Pharmacy and Pharmaceutical Sciences Commons^™

Clinical Characteristics And Outcomes Of Pediatric Staphylococcal Scalded Skin Syndrome (Ssss) At An Inner-City Tertiary Care Center, Nina Kb Gust Md, Ashley Frei Bs, Rebecca M. Adams Bs, Elika Ridelman Phd, Christina Shanti Md, Ronald Thomas Phd, Jocelyn Y. Ang Md

Medical Student Research Symposium

Introduction

Staphylococcal Scalded Skin Syndrome (SSSS) is a blistering skin condition caused by a toxin-producing staphylococcus species. Epidemiologic studies on pediatric SSSS in the United States are limited, with a reported incidence of 7.67 cases per million children and 45.1 per million infants. Immature renal function, lack of protective antibodies, and increased exotoxin target desmoglein-1 are hypothesized to increase incidence in younger children. We aimed to determine clinical and microbiological characteristics of pediatric SSSS and factors that could help predict disease severity.

Methods

A retrospective chart review was performed for admitted patients under 18 years old diagnosed with SSSS from …

Incorporating Pediatrics In Clinical Education: A Call To Action In Inpatient Pharmacy Practice., Caroline M Sierra, Amanda C Capino, Cober M Petrea, Lea S Eiland, Norm Fenn Bcps, Bcpps, Nicholas M Fusco, Lucas E Orth

Parkview Pharmacy Department

Background

The recently revised 2025 Accreditation Council for Pharmacy Education (ACPE) Standards state the expectations of Advanced Pharmacy Practice Experiences (APPEs) are to “emphasize continuity of care and incorporate acute, chronic, and wellness-promoting patient-care services…[and] expose students to diverse patient populations as related to age, sex race/ethnicity, socioeconomic factors…and disease states.”1 These expectations describe the conditions under which student pharmacists are expected to develop and demonstrate competence in the entrustable professional activities (EPAs), which were revised in 2022 to more accurately reflect current pharmacy practice.2 However, the definition of required APPE (Standard 3.2.d.) states that the inpatient patient …

Evaluation And Reduction Of Pediatric Precaution Alert Volume Across A Large Community Health System, Sarah Ferrell Pharmd

Parkview Pharmacy Department

Presented at the Midyear Clinical Meeting.

This evaluation found the potential to remove 15,174 alerts per year. Based off a physician spending a median of 8 seconds processing an alert, a reduction of 15,174 alerts per year saves about 34 hours of physician work-time per year.

Development And Implementation Of An Analgesia, Sedation, And Paralysis Order Panel For Mechanically Ventilated Pediatric Patients At A Large Community Health System, Kristin Lytal Pharmd, Mspgx

Pharmacy Residency

This project describes best practices and steps taken in development of a protocol for analgesia, sedation, and paralysis in pediatric patients.

This was presented at OHIO PRC.

Catch Flights, Not Rsv: Real-World Evaluation Of Respiratory Syncytial Virus (Rsv) Vaccine Use In Maternal And Older Adult Populations, Afamefuna Nzekwe

Pharmacy Residency

Present at the Midyear Clinical Meeting.

This evaluation found that most vaccinated patients met criteria. About 1/3 of newborns received RSV protection, but post-birth nirsevimab use could not be confirmed for non-Parkview patients.

Evaluation Of Corticosteroid Use In Pediatric Patients With Bronchiolitis, Kaitlyn Margraf Pharmd

Pharmacy Residency

Presented at Midyear Clinical Meeting.

Nearly 67% of pediatric patients treated for bronchiolitis received steroids with no underlying indication, which deviates from clinical guidelines. Patients who received steroids without an indication had an apparent trend toward more oxygen support and had an increase in maximum flow rate compared to patients with an indication for steroid use.

Assessment Of In-Vitro And In-Vivo Pre-Clinical Pharmacokinetics Of Epz015666; A Novel Small Molecule For Medulloblastoma Treatment, Pratiksha U. Kshirsagar

Theses & Dissertations

Group 3 medulloblastoma (MB) has the worst prognosis of the MB subgroups associated with elevated MYC expression and a 5-year survival rate of

Quantitation of EPZ was performed on a Shimadzu LC-MS/MS system utilizing electrospray ionization operated in positive mode. The validated assay was linear from 0.2 to 500 ng/mL. Metabolic stability studies demonstrated slow intrinsic clearance of EPZ in mouse and human liver microsomes, suggesting no CYP-mediated metabolism. Additionally, EPZ exhibited low binding affinity to plasma and brain proteins and high apparent permeability across artificial membranes, indicating efficient membrane penetration. Drug transporter studies identified EPZ as a substrate of …

Investigating The Use Of Serious Games For Cancer Control Among Children And Adolescents: Scoping Review, Sunghak Kim, Ebling Library, Olufunmilola Abraham

Pharmacy Practice and Science Faculty Publications

Background: Effective health care services that meet the diverse needs of children and adolescents with cancer are required to alleviate their physical, psychological, and social challenges and improve their quality of life. Previous studies showed that serious games help promote people’s health. However, the potential for serious games to be used for successful cancer control for children and adolescents has received less attention.

Objective: This scoping review aimed to map the use of serious games in cancer prevention and cancer care for children and adolescents, and provide future directions for serious games’ development and implementation within the context of cancer …

Evaluation Of Intravenous Immunoglobulin Utilization In Pediatric And Neonate Population Within A Community Health System., Hannah Davis Pharm D Candidate, Robert D. Beckett Pharmd, Bcps, Heather Nichols Pharm D, Bcpps, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

This project evaluated appropriateness of intravenous immunoglobulin (IVIG) use in pediatric and neonatal patients within a community health system based on current evidence. Presented at 2023 ASHP Midyear Clinical Meeting

A Review Of Guideline Directed Medication Therapy Adherence For Patients With Asthma., Jennifer Mccarthy Pharmd, Ms, Elizabeth Meisberger Pharmd, Bcps, Bccp, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs, Bhavika Patel Pharmd

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated a health system’s prescribing adherence to the 2022 GINA guideline update for inhaled corticosteroid (ICS) in combination with a long-acting beta agonist (LABA) as preferred reliever/rescue therapy for asthma within the ambulatory setting.

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

Assessment Of Readability And Quality Of Consumer-Oriented Pediatric Drug Information Websites, Kimberly A. Pesaturo, Ellie Ouellette, Peyton Calvao, Mike Mannheim

Faculty Publications - College of Pharmacy and Health Sciences

Introduction: The Internet is often a first-line medical resource for parents seeking childhood lay medical advice. Concerns exist regard- ing readability and quality of consumer-oriented Internet drug infor- mation, particularly where readability should be aimed at a sixth grade reading level.

Research Question or Hypothesis: This study sought to assess popular pediatric drug information websites for consumer-oriented readability and information quality.

Study Design: Sample websites were identified by simulating searches on three top United States search engines using pre-identified terms. The primary outcome was website readability according to the English-language and healthcare-validated Simple Measure of Gobbledygook (SMOG) Index. The secondary …

The Impact Of Medication Therapy Management Services On Pediatric Patients With Medical Complexities, Charisma Osuagwu, Erica Wong, Savion Carswell, Sophia Jenkins, Xinyu Wang, Yujin Kim

Research Day

Introduction

Medication Therapy Management (MTM) is a service provided by healthcare providers to ensure the best medical outcomes, particularly for those with multiple chronic conditions. It is often provided for senior populations supported under the Centers for Medicare & Medicaid Services. Studies show that patients provided with MTM services have higher medication adherence rates and experience fewer complications. However, there are few studies on MTM counseling in pediatric populations. In this literature review study, we investigated the potential impact of MTM services for underserved pediatric populations with chronic conditions or disabilities who are likely to benefit from MTM services.

Methods …

Evaluation Of Pharmaceutically Compounded Oral Caffeine On The Impact Of Medication Adherence And Risk Of Readmission Among Preterm Neonates: A Single-Center Quasi-Experimental Study, Gul Ambreen, Manoj Kumar, Amin Ali, Syed Akbar Ali Shah, Syed Muzaffar Saleem, Ayesha Tahir, Muhammad Sohail Salat, Muhammad Shahzad Aslam, Kashif Hussain

Department of Biological & Biomedical Sciences

Background: Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age ≥ 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates.
Methods: We conducted a single-center quasi-experimental study for this quality …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Racial And Ethnic Disparities In Opioid Use For Adolescents At Us Emergency Departments, Michael T. Phan, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Candice D. Donaldson, Michelle A. Fortier, Brooke Jenkins, Erik Linstead, Zeev N. Kain

Pharmacy Faculty Articles and Research

Background

Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.

Methods

This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. …

Cyclosporine Shows Benefit As Compared To Methotrexate For Treatment Of Pediatric Atopic Dermatitis Refractory To Topical Medications When Rapidity Of Clinical Response Is Of Key Importance To The Patient, Connor R. Buechler, Steven Daveluy Md

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.

Implementation Of A Pediatric Pharmacy Education Program At A Community Regional Medical Center., Chelsea L Ferguson Pharmd, Sarah Ferrell Pharmd, Karen Kovey Pharmd, Joanna Young, Sara Trovinger

Parkview Pharmacy Department

OBJECTIVES: This study aimed to implement a web-based pediatric education program designed for pharmacists who participate in neonatal and pediatric order verification at a community-based health system and to evaluate the success through measuring outcomes related to both comfort and competence of pharmacists in pediatric and neonatal pharmacotherapy.

METHODS: This prospective quality improvement study assessed changes in confidence and competence from before to after education. Eight educational modules were designed to provide education based on the needs of this institution. All pharmacists who participate in neonatal and pediatric order verification were eligible for inclusion throughout the health system. Time in …

Special Considerations In Pediatric Burn Patients Regarding Drug Dosage And Administration, Kelsey Lindsley, Maureen Moynihan, Angela Chu, Kristen Yaeger, Karen L. Kier

Pharmacy and Wellness Review

Pediatric burn patients are a high-risk patient population to treat. These patients have altered physiologic function as a result of the burn injury, in addition to their smaller size and developing bodies. This creates unique challenges during treatment. Accommodations for these patients are made through unique drug dosages and routes of administration. When treating pediatric burn patients, properly assessing and treating pain promptly and effectively is of utmost importance. Nurses who utilize accurate and appropriate pain assessment scales will provide the best treatment of pain. Proper assessment allows the patient to receive the correct analgesic regime, ensuring a faster and …

Pediatric Obesity: Influence On Drug Dosing And Therapeutics, Barbara Ameer Pharmd, Mba, Bcps, Fcp, Michael Weintraub Md

Department of Medicine Faculty Papers

Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of US children and adolescents. Severe obesity (³120% of the 95^th percentile of BMI-for-age, or a BMI of ³35 kg/m²) is the fastest growing subgroup and now approaches 6% of all US youth. Health consequences (e.g., type 2 diabetes, coronary heart disease) are related in a dose-dependent manner to severity of obesity. Since therapeutic interventions are less effective in severe obesity, prevention is a high priority.

Treatment plans involving combinations of …

Somatic Mutation Detection In Leukemia-Derived Circulating Dna: Utility In Monitoring Clonal Dynamics And Disease Response In Pediatric Acute Lymphoblastic Leukemia, Sarah Hisham Abdelaziz Youssef

Theses and Dissertations (ETD)

Despite the improved outcome associated with current treatment strategies ofpediatric acute lymphoblastic leukemia (ALL), relapse still represents a major challenge. Pediatric ALL demonstrates branched evolution in response to selective pressure exerted by therapy; relapse founder clones emerge from pre-leukemic clones or minor subclones present at diagnosis. It is hence crucial to develop biomarkers capable of tracking subclones throughout therapy. Current practices for monitoring disease response in leukemia rely on the analysis of BM biopsy sample at specific time points throughout therapy. Not only the invasiveness of the BM biopsy hinders the sequential sampling, but also, the currently implied techniques are …

Variability In Antifungal Utilization Among Neonatal, Pediatric, And Adult Inpatients In Academic Medical Centers Throughout The United States Of America, Jeremy S. Stultz, Rose Kohinke, Amy L. Pakyz

Pharmacotherapy and Outcomes Science Publications

Background
Identification of factors associated with antifungal utilization in neonatal, pediatric, and adult patient groups is needed to guide antifungal stewardship initiatives in academic medical centers.

Methods
For this hospital-level analysis, we analyzed antifungal use in hospitals across the United States of America, excluding centers only providing care for hematology/oncology patients. Analysis of variance was used to compare antifungal use between patient groups. Three multivariable linear regression models were used to determine independent factors associated with antifungal use in the neonatal, pediatric, and adult patient groups.

Results
For the neonatal, pediatric, and adult patient groups, 54, 44, and 60 hospitals …

Impact Of Rapid Meca Polymerase Chain Reaction Rapid Diagnostic Testing For Staphylococcus Aureus In A Pediatric Setting, Emily Drwiega

Undergraduate Honors Thesis Collection

Rapid molecular technology can detect the mecA resistance gene in Staphylococcus aureus (SA), predicting methicillin susceptibility in under one hour. In combination with antimicrobial stewardship program interventions in adults with SA bacteremia, rapid mecA testing decreases time to targeted therapy. This intervention has not yet been shown effective in pediatric patients or in the absence of real-time stewardship interventions. The objective of this study was to determine if time to optimal therapy decreased following implementation of GeneXpert rapid diagnostic testing (RDT) in a pediatric institution without a formal antimicrobial stewardship protocol for response. The primary outcome was time to optimal …

Age-Associated Expression Patterns Of Oatp 1b1 And Oatp 1b3 And Their Effect On The Disposition Of Fexofenadine, Margaret Mary Thomson

Theses and Dissertations (ETD)

As part of the drug disposition process (absorption, distribution, metabolism, excretion), an often overlooked aspect is transport. In order for drugs to be metabolized and excreted from the body they go through the liver or other drug removal organs. For drugs that are polar or are large they must rely upon transport mechanisms to transport them across the biomembranes of the drug removal organs. OATP1B1 and OATP1B3 are transporters on the sinusoidal membrane of the liver which work in concert with the drug metabolizing enzymes as part of the drug removal process. It is known that the development of each …

Occurrence Of Potential Adverse Drug Events From Prescribing Errors In A Pediatric Intensive And High Dependency Unit In Hong Kong: An Observational Study, Chad A. Knoderer, Celeste L. Ewig, Hon Ming Cheung, Kwok Ho Kam, Hiu Lam Wong

Scholarship and Professional Work – COPHS

No abstract provided.

Optimizing Guideline-Recommended Antibiotic Doses For Pediatric Infective Endocarditis, Chad A. Knoderer, Kristen R. Nichols, Emily N. Israel, Christopher A. Thomas

Scholarship and Professional Work – COPHS

The American Heart Association recently published an updated scientific statement on the management of infective endocarditis in childhood. The recommendations included for vancomycin, aminoglycoside, and β-lactam dosing and monitoring are based primarily on expert opinion and do not consider available evidence for dose optimization based on pharmacokinetic and pharmacodynamic principles in pediatric patients. This is concerning because even when clinically necessary, some practitioners may be hesitant to deviate from guideline-recommended doses. In this perspective, we highlight potential areas for improvement in the statement-recommended doses and summarize evidence supporting antibiotic dosing optimization. The addition of a pediatric clinical pharmacist with expertise …

Population Pharmacokinetics And Pharmacodynamics Of Extended-Infusion Piperacillin And Tazobactam In Critically Ill Children, Chad A. Knoderer, Kristen R. Nichols, Eun Kyoung Chung, Lauren E. Buenger, Daniel P. Healy, Jennifer Dees, Ashley S. Crumby, Michael B. Kays

Scholarship and Professional Work – COPHS

The study objective was to evaluate the population pharmacokinetics and pharmacodynamics of extended-infusion piperacillintazobactam in children hospitalized in an intensive care unit. Seventy-two serum samples were collected at steady state from 12 patients who received piperacillin-tazobactam at 100/12.5 mg/kg of body weight every 8 h infused over 4 h. Population pharmacokinetic analyses were performed using NONMEM, and Monte Carlo simulations were performed to estimate the piperacillin pharmacokinetic profiles for dosing regimens of 80 to 100 mg/kg of the piperacillin component given every 6 to 8 h and infused over 0.5, 3, or 4 h. The probability of target attainment (PTA) …

Implementing Extended-Infusion Cefepime As Standard Of Care In A Children’S Hospital: A Prospective Descriptive Study, Kristen R. Nichols, Lauren C. Karmire, Elaine G. Cox, Michael B. Kays, Chad A. Knoderer

Scholarship and Professional Work – COPHS

Background: Extended-infusion cefepime (EIC) has been associated with decreased mortality in adults, but to our knowledge, there are no studies in children.

Objective: The objective of this study was to determine the feasibility of implementing EIC as the standard dosing strategy in a pediatric population.

Methods: This was a descriptive study of children aged 1 month to 17 years, including patients in the intensive care unit, who received cefepime after admission to a freestanding, tertiary care children’s hospital. Patients were excluded if they were admitted to the neonatal intensive care unit or received cefepime in the outpatient, …

Late-Occurring Vancomycin-Associated Acute Kidney Injury In Children Receiving Prolonged Therapy, Chad A. Knoderer, Allison L. Gritzman, Kristen R. Nichols, Amy C. Wilson

Scholarship and Professional Work – COPHS

Background: Acute kidney injury (AKI) in patients receiving vancomycin has been associated with trough concentrations ≥15 mg/L and longer therapy duration. The objective of this study was to determine the incidence and factors associated with late AKI in children receiving ≥8 days of vancomycin therapy. Methods: Children aged 30 days to 17 years who were admitted to our institution and received intravenous vancomycin for at least 8 days during January to December of 2007 and 2010 and had a suspected or proven gram-positive infection were included. Late AKI was categorized as AKI occurring after the first 7 days of therapy …

A Randomized, Controlled Trial Of Catheter-Related Infectious Event Rates Using Antibiotic-Impregnated Catheters Versus Conventional Catheters In Pediatric Cardiovascular Surgery Patients, Elaine G. Cox, Chad A. Knoderer, Aimee Jennings, John W. Brown, Mark D. Rodefeld, Scott G. Walker, Mark W. Turrentine

Scholarship and Professional Work – COPHS

We conducted a randomized, controlled clinical trial to determine whether a difference in catheter-associated blood stream infection (CABSI) incidence existed between children who underwent cardiac surgery and had a central venous catheter impregnated with minocycline and rifampin versus those who had a conventional, nonimpregnated catheter after cardiac surgery. Due to a lower number of infections than expected, the study was terminated early. Among 288 evaluable patients, the rates of CABSI and line-related complications were similar between the 2 groups.