Scholars@Duke
Richard Howard Drew

Richard Howard Drew

Professor in Medicine
Medicine, Infectious Diseases
richard.drew@duke.edu
Duke Box 102359, Durham, NC 27710
169 Hanes House, Trent Drive, Durham, NC 27710

Selected Publications

Electronic health record-based readmission risk model performance for patients undergoing outpatient parenteral antibiotic therapy (OPAT).

Journal Article PLOS Digit Health · August 2023 BACKGROUND: Outpatient Parenteral Antibiotic Therapy (OPAT) provides coordinated services to deliver parenteral antibiotics outside of the acute care setting. However, the reduction in monitoring and supervision may impact the risks of readmission to the h ... Full text Link to item Cite

Harvesting the low-hanging fruit? Comparative assessment of intravenous to oral route antimicrobial conversion policy implementation.

Journal Article Infect Control Hosp Epidemiol · June 2023 Policies that promote conversion of antibiotics from intravenous to oral route administration are considered "low hanging fruit" for hospital antimicrobial stewardship programs. We developed a simple metric based on digestive days of therapy divided by tot ... Full text Link to item Cite

Utility of a risk assessment model in predicting 30 day unplanned hospital readmission in adult patients receiving outpatient parenteral antimicrobial therapy.

Journal Article JAC Antimicrob Resist · February 2023 OBJECTIVES: Outpatient parenteral antimicrobial therapy (OPAT) is associated with high hospital readmission rates. A 30 day unplanned readmission risk prediction model for OPAT patients has been developed in the UK. Given significant differences in patient ... Full text Link to item Cite

Conventional Antifungals for Invasive Infections Delivered by Unconventional Methods; Aerosols, Irrigants, Directed Injections and Impregnated Cement.

Journal Article J Fungi (Basel) · February 21, 2022 The administration of approved antifungals via unapproved formulations or administration routes (such as aerosol, direct injection, irrigation, topical formulation and antifungal-impregnated orthopedic beads or cement) may be resorted to in an attempt to o ... Full text Link to item Cite

Opportunities for Improving Antimicrobial Stewardship: Findings From a Prospective, Multi-Center Study in Three Low- or Middle-Income Countries.

Journal Article Front Public Health · 2022 BACKGROUND: To develop effective antimicrobial stewardship programs (ASPs) for low- and middle-income countries (LMICs), it is important to identify key targets for improving antimicrobial use. We sought to systematically describe the prevalence and patter ... Full text Link to item Cite

Barriers to implementing antimicrobial stewardship programs in three low- and middle-income country tertiary care settings: findings from a multi-site qualitative study.

Journal Article Antimicrob Resist Infect Control · March 25, 2021 BACKGROUND: Antimicrobial resistance has been named as one of the top ten threats to public health in the world. Hospital-based antimicrobial stewardship programs (ASPs) can help reduce antimicrobial resistance. The purpose of this study was to determine p ... Full text Link to item Cite

Combination Therapy for Invasive Fungal Infections

Journal Article Current Fungal Infection Reports · March 1, 2020 Purpose of the Review: The purpose of this review is to summarize and evaluate relevant literature on combination antifungal therapy for invasive fungal infections (IFIs). Recent Findings: Cryptococcal meningitis has the largest body and highest quality in ... Full text Cite

Point-prevalence study of antimicrobial use in public hospitals in southern Sri Lanka identifies opportunities for improving prescribing practices.

Journal Article Infect Control Hosp Epidemiol · February 2019 A point-prevalence study of antimicrobial use among inpatients at 5 public hospitals in Sri Lanka revealed that 54.6% were receiving antimicrobials: 43.1% in medical wards, 68.0% in surgical wards, and 97.6% in intensive care wards. Amoxicillin-clavulanate ... Full text Link to item Cite

Impact of select risk factors on treatment outcome in adults with candidemia.

Journal Article Pharm Pract (Granada) · 2019 BACKGROUND: Studies examining relationships between patient-related factors and treatment outcome in patients with candidemia are limited and often based on all-cause mortality. OBJECTIVE: Our purpose was to examine the impact of concurrent renal replaceme ... Full text Link to item Cite

Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure.

Journal Article J Antimicrob Chemother · June 1, 2018 BACKGROUND: This study was conducted as part of the Driving Reinvestment in Research and Development and Responsible Antibiotic Use (DRIVE-AB) project and aimed to develop generic quality indicators (QIs) for responsible antibiotic use in the inpatient set ... Full text Link to item Cite

Metrics for quantifying antibiotic use in the hospital setting: results from a systematic review and international multidisciplinary consensus procedure.

Journal Article J Antimicrob Chemother · June 1, 2018 BACKGROUND: Quantifying antibiotic use is an essential element of antibiotic stewardship since it allows comparison between different settings and time windows, and measurement of the impact of interventions. However, quantity metrics (QMs) and methods hav ... Full text Link to item Cite

Metrics to assess the quantity of antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure.

Journal Article J Antimicrob Chemother · June 1, 2018 BACKGROUND: The international Innovative Medicines Initiative (IMI) project DRIVE-AB (Driving Reinvestment in Research and Development and Responsible Antibiotic Use) aims to develop a global definition of 'responsible' antibiotic use. OBJECTIVES: To ident ... Full text Link to item Cite

Quality indicators assessing antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure.

Journal Article J Antimicrob Chemother · June 1, 2018 OBJECTIVES: Quality indicators (QIs) assessing the appropriateness of antibiotic use are essential to identify targets for improvement and guide antibiotic stewardship interventions. The aim of this study was to develop a set of QIs for the outpatient sett ... Full text Link to item Cite

Influence of Reported Penicillin Allergy on Mortality in MSSA Bacteremia.

Journal Article Open Forum Infect Dis · March 2018 BACKGROUND: Penicillin allergy frequently impacts antibiotic choice. As beta-lactams are superior to vancomycin in treating methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, we examined the effect of reported penicillin allergy on clinical o ... Full text Open Access Link to item Cite

Evaluation of a vancomycin dosing nomogram in obese patients weighing at least 100 kilograms.

Journal Article Pharm Pract (Granada) · 2018 BACKGROUND: There remains variability in both practice and evidence related to optimal initial empiric dosing strategies for vancomycin. OBJECTIVE: Our primary objective was to describe the percentage of obese patients receiving vancomycin doses consistent ... Full text Link to item Cite

Impact of automatic infectious diseases consultation on the management of fungemia at a large academic medical center.

Journal Article Am J Health Syst Pharm · December 1, 2017 PURPOSE: The impact of automatic infectious diseases (ID) consultation for inpatients with fungemia at a large academic medical center was studied. METHODS: In this single-center, retrospective study, the time to appropriate antifungal therapy before and a ... Full text Link to item Cite

Impact of Standardized Simulated Patients on First-Year Pharmacy Students' Knowledge Retention of Insulin Injection Technique and Counseling Skills.

Journal Article Am J Pharm Educ · August 2017 Objective. To compare pre- and post-intervention test scores assessing insulin injection technique and counseling skills among P1 students with (intervention) or without (control) simulated patients, and to compare counseling checklist and knowledge retent ... Full text Link to item Cite

Role of isavuconazole in the treatment of invasive fungal infections.

Journal Article Ther Clin Risk Manag · 2016 Despite recent advances in both diagnosis and prevention, the incidence of invasive fungal infections continues to rise. Available antifungal agents to treat invasive fungal infections include polyenes, triazoles, and echinocandins. Unfortunately, individu ... Full text Open Access Link to item Cite

Challenges in Preparation of Cumulative Antibiogram Reports for Community Hospitals.

Journal Article J Clin Microbiol · September 2015 Knowledge of local antimicrobial resistance is critical for management of infectious diseases. Community hospitals' compliance with Clinical and Laboratory Standards Institute (CLSI) guidance for creation of cumulative antibiograms is uncertain. This descr ... Full text Link to item Cite

Sulfonylurea Prescribing Patterns After the Introduction of DPP-4 Inhibitors and GLP-1 Receptor Agonists.

Journal Article Clin Ther · July 1, 2015 PURPOSE: Although newer agents (dipeptidyl peptidase [DPP]-4 inhibitors and glucagon-like peptide [GLP]-1 receptor agonists) are available for the treatment of hyperglycemia in patients with type 2 diabetes mellitus (T2DM), the impact of the availability o ... Full text Link to item Cite

Azole antifungals: 35 years of invasive fungal infection management.

Journal Article Expert Rev Anti Infect Ther · June 2015 Prior to 1981, treatment options for invasive fungal infections were limited and associated with significant toxicities. The introduction of ketoconazole marked the beginning of an era of dramatic improvements over previous therapies for non-life-threateni ... Full text Link to item Cite

Risk factors associated with unfavorable short-term treatment outcome in patients with documented Pseudomonas aeruginosa infection.

Journal Article Int J Clin Pharm · April 2015 BACKGROUND: Invasive infections with Pseudomonas aeruginosa (PA) are associated with significant morbidity and mortality. While risk factors for mortality have been identified, their influence on short-term outcomes impacting treatment selection has not be ... Full text Link to item Cite

Comparison of the incidence of vancomycin-induced nephrotoxicity in hospitalized patients with and without concomitant piperacillin-tazobactam.

Journal Article Pharmacotherapy · July 2014 STUDY OBJECTIVES: To determine whether the addition of piperacillin-tazobactam leads to an increased incidence of nephrotoxicity in patients receiving vancomycin and to explore potential confounding factors that may increase the risk of vancomycin-induced ... Full text Link to item Cite

Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology-oncology patients: a retrospective cohort study.

Journal Article Cancer Med · June 2014 In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole ... Full text Open Access Link to item Cite

Future strategies for the treatment of cryptococcal meningoencephalitis in pediatric patients

Journal Article Expert Opinion on Orphan Drugs · January 1, 2014 Introduction: Cryptococcal meningoencephalitis (CM) is a rare infection in pediatric patients, which is associated with substantial morbidity and mortality. Since symptoms of this infection are nonspecific, the diagnosis relies on risk assessment and labor ... Full text Cite

Recent advances in the treatment of life-threatening, invasive fungal infections.

Journal Article Expert Opin Pharmacother · December 2013 INTRODUCTION: Invasive fungal infections (IFIs) pose significant morbidity and are often life-threatening to many high-risk patients. Timely diagnosis and treatment of these infections with optimal therapy is imperative. AREAS COVERED: Advances have been m ... Full text Link to item Cite

Aerosolized antifungals for the prevention and treatment of invasive fungal infections

Journal Article Current Fungal Infection Reports · June 1, 2013 Invasive fungal infections result in significant morbidity and mortality, most notably in immunosuppressed patients. Aerosolized antifungal agents have been utilized primarily as prophylaxis (either alone or in combination with systemic antifungals) in pat ... Full text Cite

Utility of a clinical risk factor scoring model in predicting infection with extended-spectrum β-lactamase-producing enterobacteriaceae on hospital admission.

Journal Article Infect Control Hosp Epidemiol · April 2013 OBJECTIVE: To validate the utility of a previously published scoring model (Italian) to identify patients infected with community-onset extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-EKP) and develop a new model (Duke) based on local epid ... Full text Link to item Cite

How long to treat with antibiotics following amputation in patients with diabetic foot infections? Are the 2012 IDSA DFI guidelines reasonable?

Journal Article J Clin Pharm Ther · April 2013 WHAT IS KNOWN AND OBJECTIVE: To the best of our knowledge, there has been no published study designed to identify the most appropriate duration of antibiotic therapy in lower extremity skin and skin structure infections in diabetic patients [aka "diabetic ... Full text Link to item Cite

Cost of invasive fungal infections in the era of new diagnostics and expanded treatment options.

Journal Article Pharmacotherapy · October 2012 STUDY OBJECTIVE: To determine the true institutional cost of treating invasive fungal infections in light of recent advances in diagnostic techniques and antifungal therapies for both treatment and prophylaxis of these infections. DESIGN: Economic analysis ... Full text Link to item Cite

Effect of closed-loop order processing on the time to initial antimicrobial therapy.

Journal Article Am J Health Syst Pharm · August 15, 2012 PURPOSE: The results of a study comparing the average time to initiation of i.v. antimicrobial therapy with closed-versus open-loop order entry and processing are reported. METHODS: A retrospective cohort study was performed to compare order-to-administrat ... Full text Link to item Cite

Ability of an antibiogram to predict Pseudomonas aeruginosa susceptibility to targeted antimicrobials based on hospital day of isolation.

Journal Article Infect Control Hosp Epidemiol · June 2012 OBJECTIVE: To determine the utility of an antibiogram in predicting the susceptibility of Pseudomonas aeruginosa isolates to targeted antimicrobial agents based on the day of hospitalization the specimen was collected. DESIGN: Single-center retrospective c ... Full text Link to item Cite

Constructing unit-specific empiric treatment guidelines for catheter-related and primary bacteremia by determining the likelihood of inadequate therapy.

Journal Article Infect Control Hosp Epidemiol · April 2012 This study aimed to determine the feasibility of using likelihood of inadequate therapy (LIT), a parameter calculated by using pathogen frequency and in vitro susceptibility for determination of appropriate empiric antibiotic therapy for primary bloodstrea ... Full text Link to item Cite

Addressing current medical needs in invasive fungal infection prevention and treatment with new antifungal agents, strategies and formulations.

Journal Article Expert Opin Emerg Drugs · September 2011 Introduction: Morbidity and mortality associated with invasive fungal infections (IFIs) remains unacceptably high. Such diseases represent a substantial burden to the healthcare system. New options are needed to address antifungal resistance in existing an ... Full text Link to item Cite

Overview of treatment options for invasive fungal infections.

Journal Article Med Mycol · August 2011 The introduction of several new antifungals has significantly expanded both prophylaxis and treatment options for invasive fungal infections (IFIs). Relative to amphotericin B deoxycholate, lipid-based formulations of amphotericin B have significantly redu ... Full text Link to item Cite

Ceftaroline fosamil for treatment of community-acquired pneumonia: findings from FOCUS 1 and 2 and potential role in therapy.

Journal Article Expert Rev Anti Infect Ther · August 2011 Cephalosporins have been widely used over the last few decades (often as first-line antibiotic therapy) for numerous infections, owing primarily to their broad spectrum of microbiologic activity and favorable safety profile. Current Infectious Diseases Soc ... Full text Link to item Cite

Echinocandins: addressing outstanding questions surrounding treatment of invasive fungal infections.

Journal Article Am J Health Syst Pharm · July 1, 2011 PURPOSE: Recent in vitro and clinical data addressing outstanding issues regarding the selection, dosing, and monitoring of echinocandins for the treatment of invasive fungal infections (IFIs) are reviewed. SUMMARY: The echinocandins (caspofungin, micafung ... Full text Link to item Cite

Application of antimicrobial stewardship to optimise management of community acquired pneumonia.

Journal Article Int J Clin Pract · July 2011 The aim of this study was to review the application of antimicrobial stewardship principles to the management of community-acquired pneumonia (CAP). Data from 14 published clinical studies, meta-analyses and practice guidelines regarding the application of ... Full text Link to item Cite

Potential role of tigecycline in the treatment of community-acquired bacterial pneumonia.

Journal Article Infect Drug Resist · 2011 Tigecycline is a member of the glycylcycline class of antimicrobials, which is structurally similar to the tetracycline class. It demonstrates potent in vitro activity against causative pathogens that are most frequently isolated in patients with community ... Full text Link to item Cite

Echinocandin pharmacodynamics: review and clinical implications.

Journal Article J Antimicrob Chemother · June 2010 Echinocandins have made a significant impact in the treatment of select invasive fungal infections, most notably invasive candidiasis and aspergillosis. However, treatment outcomes for such infections are still less than optimal, prompting an examination o ... Full text Link to item Cite

Antifungal drug resistance: Clinical relevance and impact of antifungal drug use

Journal Article Current Fungal Infection Reports · June 1, 2010 Antifungal drug resistance significantly impacts treatment outcomes in patients with invasive fungal infections (IFIs). Although primary (intrinsic) resistance may occur independent of previous therapy, prior concomitant antifungal exposure increases the r ... Full text Cite

Aminoglycosides

Chapter · January 1, 2010 Full text Cite

Antifungal therapy for invasive fungal diseases in allogeneic stem cell transplant recipients: an update.

Journal Article Mycopathologia · December 2009 Invasive fungal diseases (IFDs) remain a major cause of morbidity and mortality in allogeneic stem cell transplant (SCT) recipients. While the most common pathogens are Candida spp. and Aspergillus spp., the incidence of infections caused by non-albicans C ... Full text Link to item Cite

Insights from the Society of Infectious Diseases Pharmacists on antimicrobial stewardship guidelines from the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

Journal Article Pharmacotherapy · May 2009 In 2007, the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America published a document that addressed the major considerations for the justification, description, and conduct of antimicrobial stewardship programs. O ... Full text Link to item Cite

Recommendations for training and certification for pharmacists practicing, mentoring, and educating in infectious diseases pharmacotherapy.

Journal Article Pharmacotherapy · April 2009 Recently created guidelines for the development of institutional antimicrobial stewardship programs recommend that a pharmacist with infectious diseases training be included as a core member of the antimicrobial stewardship team. However, training and cert ... Full text Link to item Cite

Antimicrobial stewardship programs: how to start and steer a successful program.

Journal Article J Manag Care Pharm · March 2009 BACKGROUND: Antimicrobial stewardship programs (ASPs) promote the appropriate use of antimicrobials by selecting the appropriate dose, duration, and route of administration. The appropriate use of antimicrobials has the potential to improve efficacy, reduc ... Full text Link to item Cite

Telavancin: a new lipoglycopeptide for gram-positive infections.

Journal Article Drugs Today (Barc) · March 2009 Telavancin is a lipoglycopeptide derivative of vancomycin. Similar to vancomycin, it demonstrates activity in vitro against a variety of Gram-positive pathogens, including but not limited to methicillin-resistant Staphylococccus aureus (MRSA) and penicilli ... Full text Link to item Cite

Posaconazole's impact on prophylaxis and treatment of invasive fungal infections: an update.

Journal Article Expert Rev Anti Infect Ther · March 2009 Owing to the morbidity and mortality associated with invasive fungal infections, particularly in the immunocompromised host, development of new agents for both prevention and treatment is essential. Posaconazole is a recently approved extended-spectrum tri ... Full text Link to item Cite

Antimicrobial Stewardship Programs: How to Start and Steer a Successful Program

Journal Article JOURNAL OF MANAGED CARE PHARMACY · March 1, 2009 Link to item Cite

Aerosol and other novel administrations for prevention and treatment of invasive aspergillosis.

Journal Article Med Mycol · 2009 The high incidence of invasive aspergillosis (IA) in 'at-risk' patient populations, combined with poor treatment outcomes, necessitates the application of novel prevention and management strategies. Among such strategies is administration of antifungal age ... Full text Link to item Cite

Antifungal prophylaxis in adult hematopoietic stem cell transplant recipients.

Journal Article Drugs Today (Barc) · July 2008 Invasive fungal infections (IFIs) are a frequent, costly and potentially life-threatening complication in hematopoietic stem cell transplant (HSCT) recipients. Most prevalent among the causative pathogens are Candida spp. and Aspergillus spp. Risk factors ... Full text Link to item Cite

Antifungal serum concentration monitoring: an update.

Journal Article J Antimicrob Chemother · January 2008 Invasive fungal infections (IFIs) are occurring with increasing incidence and are associated with significant morbidity and mortality. Understanding the relationship between the pharmacokinetic and pharmacodynamic properties of antifungals is essential to ... Full text Link to item Cite

Analysis of two- and three-year trends in antimicrobial resistance in intensive care units using unit-specific antibiograms.

Journal Article Scand J Infect Dis · 2008 Unit-specific antibiograms serve as useful guides to clinicians and infection control personnel. We compared trends in antimicrobial resistance in intensive care units using traditional 2-y unit-specific antibiogram data and 3 y of data. Three-y unit-speci ... Full text Link to item Cite

Tigecycline in the treatment of complicated intra-abdominal and complicated skin and skin structure infections.

Journal Article Ther Clin Risk Manag · December 2007 Tigecycline, a glycylcycline related to the tetracycline class of antibiotics, represents a new option for the treatment of complicated intra-abdominal and complicated skin and skin structure infections. It displays favorable activity in vitro against the ... Link to item Cite

Could risk assessment for non-albicans Candida improve empiric treatment for invasive candidiasis?

Journal Article Ann Pharmacother · April 2007 The changing epidemiology of invasive candidiasis, along with concerns for the emergence of drug resistance, necessitates the identification of patients at increased risk of non-albicans Candida (NAC) to optimize selection of antifungal therapy. The major ... Full text Link to item Cite

Emerging options for treatment of invasive, multidrug-resistant Staphylococcus aureus infections.

Journal Article Pharmacotherapy · February 2007 Limited established treatment options exist for the treatment of serious, invasive infections caused by multidrug-resistant Staphylococcus aureus, most notably nosocomially acquired methicillin-resistant S. aureus (MRSA). Although vancomycin represents the ... Full text Link to item Cite

Tigecycline: a new glycylcycline antimicrobial.

Journal Article Int J Clin Pract · December 2006 Tigecycline is a new glycyclcycline antimicrobial recently approved for use in the USA, Europe and elsewhere. While related to the tetracyclines, tigecycline overcomes many of the mechanisms responsible for resistance to this class. It demonstrates favoura ... Full text Link to item Cite

Potential role of aerosolized amphotericin B formulations in the prevention and adjunctive treatment of invasive fungal infections.

Journal Article Int J Antimicrob Agents · June 2006 The incidence of invasive fungal infections (IFIs) continues to increase, largely due to the steady rise in the number of at-risk patients and the increased use of aggressive immunosuppressant agents. Many available treatments are often limited by concerns ... Full text Link to item Cite

Emerging echinocandins for treatment of invasive fungal infections.

Journal Article Expert Opin Emerg Drugs · May 2006 The echinocandins are a new class of antifungals, developed in response to the need for safe and effective antifungals for the treatment of invasive fungal infections. These agents work by inhibiting 1,3-beta-d-glucan synthase, an enzyme essential for prod ... Full text Link to item Cite

Reply to Wise

Journal Article Clinical Infectious Diseases · October 1, 2005 Full text Cite

Is it time to abandon the use of amphotericin B bladder irrigation?

Journal Article Clin Infect Dis · May 15, 2005 In this article, we review the issues surrounding funguria and its management. With this background, the value of bladder irrigation with amphotericin B for the management of funguria is directly examined. Amphotericin B bladder irrigation is used frequent ... Full text Link to item Cite

Liposomal amphotericin B: clinical experience and perspectives.

Journal Article Expert Rev Anti Infect Ther · April 2005 While amphotericin B deoxycholate (Fungizone, Apothecon Pharmaceuticals) has been considered by many to be the gold standard for the treatment for numerous invasive fungal infections for over 45 years, toxicities associated with its use often necessitate t ... Full text Link to item Cite

Liposomal amphotericin B: Clinical experience and perspectives

Journal Article Expert Review of Anti-Infective Therapy · 2005 While amphotericin B deoxycholate (Fungizone®, Apothecon Pharmaceuticals) has been considered by many to be the gold standard for the treatment for numerous invasive fungal infections for over 45 years, toxicities associated with its use often necessitate ... Full text Cite

Key references in infectious diseases pharmacotherapy.

Journal Article Pharmacotherapy · November 2004 Most health care practitioners are challenged to maintain knowledge of contemporary practice issues in many therapeutic disciplines. Like many other areas, infectious diseases pharmacotherapy continues to evolve because of new information regarding disease ... Full text Link to item Cite

Design of aerosolized amphotericin b formulations for prophylaxis trials among lung transplant recipients.

Journal Article Clin Infect Dis · October 15, 2004 BACKGROUND: Emphasis has been placed on the need for antifungal prophylaxis when transplanted organs are directly exposed to the environment. In lung transplantation, one strategy for prevention has been aerosolization of polyenes into the lung. Despite wi ... Full text Link to item Cite

Novel modes of antifungal drug administration.

Journal Article Expert Opin Investig Drugs · August 2004 Administration of antifungals by routes other than that for which the agent was designed or approved have been utilised in attempts to provide directed therapy, reduce adverse effects and improve drug penetration into selected infection sites, such as the ... Full text Link to item Cite

Comparative safety of amphotericin B lipid complex and amphotericin B deoxycholate as aerosolized antifungal prophylaxis in lung-transplant recipients.

Journal Article Transplantation · January 27, 2004 BACKGROUND: Aerosolized administrations of amphotericin B deoxycholate (AmBd) and amphotericin B lipid complex (ABLC) in lung transplant recipients were compared for safety and tolerability. The incidence of invasive fungal infections in patients receiving ... Full text Link to item Cite

Rational use of antifungals for invasive fungal infections in the institutional setting

Chapter · January 1, 2004 The incidence of invasive fungal infections (IFIs) is increasing at an alarming rate. In the past decade alone, Candida spp. have become the fourth leading cause of nosocomial bloodstream infections in the United States (1). The incidence of Aspergillus in ... Cite

Antifungal pharmacotherapy for invasive mould infections.

Journal Article Expert Opin Pharmacother · February 2003 The incidence of invasive mould infections is increasing and is associated with significant morbidity and mortality. Among the most prevalent of these infections are those caused by Aspergillus and Fusarium species. Invasive disease caused by moulds freque ... Full text Link to item Cite

A randomized comparative study to determine the effect of omeprazole on the peak serum concentration of itraconazole oral solution.

Journal Article J Antimicrob Chemother · February 2003 To determine the effect of omeprazole on peak serum concentrations (C(max)) of itraconazole oral solution (IOS), we carried out a randomized, open-label, prospective, crossover study. Fifteen healthy, non-pregnant adults received a single dose of IOS 400 m ... Full text Link to item Cite

Safety and efficacy of quinupristin/dalfopristin for treatment of invasive Gram-positive infections in pediatric patients.

Journal Article Pediatr Infect Dis J · October 2002 BACKGROUND: Antibiotic-resistant Gram-positive pathogens are an increasingly common cause of serious pediatric infections. Although quinupristin/dalfopristin demonstrates favorable activity against resistant Gram-positive pathogens (including many vancomyc ... Full text Link to item Cite

Recent advances in the epidemiology, prevention, diagnosis, and treatment of fungal pneumonia.

Journal Article Curr Opin Infect Dis · April 2002 Although pneumonia caused by fungi is not a common occurrence in the general population, disease in an enlarging immunocompromised population is encountered with increasing frequency. Fungal pneumonias are most frequently caused by Aspergillus spp., dimorp ... Full text Link to item Cite

Safety of aerosolized amphotericin B lipid complex in lung transplant recipients.

Journal Article Transplantation · August 15, 2001 BACKGROUND: Fungal infections remain an important cause of morbidity and mortality in lung transplant recipients. Aerosolized amphotericin B lipid complex (ABLC) may be more efficacious than conventional amphotericin B in the prevention of fungal infection ... Full text Link to item Cite

The effects of intravenous doxycycline therapy for rheumatoid arthritis: a randomized, double-blind, placebo-controlled trial.

Journal Article Arthritis Rheum · May 2001 OBJECTIVE: To determine the feasibility, safety, and potential clinical efficacy of intravenous (IV) doxycycline therapy for rheumatoid arthritis (RA), as well as its possible effects on serum and urinary markers of collagen breakdown. METHODS: The explora ... Full text Link to item Cite

Impact of a pharmacy student-based inpatient pneumococcal vaccination program

Journal Article American Journal of Pharmaceutical Education · January 1, 2001 Pneumococcal disease remains a significant cause of morbidity and mortality in the adult, at-risk population. Even with the availability of a safe and effective vaccine and well-defined guidelines for its administration, less than half of eligible individu ... Cite

Treatment of methicillin-resistant staphylococcus aureus infections with quinupristin-dalfopristin in patients intolerant of or failing prior therapy. For the Synercid Emergency-Use Study Group.

Journal Article J Antimicrob Chemother · November 2000 Safety and efficacy of quinupristin-dalfopristin (an injectable streptogramin antibiotic) were evaluated in the treatment of a variety of infections due to methicillin-resistant Staphylococcus aureus (MRSA) in patients either intolerant of or failing prior ... Full text Link to item Cite

Antifungal pharmacodynamics: review of the literature and clinical applications.

Journal Article Pharmacotherapy · November 2000 Invasive fungal infections are seen with growing frequency, likely due to increases in numbers of patients at risk of infection. Optimal selection and dosing of antifungal agents are important, as these infections are often refractory to available therapy. ... Full text Link to item Cite

Agents for treatment of invasive fungal infections.

Journal Article Otolaryngol Clin North Am · April 2000 The incidence of fungal infections continues to rise as the population of immunocompromised individuals increases. Despite the enlarging numbers of infections, there are only a few antifungal agents for treatment of deep-seated, invasive infections. These ... Full text Link to item Cite

Excessive use of vancomycin: a successful intervention strategy at an academic medical center.

Journal Article Infect Control Hosp Epidemiol · January 2000 The project goal was to decrease excessive vancomycin use. Interventions included an educational chart note the first day of therapy, followed by pharmacists discussing the need for continued therapy with patients' physicians. Empirical vancomycin use impr ... Full text Link to item Cite

Ceftriaxone once daily for four weeks compared with ceftriaxone plus gentamicin once daily for two weeks for treatment of endocarditis due to penicillin-susceptible streptococci. Endocarditis Treatment Consortium Group.

Journal Article Clin Infect Dis · December 1998 This randomized, multicenter, open-label study compared the efficacy and safety of monotherapy with 2 g of intravenous ceftriaxone once daily for 4 weeks with those of combination therapy with 2 g of intravenous ceftriaxone and 3 mg of intravenous gentamic ... Full text Link to item Cite

Programs promoting timely sequential antimicrobial therapy: an American perspective.

Journal Article J Infect · July 1998 Interventional programs promoting the timely conversion of intravenous to oral antimicrobial therapy have been reported from several hospitals in the U.S.A. and elsewhere. Factors influencing the initiation and conduct of these programs include technologic ... Full text Link to item Cite

Chest discomfort associated with liposomal amphotericin B: report of three cases and review of the literature.

Journal Article Pharmacotherapy · 1998 Liposomal formulations of amphotericin B are designed to maintain therapeutic efficacy of amphotericin B deoxycholate while reducing its associated toxicities. In three patients chest discomfort occurred during planned 1-hour infusions of liposomal amphote ... Link to item Cite

A successful program to optimize use of Amphotericin B Lipid Complex (ABLC) at an academic medical center

Journal Article Clinical Infectious Diseases · December 1, 1997 Lipid-based antifungal products have been developed, and some may reduce nephrotoxicily and infusion-related side-effects, compared to standard amphotericin B (AmB). However, questions remain about optimal daily and cumulative dosing strategies, and no pub ... Cite

Improving clinician adherence to vancomycin-use guidelines: Results of a pharmacist-based strategy at an Academic Medical Center

Journal Article Clinical Infectious Diseases · December 1, 1997 Vancomycin (vanc) is the only licensed antibiotic effective against several highly resistant bacteria. Unfortunately, its use has contributed to the emergence of vancomycin-resistant enterococci (VRE). The first VRE was isolated at Duke in 1992; by 1995, 1 ... Cite

A prospective, open-label study of single-dose ciprofloxacin absorption after chemotherapy in patients with malignancy.

Journal Article Pharmacotherapy · 1997 The absorption of a single oral dose of ciprofloxacin 750 mg in patients with cancer who had chemotherapy-induced Cancer and Leukemia Group B grade I or II mucositis was evaluated. Ciprofloxacin was administered after an overnight fast. Plasma samples were ... Link to item Cite

Treatment of vancomycin-resistant enterococci, with a focus on quinupristin-dalfopristin.

Journal Article Pharmacotherapy · 1996 Enterococci are the second most common cause of hospital-acquired infections, and drug resistance among these organisms is a growing problem. Vancomycin-resistant enterococci (VRE) now account for 7.9% of the nosocomial enterococcal infections. There is no ... Link to item Cite

Effect of simultaneous didanosine administration on itraconazole absorption in healthy volunteers.

Journal Article Pharmacotherapy · 1994 STUDY OBJECTIVE: To investigate the effect of simultaneously administered didanosine (ddI) on the absorption of a single dose of itraconazole. DESIGN: Randomized, crossover, unblinded single-dose pharmacokinetic study in healthy volunteers. Comparisons of ... Link to item Cite

Pharmacotherapy of disseminated histoplasmosis in patients with AIDS.

Journal Article Ann Pharmacother · December 1993 OBJECTIVE: To review the pharmacotherapy of disseminated histoplasmosis (DH) in patients with AIDS. The article provides an overview of the pathophysiology, epidemiology, clinical presentation and diagnosis of this disease. Clinical trials reporting interv ... Full text Link to item Cite

Adverse drug reactions to systemic antifungals. Prevention and management.

Journal Article Drug Saf · 1992 Systemic administration of antifungal agents for invasive mycoses has dramatically increased over the past 10 years in many fields of medicine. The increase has been due both to an increasing immune compromised population and to potent antibacterial agents ... Full text Link to item Cite

Azithromycin--spectrum of activity, pharmacokinetics, and clinical applications.

Journal Article Pharmacotherapy · 1992 Azithromycin is an azalide antimicrobial agent. Structurally related to the macrolide antibiotic erythromycin, its mechanism of activity (similar to erythromycin) is interference with bacterial protein synthesis by binding to the 50S component of the 70S r ... Link to item Cite

Amphotericin B: 30 years of clinical experience.

Journal Article Rev Infect Dis · 1990 Amphotericin B, the first commercially significant antifungal drug, has been available for more than 30 years. This polyene macrolide antifungal agent continues to play a major role in the treatment of systemic fungal infections, despite the introduction o ... Full text Link to item Cite

Comparison of the safety and efficacy of intravenous ciprofloxacin and intravenous ceftazidime in the treatment of selected infections.

Journal Article Am J Med · November 30, 1989 A study was conducted to determine the comparative safety and efficacy of intravenous ciprofloxacin with that of intravenous ceftazidime in the treatment of selected infections. Male and female inpatients 18 years or older had bacterial infections of the b ... Full text Link to item Cite

Bioequivalence assessment of zidovudine (Retrovir) syrup, solution, and capsule formulations in patients infected with human immunodeficiency virus.

Journal Article Antimicrob Agents Chemother · October 1989 The objectives of this open-labeled, multiple-dose, three-way-crossover trial were to evaluate the safety and tolerance of zidovudine (Retrovir) oral syrup and to assess the bioequivalence of this formulation relative to zidovudine solution and capsule for ... Full text Link to item Cite

Ofloxacin: its pharmacology, pharmacokinetics, and potential for clinical application.

Journal Article Pharmacotherapy · 1988 Ofloxacin is a 4-quinolone antibiotic with rapid bactericidal activity against a wide variety of organisms. Its proposed mechanism of activity is interference with DNA gyrase, an enzyme essential for the replication of bacterial DNA. In vitro activity of o ... Full text Link to item Cite

Neuropsychological deficits in active licensed professional boxers.

Journal Article J Clin Psychol · May 1986 Young, active, licensed professional boxers (N = 19) were found to display a pattern of neuropsychological deficits consistent with the more severe punch-drunk syndrome of years past. These deficits resulted in significantly lower test performance than tha ... Full text Link to item Cite

Sulfites in medicines.

Journal Article N C Med J · June 1984 Link to item Cite

The use of hydroxocobalamin in the prophylaxis and treatment of nitroprusside-induced cyanide toxicity.

Journal Article Vet Hum Toxicol · October 1983 The use of OHB12 in the prophylaxis of CN intoxication resulting from SNP infusions is well documented in the literature. However, data is lacking to support its use as an antidote once signs and symptoms have developed. Because of the efficacy of oxygen t ... Link to item Cite

Whatever happened to starch blockers?

Journal Article N C Med J · August 1983 Link to item Cite