Digital Commons Network^™

Multicenter, Observational Cohort Study Evaluating Third-Generation Cephalosporin Therapy For Bloodstream Infections Secondary To Enterobacter, Serratia, And Citrobacter Species, Caroline Derrick, P. Brandon Bookstaver, Zhiqiang K. Lu, Christopher M. Bland, S. Travis King, Kayla R. Stover, Kathey Rumley, Shawn H. Macvane, Jenna Swindler, Scott Kincaid, Trisha Branan, David Cluck, Benjamin Britt, Kelly E. Pillinger, Bruce M. Jones, Virginia Fleming, V. Paul Dimondi, Sandy Estrada, Brad Crane, Brian Odle, Majdi N. Al-Hasan, Julie Ann Justo

Faculty Publications

Objectives: There is debate on whether the use of third-generation cephalosporins (3GC) increases the risk of clinical failure in bloodstream infections (BSIs) caused by chromosomally-mediated AmpC-producing Enterobacterales (CAE). This study evaluates the impact of definitive 3GC therapy versus other antibiotics on clinical outcomes in BSIs due to Enterobacter, Serratia, or Citrobacter species. Methods: This multicenter, retrospective cohort study evaluated adult hospitalized patients with BSIs secondary to Enterobacter, Serratia, or Citrobacter species from 1 January 2006 to 1 September 2014. Definitive 3GC therapy was compared to definitive therapy with other non-3GC antibiotics. Multivariable Cox proportional hazards regression evaluated the impact of …

Commentary: Phytocannabinoids As Therapeutic Agents To Combat Chronic Gingival Disease., Nick Narek Ohanian

Pacific Journal of Health

The therapeutic potential of cannabis has been harnessed for thousands of years yet the United States Food and Drug Administration (FDA) has still not approved cannabis as a safe or effective drug. The FDA has, however, approved the manufacturing of pharmaceutical drugs, which contain a “synthetic version of a substance that is present in the marijuana” and other compounds that mimic its action. A search of the US National Library of Medicine and National Institute of Health for keywords “CBD” and “Periodontitis” together yields only 2 publications. Although the current State and Federal regulations on the use of cannabis for …

The Impact Of Multidrug-Resistant Organisms On Outcomes In Patients With Diabetic Foot Infections, Oryan Henig, Jason M. Pogue, Emily Martin, Umar Hayat, Mahmoud Ja'ara, Paul E. Kilgore, Raymond Cha, Sorab Dhar, Keith S. Kaye

Department of Pharmacy Practice

Background. Multidrug-resistant organisms (MDROs) are important diabetic foot infection (DFI) pathogens. This study evaluated the impact of DFIs associated with MDRO pathogens (DFI-MDRO) on clinical outcomes.

Methods. Adults admitted to Detroit Medical Center from January 2012 to December 2015 with culture-positive DFI were included. Associations between outcomes and DFI-MDRO (evaluated as a single group that included methicillin-resistant Staphylococcus aureus [MRSA], vancomycin-resistant enterococci, Enterobacteriaceae resistant to third-generation cephalosporin [3GCR-EC], Acinetobacter baumannii, and Pseudomonas aeruginosa) were analyzed. Outcomes included above- and below-knee lower extremity amputation (LEA), readmissions, and mortality within a year after DFI. A propensity score predicting the likelihood …

Multicenter, Observational Cohort Study Evaluating Third-Generation Cephalosporin Therapy For Bloodstream Infections Secondary To Enterobacter, Serratia, And Citrobacter Species, Caroline Derrick, P. Brandon Bookstaver, Zhiqiang K. Lu, Christopher M. Bland

Faculty and Student Publications

Objectives: There is debate on whether the use of third-generation cephalosporins (3GC) increases the risk of clinical failure in bloodstream infections (BSIs) caused by chromosomally-mediated AmpC-producing Enterobacterales (CAE). This study evaluates the impact of definitive 3GC therapy versus other antibiotics on clinical outcomes in BSIs due to Enterobacter, Serratia, or Citrobacter species. Methods: This multicenter, retrospective cohort study evaluated adult hospitalized patients with BSIs secondary to Enterobacter, Serratia, or Citrobacter species from 1 January 2006 to 1 September 2014. Definitive 3GC therapy was compared to definitive therapy with other non-3GC antibiotics. Multivariable Cox proportional hazards regression evaluated the impact of …

Role Of Protein Phosphatase-2a In Regulating Monocyte Activation By Soluble And Crystalline Uric Acid In Gout, Sandy Elsayed

Pharmaceutical Sciences (MS) Theses

Gout is a chronic inflammatory disease caused by the phagocytosis of monosodium urate monohydrate (MSU) crystals by monocytes/macrophages resulting in downstream expression and production of interleukin-1 beta (IL-1β) and chemokines. The activation of monocytes by MSU crystals involves the priming of monocytes with danger signals e.g. lipopolysaccharide (LPS) or soluble uric acid (UA), crystal phagocytosis and subsequent NLRP3 inflammasome activation and conversion of pro-IL-1β to active IL-1β. Protein-phosphatase-2A (PP2A) is a serine/threonine phosphatase that plays an important role in cell growth and inflammation. The prodrug Fingolimod (FTY720) and its phosphorylated active metabolite (p-FTY720) activate intracellular PP2A. We hypothesized that monocyte …

Leadership Challenges And Collaborative Opportunities Unveiled Through Covid-19, Gayle Brazeau

Marshall Journal of Medicine

No abstract provided.

Effect Of A Pharmacist-Led Antimicrobial Stewardship (Ams) Program On Outpatient Fluoroquinolone Prescribing In The Elderly, Katie Larue, Chelsea Mannebach, Bonnie Jiron

Providence Pharmacy PGY2 Program at Providence Medical Group 2020

Title: Effect of a pharmacist-led antimicrobial stewardship (AMS) program on outpatient fluoroquinolone prescribing in the elderly

Authors: LaRue, Katie PharmD; Mannebach, Chelsea PharmD, BCPS, BCACP; Jiron, Bonnie, PharmD, BCACP

Introduction: The Center for Disease Control and Prevention, the Society of Infectious Diseases Pharmacists, and American Pharmacists Association recognize the need for outpatient AMS programs and the important role pharmacists play in appropriate prescribing. Fluoroquinolones (FQ) pose many risks, highlighted by U.S Food and Drug Administration safety warnings, including aortic dissection, hypoglycemia, mental health side effects, and tendonitis, along with the risk of Clostridium difficile infections, particularly in …

Evaluation Of Surgical Antibiotic Prophylaxis At A Large, Tertiary Medical Center, Emily Fox, Brent Footer, Angel Mendez

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2020

Emily Fox, PharmD, PGY-1 Pharmacy Resident

Brent Footer, PharmD, BCPS; Angel Mendez, Pharmacy Student

Providence Portland Medical Center, Portland, Oregon

Evaluation of surgical antibiotic prophylaxis at a large, tertiary medical center

Surgical site infections (SSI) are a significant cause of morbidity, prolonged hospitalization, and mortality. The cost of a single SSI is estimated to be upward of $25,000 and increases a patient’s length of hospital stay by ~10 days. Our institution has identified inappropriate or less than optimal antimicrobial prophylaxis as a potential contributor in several recent SSI cases. Current literature on this topic has found that there may be …

Impact Of Real-Time Antimicrobial Stewardship Team Intervention Versus Conventional Microbiology Reporting On Time To Appropriate Antimicrobial Therapy In Patients With Enterobacterales Bacteremia, Scott C. King, Alyssa B Christensen, Brent Footer, Timothy G. Shan, Kim Health, Ivor Thomas, Margaret Oethinger

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2020

Scott C. King

Alyssa B. Christensen, Brent W. Footer, Timothy G. Shan, Kim Health, Ivor Thomas, and Margret Oethinger

Impact of real-time antimicrobial stewardship team intervention versus conventional microbiology reporting on time to appropriate antimicrobial therapy in patients with Enterobacterales bacteremia.

Introduction:

The benefit of rapid laboratory speciation combined with real time antimicrobial stewardship team (AMT) interventions has been shown to improve patient outcomes and decrease hospital costs. The Providence Oregon region conducts direct from blood culture matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) identification, which results in decreased time to organism identification. The MALDI-TOF identification has allowed the AMT …

Development And Characterization Of Selective Cb2r Inverse Agonists As A Novel Anti-Inflammatory Therapy For Neuroinflammation – Mechanisms Of Action In Murine And Human Microglia Models Provide Valuable Insights Into Their Therapeutic Potential, Sahar Saleh Alghamdi

Theses and Dissertations (ETD)

Introduction: Recently, research has revealed the presence of cannabinoid receptor 2 (CB2R) in the central nervous system (CNS); since then, the receptor has emerged as a promising therapeutic target for treating multiple neurodegenerative diseases (NDD) such as Alzheimer’s (AD), Parkinson’s (PD), Human Immunodeficiency Virus (HIV) and Multiple Sclerosis (MS). The restricted and upregulated expression of CB2R in activated microglia and lack of psychotropic activity make this receptor an attractive target for discovering novel therapy to treat neuroinflammatory diseases for which there is currently no curative treatment. Methodology: A library of compounds were synthesized and evaluated in ACTOne and TANGO-bla functional …

Pharmacist-Driven Culture And Sexually Transmitted Infection Testing Follow-Up Program In The Emergency Department, Stephanie C. Shealy, Christine Alexander, Tina Grof Hardison, Joseph Magagnoli, Julie Ann Justo, Caroline Derrick, Joseph Kohn, Hana Rac Winders, Troy Privette, Majdi N. Al-Hasan, P. Brandon Bookstaver

Faculty Publications

Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the ED. This was a single-center, pre- and post-implementation, cohort study examining the impact of a pharmacist-driven culture/RDT follow-up program in the ED. Adult patients discharged from the ED with subsequent positive cultures and/or RDT during the pre- (21 August 2018–18 November 2018) and post-implementation (19 November 2018–15 February 2019) periods were screened for inclusion. The primary endpoints were time from ED discharge to …

Vaccines In Current Culture: The Hpv Vaccine Controversy, Alyssa Johnston

Senior Honors Theses

The use of vaccinations has drastically decreased mortality and morbidity rates related to infectious disease and has become an intrinsic part of modern health care. However, the fear of risks related to vaccines has been partially responsible for the decisions of many parents to delay or avoid vaccinating their children. The human papilloma virus (HPV) vaccine specifically is one of the most controversial vaccines in current culture due to reports of new onset or exacerbation of autoimmune diseases, infertility, and even death following its administration. This review synthesizes information regarding the relevance and safety of the HPV vaccine, as well …

The Pediatric Anti-Viral Immune Response Impairs Neural Stem/Progenitor Cell Activity, Yashika Kamte, Manisha N. Chandwani, Lauren A. O'Donnell

Graduate Student Research Symposium

The neuropathological outcomes of a viral infection in the brain are often age-dependent. Infection of the immature CNS can lead to impairment of neural/stem progenitor cell (NSPCs) activity. NSPCs are multi-potent progenitor cells of the CNS and are responsible for populating the brain with neurons, astrocytes, and oligodendrocytes during development. Viral infections may alter NSPC activity via two mechanisms; directly by infection of the NSPC or indirectly due to the anti-viral immune response. Here, we examined the impact of a neurotropic infection on NSPC activity in pediatric mice (postnatal day 10), where brain and immune system development is ongoing. In …

Impact Of Reappraisal Of Fluoroquinolone Minimum Inhibitory Concentration Susceptibility Breakpoints In Gram-Negative Bloodstream Isolates, Stephanie C. Shealy, Matthew M. Brigmon, Julie Ann Justo, P Brandon Bookstaver, Joseph Kohn, Majdi N. Al-Hasan

Faculty Publications

The Clinical Laboratory Standards Institute lowered the fluoroquinolone minimum inhibitory concentration (MIC) susceptibility breakpoints for and glucose non-fermenting Gram-negative bacilli in January 2019. This retrospective cohort study describes the impact of this reappraisal on ciprofloxacin susceptibility overall and in patients with risk factors for antimicrobial resistance. Gram-negative bloodstream isolates collected from hospitalized adults at Prisma Health-Midlands hospitals in South Carolina, USA, from January 2010 to December 2014 were included. Matched pairs mean difference (MD) with 95% confidence intervals (CI) were calculated to examine the change in ciprofloxacin susceptibility after MIC breakpoint reappraisal. Susceptibility of to ciprofloxacin declined by 5.2% (95% …

Risk Factors, Predictive Markers And Prevention Strategies For Intrauterine Fetal Death. An Integrative Review, Roxana Bohiltea, Natalia Turcan, Christina M. Cavinder, Ionită Ducu, Ioana Paunica, Liliana Florina Andronache, Monica Mihaela Cirstoiu

Journal of Mind and Medical Sciences

According to World Health Organization (WHO), fetal death is defined as the death of the fetus prior to its complete expulsion, independent of the duration of pregnancy, thus only ascribing the term stillbirth to fetal deaths in the case of pregnancies after 28 weeks of gestation. The great progress of perinatology care is reflected in a significant reduction in the rate of stillbirths, especially in well-developed countries, with approximately 98% of stillbirth cases now occurring in poor and developing countries. Stillbirth powerfully impacts both the patient and the practitioner. Because nearly half of stillbirth cases result from apparently uncomplicated pregnancies, …

Coronavirus Disease 2019 (Covid-19), Matthew Dunbar

Pharmacy Student Scholarship

No abstract provided.

Influenza Vaccination Coverage In Pediatric Patients With Inflammatory Bowel Disease, Kelly Brown

Senior Theses

Background: Children with chronic health conditions, including inflammatory bowel disease (IBD), are at especially high risk for influenza infection and complications. The Crohn’s & Colitis Foundation and American College of Gastroenterology recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients.

Methods: We utilized longitudinal data (2000 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was IBD diagnosis based upon ICD-9/10 diagnosis codes. Children with IBD were …

Pharmacy Newsletter : March 2020, Pharmacy Department

Department of Pharmacy Archives

Content:

• Roles of Pharmacist during the COVID‐19 Pandemic
• Drug Interaction Update
• ToxTalk | Bleach Ingestion
• COVID-19- Recommended Practice
• Drug Induced Nutrient & Vitamin Deficiency

An Interprofessional Approach To A Service-Learning Health Project For Area Homeless: A Case Study, Caroline Carpenter, Samuel T. Shannon, Jana P. Sutton, Theresa D. Thomas, John R. Webb, Ashley Wiltcher, Rhonda Hensley

Journal of Interprofessional Practice and Collaboration

Providing health care services for the homeless community requires multiple health care disciplines to meet the varying needs of the community. The needs of the homeless are multifaceted and thus require expertise of an interprofessional team to help break down barriers and achieve positive outcomes for the clients served. This case study shares the work done by a team of faculty and students from a local university in Marriage and Family Therapy, Counseling, and graduate nursing. The focus of the group was to provide physical and mental health screenings and make appropriate community referrals as needed. The work was sponsored …

A Real-World Analysis Of Patient Characteristics And Predictors Of Hospitalization Among Us Medicare Beneficiaries With Respiratory Syncytial Virus Infection, Veronique Wyffels, Furaha Kariburyo, Sandra Gavart, Roman Fleischhackl, Huseyin Yuce

Publications and Research

Introduction: Little has been published on respiratory syncytial virus (RSV) among Medicare patients at high risk (HR) of RSV complications due to age or comorbidity. Methods: Adult patients (at least 18 years of age) with at least 1 diagnostic code for RSV were identified using the 5% US Medicare database from 2011 through 2015. Patients were required to have continuous health plan enrollment for 180 days pre- and 180 days post-RSV diagnosis (baseline and follow-up periods, respectively). HR was defined as diagnosis of chronic lung disease, congestive heart failure, or weakened immune system for 180 days during the base-line period. …

Identification Of Ebsulfur Analogues With Broad-Spectrum Antifungal Activity, Sylvie Garneau-Tsodikova, Huy X. Ngo, Sanjib K. Shrestha

Pharmaceutical Sciences Faculty Patents

The invention relates to novel ebsulfur analogues and novel pharmaceutical compositions comprising ebsulfur analogues. The invention also relates to novel methods of treating infections caused by fungal species comprising administration of ebselen, ebsulfur, and ebsulfur analogues.

Updates On Human Immunodeficiency Virus (Hiv), Jose Ojeda

All Publications

No abstract provided.

Evaluation Of Antimicrobial Agents With Potential To Develop Adverse Mental Health In Geriatrics, Sonal M. Sekhar Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: With advanced age, there is increased risk of various infections. Antimicrobial agents are majorly prescribed for management of these infections. Due to age-related physiological changes, many of the antimicrobial agents cause adverse mental health. Therefore, we evaluated the geriatric antimicrobial prescription to determine its potential to cause mental health issue. Objectives:  To prepare a checklist for antimicrobials which have the potential to cause adverse mental health.  Evaluate the geriatric antimicrobial prescription to determine its potential to cause mental health issue.  To determine antimicrobial-related mental health problems in geriatric patients. Methods: A prospective observational study was conducted …

Evaluation Of Antibiotic Use And Duration For Febrile Neutropenia, Kayla Jensen, Patricia Aubert, Joy Ward, Ann Wigton

Pharmacy Posters

Introduction:

• Febrile neutropenia (FN) affects over 80% of patients with hematologic cancer and 10% to 50% of patients with solid tumors
• National Comprehensive Cancer Network (NCCN) guidelines recommend empiric broad-spectrum monotherapy until the absolute neutrophil count (ANC) is over 500 cells/uL.
• Extended durations with broad-spectrum agents leads to increased risk of antibiotic resistance, toxicity and C. difficile infection.

Purpose

• To evaluate antibiotic prescribing patterns for patients with FN to optimize antibiotic stewardship.

Gm-1111 Preserves Phagocytic Function Of Macrophages Exposed To Prolonged Hyperoxia Via Interruption Of Hmgb1-Mediated Signaling, Leanne Daley

Theses and Dissertations

Supraphysiological levels of oxygen (i.e. hyperoxia) are used to treat patients with respiratory distress. Prolonged exposure to hyperoxia can impair alveolar macrophage functions and increase susceptibility to ventilator-associated pneumonia (VAP). Hyperoxia-induced alveolar macrophage dysfunction is, in part, mediated by high airway levels of the pro-inflammatory mediator, high mobility group box-1 (HMGB1). An early generation glycosaminoglycan (GAG), 2-O, 3-O desulfated heparin (ODSH), attenuates hyperoxia-compromised innate immunity by preventing the binding of HMGB1 with receptors that activate pro-inflammatory pathways. In this study, we investigated whether the next generation GAG, GM-1111, can attenuate hyperoxia-compromised macrophage function. GM-1111 (100μM) prevented hyperoxia-induced (95% O2 for …

Agal Antigen And Rutinose Glycosides As Model Compounds For The Design Of Classical And Conformational Glycomimetics, Dhwani Ashish Mehta

Theses and Dissertations

αGal or Galili epitope (αGal(1→3)βGal(1→4)GlcNAc) is a natural trisaccharide associated with cell-surface glycoproteins of certain mammalian and non-mammalian cells. The saccharide is not expressed by humans and anti-αGal antibodies account for ~1% of the total circulating antibodies in sera as a result of our constant exposition to the antigen from food and intestinal flora. Our interest in αGal relies on its involvement in a variety of pathologies including red meat allergy, hyperacute xenotransplant rejection, and parasitic and bacterial infections. In particular, we have an interest in developing structurally simple glycomimetics for engaging in high-affinity binding αGal-recognizing receptors such as the …

Cefepime-Induced Neurotoxicity: A Retrospective Cohort Study In A Tertiary Healthcare Facility, Sonal M. Sekhar

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Cefepime is a fourth-generation cephalosporin with broad spectrum of activity. Cefepime continues as a major part of parenteral treatment for neutropenic fever and hospital-associated infections including pneumonia, urinary tract infections, skin and soft tissue infections, etc. The principle mechanism of Cefepime-induced neurotoxicity is via inhibition of GABA-A receptors or GABA release. Neurotoxic adverse drug reactions (ADRs) include unconsciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Risk factors of the ADRs include renal failure, over dosing, pre-existing brain injury, and elevated serum Cefepime levels.

Objectives: Primary objective is to determine incidence of neurotoxic ADRs related to the use Cefepime. Secondary objective …

Primary Healthcare Policy And Vision For Community Pharmacy And Pharmacists In The United States, Teresa M. Salgado, Meagen M. Rosenthal, Antoinette B. Coe, Tana N. Kaefer, Dave L. Dixon, Karen B. Farris

Faculty and Student Publications

© 2020, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved. The United States (US) has a complex healthcare system with a mix of public, private, nonprofit, and for-profit insurers, healthcare institutions and organizations, and providers. Unlike other developed countries, there is not a single payer healthcare system or a national pharmaceutical benefits scheme/plan. Despite spending over USD 10,000 per capita in healthcare, the US is among the worst performers compared to other developed countries in outcomes including life expectancy at birth, infant mortality, safety during childbirth, and unmanaged chronic conditions (e.g., asthma, diabetes). Primary care is delivered by physicians …

Gabapentin Abuse, Tuyet-Anh Nguyen

College of Pharmacy Student Research

No abstract provided.

An Evaluation Of The Usda's Policy To Reduce Listeria Illnesses In Ready‐To‐Eat Meat And Poultry Products, Travis Minor, Matt Parrett

United States Food and Drug Administration: Publications

Using 1998–2008 data collected by the Centers for Disease Control and Prevention on foodborne illnesses and outbreaks, we examine the economic impact of the United States Department of Agriculture's proposed and final rules to reduce the incidence of Listeria monocytogenes (Lm) in ready‐to‐ eat meat and poultry products. Using a difference‐in‐ differences approach, we find that these rules together reduced meat‐related Lm illnesses by about 60 per year, which we attribute to reductions in both the number and average size of meat‐related Lm outbreaks. We then monetize this illness reduction using an underreporting and underdiagnosis multiplier of 2.3 and an …