infection and active tuberculosis, as well as risk assessment for active tuberculosis in the critical peri-liver transplantation period. We detail therapeutic adjustments required for the management of antituberculosis drugs in latent tuberculosis infection and active tuberculosis, particularly when concomitantly using rifampicin and immunosuppressive drugs.
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Affiliation(s)
- A Bosch
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France
| | - F Valour
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm, U1111, université Claude-Bernard Lyon 1, CNRS, UMR5308, École normale supérieure de Lyon, université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France.
| | - O Dumitrescu
- Centre international de recherche en infectiologie (CIRI), Inserm, U1111, université Claude-Bernard Lyon 1, CNRS, UMR5308, École normale supérieure de Lyon, université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France; Institut des agents infectieux, hospices civils de Lyon, 69004 Lyon, France
| | - J Dumortier
- Université Claude-Bernard Lyon 1, 69007 Lyon, France; Service d'hépato-gastro-entérologie et de transplantation hépatique, hôpital Édouard-Herriot, hospices civils de Lyon, 69007 Lyon, France
| | - S Radenne
- Service d'hépato-gastro-entérologie et de transplantation hépatique, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France
| | - M Pages-Ecochard
- Service d'hépato-gastro-entérologie et de transplantation hépatique, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France
| | - C Chidiac
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm, U1111, université Claude-Bernard Lyon 1, CNRS, UMR5308, École normale supérieure de Lyon, université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France
| | - T Ferry
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm, U1111, université Claude-Bernard Lyon 1, CNRS, UMR5308, École normale supérieure de Lyon, université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France
| | - T Perpoint
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France
| | - P Miailhes
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France
| | - A Conrad
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm, U1111, université Claude-Bernard Lyon 1, CNRS, UMR5308, École normale supérieure de Lyon, université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France
| | - S Goutelle
- Service de pharmaceutique, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; UMR, CNRS 5558, laboratoire de biométrie et biologie évolutive, ISPB, faculté de pharmacie, université Claude-Bernard Lyon 1, 69007 Lyon, France
| | - F Ader
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm, U1111, université Claude-Bernard Lyon 1, CNRS, UMR5308, École normale supérieure de Lyon, université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France
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Tod M, Goutelle S, Bleyzac N, Bourguignon L. A Generic Model for Quantitative Prediction of Interactions Mediated by Efflux Transporters and Cytochromes: Application to P-Glycoprotein and Cytochrome 3A4. Clin Pharmacokinet 2018; 58:503-523. [DOI: 10.1007/s40262-018-0711-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Lafarge L, Bourguignon L, Bernard N, Vial T, Dehan-Moya MJ, De La Gastine B, Goutelle S. [Pharmacokinetic risk factors of beta-blockers overdose in the elderly: Case report and pharmacology approach]. Ann Cardiol Angeiol (Paris) 2018; 67:91-97. [PMID: 29544975 DOI: 10.1016/j.ancard.2018.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 02/18/2018] [Indexed: 12/15/2022]
Abstract
Beta-blockers are widely prescribed in elderly patients and may induce severe adverse drug reactions. We report a case of bisoprolol-induced bradycardia in an elderly patient with impaired renal function and use of cytochrome P450 inhibitors. A literature review has been performed in order to analyze pharmacokinetic risk factors of beta-blockers overdosing in geriatrics. Various mechanisms can result in decreased elimination of beta-blockers. These mechanisms vary according to the beta-blocker agent and may be combined in some individuals, especially elderly patients. This can lead to unexpected overexposure. Knowledge about drug interactions and pharmacokinetic elimination pathways is important for preventing overexposure and adverse drug reactions when using beta-blockers.
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Affiliation(s)
- L Lafarge
- Service pharmaceutique, centre hospitalier Pierre-Garraud, groupement hospitalier Nord, hospices civils de Lyon, 136, rue Commandant-Charcot, 69005 Lyon, France.
| | - L Bourguignon
- Service pharmaceutique, centre hospitalier Pierre-Garraud, groupement hospitalier Nord, hospices civils de Lyon, 136, rue Commandant-Charcot, 69005 Lyon, France; ISPB, faculté de pharmacie de Lyon, université de Lyon-1, 69008 Lyon, France; UMR CNRS 5558, laboratoire de biométrie et biologie évolutive, université Lyon-1, 69100 Villeurbanne, France
| | - N Bernard
- Centre régional de pharmacovigilance, hospices civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France
| | - T Vial
- Centre régional de pharmacovigilance, hospices civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France
| | - M-J Dehan-Moya
- Gériatrie, centre hospitalier Pierre-Garraud, groupement hospitalier Nord, hospices civils de Lyon, 136, rue Commandant-Charcot, 69005 Lyon, France
| | - B De La Gastine
- Gériatrie, centre hospitalier Pierre-Garraud, groupement hospitalier Nord, hospices civils de Lyon, 136, rue Commandant-Charcot, 69005 Lyon, France
| | - S Goutelle
- Service pharmaceutique, centre hospitalier Pierre-Garraud, groupement hospitalier Nord, hospices civils de Lyon, 136, rue Commandant-Charcot, 69005 Lyon, France; ISPB, faculté de pharmacie de Lyon, université de Lyon-1, 69008 Lyon, France; UMR CNRS 5558, laboratoire de biométrie et biologie évolutive, université Lyon-1, 69100 Villeurbanne, France
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10
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Triffault-Fillit C, Valour F, Tod M, Goutelle S, Lustig S, Fessy M, Laurent F, Chidiac C, Ferry T. Evènements indésirables (EI) de l’antibiothérapie probabiliste au cours des infections sur prothèse articulaire (IPA) : étude prospective en CRIOAc sur 5 ans. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Dauphinot V, Faure R, Bourguignon L, Goutelle S, Krolak-Salmon P, Mouchoux C. Factors associated with changes in exposure to anticholinergic and sedative medications in elderly hospitalized patients: multicentre longitudinal study. Eur J Neurol 2016; 24:483-490. [PMID: 28026898 DOI: 10.1111/ene.13228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/14/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Elderly patients exposed to drugs with anticholinergic or sedative properties may have an increased risk of adverse events. This study aimed to assess the relationship between patient characteristics and changes of exposure to anticholinergic and sedative medications during their hospital stay. METHODS A multicentre longitudinal study was set up on hospitalized patients (aged ≥65 years) using at least one drug at admission. The primary outcome was change of exposure to anticholinergic and sedative drugs between admission and discharge. Sociodemographic characteristics of the patients, comorbidities, life habits and information about the hospital stay (origin of admission, reasons for hospitalization) were collected. RESULTS The study included 337 patients (mean age, 85.4 years) with an average hospital stay of 30.1 ± 37.5 days. The drug burden index increased during the hospital stay among males (P = 0.03), patients for whom the reason for hospitalization was either a stroke (P = 0.001) or inability to stay in their own home (P = 0.001), and patients with diabetes mellitus (P = 0.009). In the adjusted model, drug burden index increased among patients hospitalized for stroke, inability to stay in their own home or post-surgery, and for patients with diabetes mellitus or hypertension. CONCLUSIONS The drug management of elderly patients during hospital stays may increase exposure to anticholinergic and sedative drugs. Although the anticholinergic and sedative properties may be in relation to the therapeutic purpose, they also represent an unexpected risk. Physicians and clinical pharmacists should consider performing optimization of the drug prescriptions for patients at risk.
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Affiliation(s)
- V Dauphinot
- Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne.,Centre de Recherche Clinique-Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne
| | - R Faure
- Groupement Hospitalier Edouard Herriot, Service Pharmaceutique, Hospices Civils de Lyon, Lyon
| | - L Bourguignon
- Groupement Hospitalier de Gériatrie, Service Pharmaceutique, Hospices Civils de Lyon, Lyon.,ISPB - Faculté de Pharmacie de Lyon, Université Lyon 1, Lyon
| | - S Goutelle
- Groupement Hospitalier de Gériatrie, Service Pharmaceutique, Hospices Civils de Lyon, Lyon.,ISPB - Faculté de Pharmacie de Lyon, Université Lyon 1, Lyon
| | - P Krolak-Salmon
- Centre Mémoire de Ressources et de Recherche (CMRR) de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne.,Centre de Recherche Clinique-Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne.,U1028, INSERM, Université Lyon 1, Lyon.,UMR CNRS 5292, Centre de Recherche en Neurosciences de Lyon, Lyon
| | - C Mouchoux
- Centre de Recherche Clinique-Vieillissement-Cerveau-Fragilité), Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne.,Groupement Hospitalier de Gériatrie, Service Pharmaceutique, Hospices Civils de Lyon, Lyon.,UMR CNRS 5558, Laboratoire de Biométrie et Biologie Evolutive, Université Lyon 1, Villeurbanne, France
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12
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Tod M, Goutelle S, Bourguignon L, Bleyzac N. Quantitative Prediction of Drug-Drug Interactions Involving Inhibitory Metabolites by Physiologically Based Pharmacokinetic Models: Is it Worth It? CPT Pharmacometrics Syst Pharmacol 2016; 6:226. [PMID: 27984676 PMCID: PMC5397559 DOI: 10.1002/psp4.12164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/06/2016] [Indexed: 01/26/2023]
Affiliation(s)
- M Tod
- Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,EMR3738, Université Claude Bernard Lyon 1, Lyon, France
| | - S Goutelle
- Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,UMR5758, Université Claude Bernard Lyon 1, Lyon, France
| | - L Bourguignon
- Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,UMR5758, Université Claude Bernard Lyon 1, Lyon, France
| | - N Bleyzac
- EMR3738, Université Claude Bernard Lyon 1, Lyon, France.,Institut d'Hémato-Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
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Tod M, Bourguignon L, Bleyzac N, Goutelle S. A Model for Predicting the Interindividual Variability of Drug-Drug Interactions. AAPS J 2016; 19:497-509. [PMID: 27924615 DOI: 10.1208/s12248-016-0021-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/28/2016] [Indexed: 11/30/2022]
Abstract
Pharmacokinetic drug-drug interactions are frequently characterized and quantified by an AUC ratio (Rauc). The typical value of the AUC ratio in case of cytochrome-mediated interactions may be predicted by several approaches, based on in vitro or in vivo data. Prediction of the interindividual variability of Rauc would help to anticipate more completely the consequences of a drug-drug interaction. We propose and evaluate a simple approach for predicting the standard deviation (sd) of Ln(Rauc), a metric close to the interindividual coefficient of variation of Rauc. First, a model was derived to link sd(Ln Rauc) with the substrate fraction metabolized by each cytochrome and the potency of the interactors, in case of induction or inhibition. Second, the parameters involved in these equations were estimated by a Bayesian hierarchical model, using the data from 56 interaction studies retrieved from the literature. Third, the model was evaluated by several metrics based on the fold prediction error (PE) of sd(Ln Rauc). The median PE was 0.998 (the ideal value is 1) and the interquartile range was 0.96-1.03. The PE was in the acceptable interval (0.5 to 2) in 52 cases out of 56. Fourth, a surface plot of sd(Ln Rauc) as a function of the characteristics of the substrate and the interactor has been built. The minimal value of sd(Ln Rauc) was about 0.08 (obtained for Rauc = 1) while the maximal value, 0.7, was obtained for interactions involving highly metabolized substrates with strong interactors.
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Affiliation(s)
- M Tod
- Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France. .,EMR3738, Faculté de médecine Lyon-sud, Université Lyon 1, Lyon, France. .,Faculté de pharmacie, Université Lyon 1, Lyon, France.
| | - L Bourguignon
- Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Faculté de pharmacie, Université Lyon 1, Lyon, France.,UMR CNRS 5558, Laboratoire de Biométrie et Biologie Evolutive, Université Lyon 1, Lyon, France
| | - N Bleyzac
- EMR3738, Faculté de médecine Lyon-sud, Université Lyon 1, Lyon, France.,Pharmacie, Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - S Goutelle
- Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Faculté de pharmacie, Université Lyon 1, Lyon, France.,UMR CNRS 5558, Laboratoire de Biométrie et Biologie Evolutive, Université Lyon 1, Lyon, France
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14
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Gabriel L, Darcissac C, Goutelle S, Sève P, Vial T, de La Gastine B. Œdèmes des membres inférieurs au cours d’un traitement par valpromide : cas clinique et revue de la littérature. Rev Med Interne 2015; 36:698-700. [DOI: 10.1016/j.revmed.2014.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/07/2014] [Accepted: 11/23/2014] [Indexed: 11/27/2022]
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15
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Philippe M, Goutelle S, Guitton J, Fonrose X, Bergeron C, Girard P, Bertrand Y, Bleyzac N. Should busulfan therapeutic range be narrowed in pediatrics? Experience from a large cohort of hematopoietic stem cell transplant children. Bone Marrow Transplant 2015; 51:72-8. [PMID: 26389835 DOI: 10.1038/bmt.2015.218] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/04/2015] [Accepted: 08/07/2015] [Indexed: 01/03/2023]
Abstract
Busulfan, the corner stone of hematopoietic stem cell transplantation regimens, has a narrow therapeutic window. Therapeutic drug monitoring (TDM)-guided dosing to reach the conventional area under the concentration-time curve (AUC) target range of 900-1500 μmol min/L is associated with better outcomes. We report our experience with busulfan TDM in a large cohort of children. The aims were to investigate the relevance of using a more restricted therapeutic range and investigate the association between busulfan therapeutic range and clinical outcome. This study includes 138 children receiving 16 doses of intravenous busulfan, with the first dose assigned based on weight and doses adjusted to a local AUC target range of 980-1250 μmol min/L. Busulfan TDM combined with model-based dose adjustment was associated with an increased probability of AUC target attainment, for both target range: 90.8% versus 74.8% for the conventional target range and 66.2% versus 43.9% for the local target range (P<0.001). The median follow-up was 56.2 months. Event-free survival was 88.5%, overall survival was 91.5% and veno-occlusive disease occurred in 18.3% of patients. No difference was observed for clinical outcomes depending on the selected target range. Pharmacokinetic monitoring and individualization of busulfan dosage regimen are useful in improving target attainment, but using a restricted target range has no impact on clinical outcomes.
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Affiliation(s)
- M Philippe
- Hematology Department, Institute of Pediatric Hematology and Oncology, and Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, Université Lyon 1, Villeurbanne, France
| | - S Goutelle
- Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, Université Lyon 1, Villeurbanne, France.,ISPB - Faculté de Pharmacie de Lyon, Université Lyon 1, Lyon, France.,Service Pharmaceutique, Groupement Hospitalier de Gériatrie, Hospices Civils de Lyon, Lyon, France
| | - J Guitton
- ISPB - Faculté de Pharmacie de Lyon, Université Lyon 1, Lyon, France.,Laboratoire de Ciblage Thérapeutique en Cancérologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - X Fonrose
- Laboratoire de Pharmacologie, University Hospital Centre, Grenoble, France
| | - C Bergeron
- Hematology Department, Institute of Pediatric Hematology and Oncology, and Hospices Civils de Lyon, Lyon, France
| | - P Girard
- Clinique de Pédiatrie, Hôpital Couple Enfant, University Hospital Centre, Grenoble, France
| | - Y Bertrand
- Hematology Department, Institute of Pediatric Hematology and Oncology, and Hospices Civils de Lyon, Lyon, France
| | - N Bleyzac
- Hematology Department, Institute of Pediatric Hematology and Oncology, and Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, Université Lyon 1, Villeurbanne, France
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Maison O, De la Gastine B, Peter-Derex L, Berger C, Goutelle S. Administration de lévétiracétam par voie sous-cutanée en gériatrie. Rev Neurol (Paris) 2015; 171:398-9. [DOI: 10.1016/j.neurol.2015.01.567] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/15/2015] [Accepted: 01/28/2015] [Indexed: 11/26/2022]
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Goutelle S, Lalande L, Maire P, Bourguignon L. Choix d’une formule d’estimation de la fonction rénale pour adapter la posologie des médicaments chez les sujets âgés. Commentaires sur l’article de Andro et al. Rev Med Interne 2012; 33:350-1. [DOI: 10.1016/j.revmed.2012.03.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 03/31/2012] [Indexed: 10/28/2022]
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Bourguignon L, Goutelle S, de Saint Martin JB, Guillermet A, Bouniot P, Maire P, Ducher M. [Interindividual pharmacokinetic variability in long-term antibiotherapy]. Med Mal Infect 2009; 40:38-41. [PMID: 19346086 DOI: 10.1016/j.medmal.2009.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 12/17/2008] [Accepted: 03/04/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The authors wanted to assess intraindividual pharmacokinetic variability, with a case of long-term amikacin therapy. DESIGN A 92-year-old female patient, weighing 44kg, with renal failure, was treated by amikacin for 52 days. Her individual pharmacokinetic parameters were assessed 12 times in the course of therapy. The intraindividual variability of key parameters was quantified and compared with published interindividual variability. RESULTS Intraindividual volume and clearance variability was measured at about one fourth to one third of the value observed for interindividual variability. Half-life intraindividual variability was almost equivalent to the interindividual variability: 24.5% versus 32%. CONCLUSIONS The high pharmacokinetic variability observed has important potential clinical consequences. This case illustrates the need to ensure the effectiveness of treatment, to re-evaluate periodically the patient's status in order to take into account the intraindividual variability of pharmacokinetics parameters.
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Affiliation(s)
- L Bourguignon
- Université Lyon-1, UMR CNRS 5558, biométrie et biologie évolutive, bâtiment G.-Mendel, 43, boulevard du 11-Novembre-1918, 69622 Villeurbanne cedex, France.
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