2022 Research Manuscript Publications

The impact of a pharmacist on inpatient urinary tract infections
Aspen Bryant, PharmD
Background:
About 150 million urinary tract infections (UTIs) occur globally every year. High prevalence of infection correlates with high antibiotic prescribing and the potential for antibiotic overuse. Inappropriate antibiotic use may approach up to 50%. The rapid, worldwide occurrence of antimicrobial resistance is endangering the efficacy of antibiotics and antibiotic overuse is a major cause. Pharmacists have the potential to play a role in reducing antimicrobial resistance by monitoring for appropriate antibiotic usage. There are different types of UTIs: pyelonephritis (involving the upper urinary tract) and cystitis (only involving the lower urinary tract). These types can be further broken down into uncomplicated (occurring in females, cystitis and lower urinary tract symptoms only) and complicated (occurring in males, pyelonephritis, and/or cystitis with one or more complicating factors). The recommended treatment for an uncomplicated UTI is 3 to 7 days of antibiotics. The recommended treatment for a complicated UTI is typically 5 to 14 days of antibiotics.

Dose effectiveness of piperacillin/tazobactam in prophylaxis of type III open fractures
Justin N. Fernando, PharmD
Background:
Open-fractures are commonly classified using the Gustilo-Anderson classification system. A type III fracture is defined as an open segmental fracture, open fracture with extensive soft tissue damage, or a traumatic amputation. Patients with type III fractures have up to a 40% chance of developing an infection at the site of injury. Piperacillin/tazobactam is sometimes used for post-operative prophylaxis in this patient population, however optimal dosing strategies are unknown. This study explored the safety and efficacy of different doses of piperacillin/tazobactam in the prevention of surgical site infections in contaminated type-III open fractures.

Rates of vancomycin associated nephrotoxicity when converting to AUC in a community hospital
Vivian Lee, PharmD
Background
Vancomycin is the mainstay treatment for methicillin-resistant Staphylococcus aureus (MRSA) infections. Efficacious treatment is typically associated with an AUC:MIC between 400-600 mcg*h/mL. Recent studies have suggested that using a trough of 15 mg/L as a surrogate marker inaccurately estimates AUC and correlates with increased risk of nephrotoxicity. Vancomycin induced nephrotoxicity (VIN) is the development of acute kidney injury (AKI) on vancomycin therapy with no other apparent cause. The 2020 revised consensus guideline on therapeutic monitoring of vancomycin for serious MRSA infections now recommend AUC-guided dosing and monitoring as the most accurate and optimal way to manage therapy. The objective of this study aims to evaluate the safety of AUC-guided dosing as compared to trough-based dosing in relation to the rates of VIN in a community hospital setting.