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Boissière C, Bacle A, Pelletier R, Le Bouedec D, Gicquel T, Lurton Y, Le Daré B. In vitro assessment of isopropanol leakage from antiseptic barrier caps into commonly used needleless connectors. Infect Control Hosp Epidemiol 2024; 45:576-582. [PMID: 38213184 PMCID: PMC11027082 DOI: 10.1017/ice.2023.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Needleless connectors (NCs) can be disinfected using antiseptic barrier caps (ABCs) to reduce the risk of catheter-related bloodstream infections. However, recent evidence suggests that isopropanol can leak from the ABC into the NC, posing concern about their safe use. We sought to determine in vitro which ABC and NC parameters influence the leakage of isopropanol through the infusion circuit. METHODS We assessed 13 NCs and 4 ABCs available in the European market. In vitro circuits consisting of an isopropanol cap, a NC, and an 11-cm catheter line were created. The circuits were left in place for 1 to 7 days at room temperature to assess the kinetics of isopropanol leakage. Isopropanol content in ABC and in circuit flushing solutions (5 mL NaCl 0.9%) after exposure to the cap were measured using gas chromatography with a flame ionization detector. RESULTS The leakage of isopropanol from the cap to the NC was dependent on the NC, but not the cap. The NC mechanism did not predict the leakage of isopropanol. The Q-Syte NC exhibited the most isopropanol leakage (7.01±1.03 mg and 28.32±2.62 mg at 24 hours and 7 days, respectively), whereas the Caresite NC had the lowest isopropanol leakage at 7 days (1.69±0.01 mg). CONCLUSION The use of isopropanol ABCs can cause isopropanol leakage into the catheter circuit according to NC parameters. Caution should be exercised when using these devices, especially in the pediatric and neonatal population.
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Affiliation(s)
- Camille Boissière
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, Rennes, France
| | - Astrid Bacle
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, Rennes, France
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail), Rennes, France
| | - Romain Pelletier
- Laboratoire de Toxicologie biologique et médico-légale, CHU Pontchaillou, Rennes, France
- University of Rennes, INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Rennes, France
| | - Diane Le Bouedec
- Laboratoire de Toxicologie biologique et médico-légale, CHU Pontchaillou, Rennes, France
| | - Thomas Gicquel
- Laboratoire de Toxicologie biologique et médico-légale, CHU Pontchaillou, Rennes, France
- University of Rennes, INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Rennes, France
| | - Yves Lurton
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, Rennes, France
| | - Brendan Le Daré
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, Rennes, France
- University of Rennes, INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Rennes, France
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Boissiere C, Rallon T, Vigneau C, Demay E, Chatron C, Bacle A. Study of therapeutic patient education practices in French renal transplantation centres. Eur J Hosp Pharm 2024:ejhpharm-2023-004006. [PMID: 38429078 DOI: 10.1136/ejhpharm-2023-004006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES Therapeutic patient education (TPE) plays a critical role in the management of kidney transplant recipients. However, discrepancies exist in the guidance provided regarding the usage of immunosuppressants across different kidney transplant centres in France. METHODS To assess the current landscape of TPE practices in this patient population, an online questionnaire consisting of 51 questions was distributed to 32 French renal transplantation centres. RESULTS The participation rate in our survey was 96.9%, (31 of the 32 centres contacted). The respondents had diverse professions: they were nurses (15/31), physicians (9/31) and pharmacists (7/31). Virtually all institutions have implemented TPE initiatives, with an implementation rate of 93.5% (29/31). The topic of anti-rejection medication was consistently addressed, with only one centre not providing support at the conclusion of these sessions. However, the content of the sessions varied significantly from one centre to another, particularly regarding the proper management of anti-rejection medications. Only 19.4% (6/31) of the centres provided the correct recommendation regarding fasting when taking tacrolimus. Dietary guidance was a topic covered in 89.7% (26/29) of the centres, but significant divergences were also observed. TPE teams primarily consisted of nurses, with pharmacists present in only 51.6% (16/31) of the centres. We also observed limited involvement of patient partners, with just 9.7% (3/31) of the centres including them in their programme. CONCLUSION These findings highlight considerable variability in the approach towards TPE among kidney transplant centres. Addressing counselling variability and increasing pharmacist and patient partner involvement is an essential step to improving the quality and effectiveness of TPE. By establishing a standardised and comprehensive approach to patient education, healthcare providers can ensure that kidney transplant recipients receive information that will ultimately help them improve their health and well-being.
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Affiliation(s)
- Camille Boissiere
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, 35000, Rennes, France
| | - Tristan Rallon
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, 35000, Rennes, France
| | - Cécile Vigneau
- Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, IRSET, 35000, Rennes, Bretagne, France
| | - Elouan Demay
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, 35000, Rennes, France
| | | | - Astrid Bacle
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, 35000, Rennes, France
- Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, IRSET, 35000, Rennes, Bretagne, France
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Cambien G, Dupuis A, Belmouaz M, Bauwens M, Bacle A, Ragot S, Migeot V, Albouy M, Ayraud-Thevenot S. Bisphenol A and chlorinated derivatives of bisphenol A assessment in end stage renal disease patients: Impact of dialysis therapy. Ecotoxicol Environ Saf 2024; 270:115880. [PMID: 38159342 DOI: 10.1016/j.ecoenv.2023.115880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/25/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
Patients with end stage kidney disease treated by dialysis (ESKDD) process dialysis sessions to remove molecules usually excreted by kidneys. However, dialysis therapy could also contribute to endocrine disruptors (ED) burden. Indeed, materials like dialyzer filters, ultrapure dialysate and replacement fluid could exposed ESKDD patients to Bisphenol A (BPA) and chlorinated derivatives of BPA (ClxBPAs). Thus, our aim was to compare BPA and ClxBPAs exposure between ESKDD patients, patients with stage 5 chronic kidney disease (CKD5) not dialyzed and healthy volunteers. Then we describe the impact of a single dialysis session, according to dialysis modalities (hemodialysis therapy (HD) versus online hemodiafiltration therapy (HDF)) and materials used with pre-post BPA and ClxBPAs concentrations. The plasma levels of BPA and four ClxBPAs, were assessed for 64 ESKDD patients in pre and post dialysis samples (32 treated by HD and 32 treated by HDF) in 36 CKD5 patients and in 24 healthy volunteers. BPA plasma concentrations were 22.5 times higher for ESKDD patients in pre-dialysis samples versus healthy volunteers (2.208 ± 5.525 ng/mL versus 0.098 ± 0.169 ng/mL) (p < 0.001). BPA plasma concentrations were 16 times higher for CKD5 patients versus healthy volunteers, but it was not significant (1.606 ± 3.230 ng/mL versus 0.098 ± 0.169 ng/mL) (p > 0.05). BPA plasma concentrations for ESKDD patients in pre-dialysis samples were 1.4 times higher versus CKD5 patients (2.208 ± 5.525 ng/mL versus 1.606 ± 3.230 ng/mL) (p < 0.001). For healthy volunteers, ClxBPAs were never detected, or quantified while for CKD5 and ESKDD patients one ClxBPAs at least has been detected or quantified in 14 patients (38.8%) and 24 patients (37.5%), respectively. Dialysis therapy was inefficient to remove BPA either for HD (1.983 ± 6.042 ng/mL in pre-dialysis versus 3.675 ± 8.445 ng/mL in post-dialysis) or HDF (2.434 ± 5.042 ng/mL in pre-dialysis versus 7.462 ± 15.960 ng/mL in post dialysis) regarding pre-post BPA concentrations (p > 0.05). The same result was observed regarding ClxBPA analysis. Presence of polysulfone in dialyzer fibers overexposed ESKDD patients to BPA in pre-dialysis samples with 3.054 ± 6.770 for ESKDD patients treated with a polysulfone dialyzer versus 0.708 ± 0.638 (p = 0.040) for ESKDD patients treated without a polysulfone dialyzer and to BPA in post-dialysis samples with 6.629 ± 13.932 for ESKDD patients treated with a polysulfone dialyzer versus 3.982 ± 11.004 (p = 0.018) for ESKDD patients treated without a polysulfone dialyzer. This work is to our knowledge the first to investigate, the impact of a dialysis session and materials used on BPA and ClxBPAs plasma concentrations and to compare these concentrations to those found in CKD5 patients and in healthy volunteers.
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Affiliation(s)
- Guillaume Cambien
- Université de Poitiers, CNRS, EBI, F-86000 Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'investigation Clinique CIC1402, Axe santé Environnementale, Poitiers, France; CHU de Poitiers, Biology-Pharmacy-Public Health Department, F-86000 Poitiers, France.
| | - Antoine Dupuis
- Université de Poitiers, CNRS, EBI, F-86000 Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'investigation Clinique CIC1402, Axe santé Environnementale, Poitiers, France; CHU de Poitiers, Biology-Pharmacy-Public Health Department, F-86000 Poitiers, France.
| | - Mohamed Belmouaz
- CHU de Poitiers, Digestiv, Urology, Nephrology, Endocrinology Department, F-86000 Poitiers, France.
| | - Marc Bauwens
- CHU de Poitiers, Digestiv, Urology, Nephrology, Endocrinology Department, F-86000 Poitiers, France.
| | - Astrid Bacle
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France; Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000, Rennes, France.
| | - Stéphanie Ragot
- Université de Poitiers, CHU de Poitiers, INSERM, Centre d'investigation Clinique CIC1402, Axe SCALE-EPI, Poitiers, France.
| | - Virginie Migeot
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France; CHU Rennes, Epidemiology and Public Health Department, F-35000 Rennes, France.
| | - Marion Albouy
- Université de Poitiers, CNRS, EBI, F-86000 Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'investigation Clinique CIC1402, Axe santé Environnementale, Poitiers, France; CHU de Poitiers, Biology-Pharmacy-Public Health Department, F-86000 Poitiers, France.
| | - Sarah Ayraud-Thevenot
- Université de Poitiers, CNRS, EBI, F-86000 Poitiers, France; Université de Poitiers, CHU de Poitiers, INSERM, Centre d'investigation Clinique CIC1402, Axe santé Environnementale, Poitiers, France; CHU de Poitiers, Biology-Pharmacy-Public Health Department, F-86000 Poitiers, France.
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Boissiere C, Francois E, Vabret E, Le Daré B, Bacle A. Spice-drug interactions: a case report on the use of turmeric, curry and ginger in a renal transplant patient on tacrolimus. Eur J Hosp Pharm 2023; 31:68-69. [PMID: 37586787 PMCID: PMC10800271 DOI: 10.1136/ejhpharm-2023-003871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/24/2023] [Indexed: 08/18/2023] Open
Abstract
Tacrolimus is a widely used immunosuppressant for the prevention of rejection after transplantation. In vitro studies suggest that interactions exist between spices and tacrolimus. We present the case of a renal transplant patient aged around 70 years who was treated with prednisone, mycophenolate-mofetil and tacrolimus. The patient had a pre-transplant dietary habit of consuming foods spiced with turmeric, curry and ginger. The following protocol was implemented in parallel with close monitoring of plasma tacrolimus concentrations: administration of 10 g/day of turmeric for 4 days, then 10 g/day of curry for 4 days and then 10 g/day of ginger for 4 days. No change in tacrolimus plasma concentrations during and after the implementation of the protocol was observed. The impact of turmeric, curry and ginger on plasma tacrolimus concentrations seems negligible in vivo although further studies are needed. A shared decision to test the impact of spice consumption in a patient with dietary habits involving these spices seems reasonable.
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Affiliation(s)
- Camille Boissiere
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000, Rennes, France
| | - Elise Francois
- Service de Néphrologie, CHU Rennes, 35000, Rennes, France
| | - Elsa Vabret
- Service de Néphrologie, CHU Rennes, 35000, Rennes, France
| | - Brendan Le Daré
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000, Rennes, France
- INSERM, INRAE, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Université de Rennes 1, 35000, Rennes, France
| | - Astrid Bacle
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000, Rennes, France
- Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, 35000, Rennes, France
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Merien A, Bacle A, Tattevin P, Bellasfar D, Piau C, Cattoir V, Soulat L, Malledant Y, Garlantezec R. Effectiveness of a multimodal intervention to improve blood culture collection in an adult emergency department. Eur J Clin Microbiol Infect Dis 2023; 42:1519-1522. [PMID: 37853227 DOI: 10.1007/s10096-023-04680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
We investigated the impact of a multimodal intervention to improve the compliance of BC collections as a composite outcome, taking into account both blood volume collected and absence of solitary BC. We performed a quasi-experimental study using a before-after design (5 months for pre- and post-intervention evaluation) in an adult emergency department at a tertiary care hospital that showed that a multimodal intervention was associated with a dramatic increase in the proportion of blood cultures that were collected as recommended per national guidelines, from 17.3% (328/1896) to 68.9% (744/1080), P < 0.0001. The implementation of such intervention in other settings could improve the diagnosis of bloodstream infections and reduce irrelevant costs.
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Affiliation(s)
- Alexis Merien
- Adult Emergency Department, CHU de Rennes, F-35000, Rennes, France
| | - Astrid Bacle
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement Et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Pierre Tattevin
- CHU de Rennes, Univ Rennes, INSERM U1230, IFR140, F-35033, Rennes, France
| | - Dorsaf Bellasfar
- Adult Emergency Department, CHU de Rennes, F-35000, Rennes, France
| | - Caroline Piau
- CHU de Rennes, Univ Rennes, INSERM U1230, IFR140, F-35033, Rennes, France
| | - Vincent Cattoir
- CHU de Rennes, Univ Rennes, INSERM U1230, IFR140, F-35033, Rennes, France
| | - Louis Soulat
- Adult Emergency Department, CHU de Rennes, F-35000, Rennes, France
| | - Yannick Malledant
- CHU de Rennes, Univ Rennes, Inra, Inserm, Institut NUMECAN - UMR_A 1341, UMR_S 1241, 35000, Rennes, France
| | - Ronan Garlantezec
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement Et Travail) - UMR_S 1085, F-35000, Rennes, France.
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Bacle A, Lhermitte R, Le Daré B, Mercerolle M, Vigneau C, Le Corre P, Chemouny JM. Unexpected overdose of oral cyclosporine in a kidney transplant patient: a case report. Eur J Hosp Pharm 2023; 30:242-244. [PMID: 34117088 PMCID: PMC10359783 DOI: 10.1136/ejhpharm-2021-002730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/01/2021] [Indexed: 11/04/2022] Open
Abstract
Cyclosporine is a widely used immunosuppressive agent to prevent rejection of solid organ transplant. Here, we describe the case of a 71-year-old man who received the prescribed dose of cyclosporine 10 times 6 days after a kidney transplantation because of a concentration miscalculation involving two galenic forms. The patient presented gastrointestinal and neurological disorders. Therapeutic drug monitoring revealed high cyclosporine blood concentrations (693 ng/mL, therapeutic range 100-300 ng/mL). Symptomatic management of digestive disorders was performed, and haemodialysis was started the day after the cyclosporine overdose in the face of acute renal failure. The patient's disorders were quickly resolved. The dosing regimen was adapted in order to administer the most appropriate galenic form and to avoid another administration error. Long-term follow-up showed no failure of renal transplantation. The purpose of this case report is to warn physicians and clinical pharmacists about the vigilance required on cyclosporine prescription, especially when two galenic forms are administered to obtain the prescribed dose.
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Affiliation(s)
- Astrid Bacle
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Roxane Lhermitte
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France
| | - Brendan Le Daré
- Laboratoire de toxicologie et médico-légale, CHU Rennes, Rennes, France
- NSERM, INRAE, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Rennes 1 University, Rennes, France
| | - Marion Mercerolle
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France
| | - Cécile Vigneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Pascal Le Corre
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Jonathan M Chemouny
- Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
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Lebret C, Le Daré B, Laval F, Vigneau C, Bacle A. Assessing health literacy in transplant patients to better tailor the content of their therapeutic education: an observational study. Eur J Hosp Pharm 2023:ejhpharm-2022-003553. [PMID: 37142387 DOI: 10.1136/ejhpharm-2022-003553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 04/18/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVES Evaluate health literacy in transplant patients to better tailor the content of their continuing therapeutic education. METHODS A 20-item questionnaire divided into five themes (sport/recreation, dietary measures, hygiene measures, recognition of the signs of graft rejection and medication management) was sent to transplant patient associations. Participants' responses (a score out of 20 points), were analysed according to demographic characteristics, transplanted organ (kidney, liver or heart), type of donor (living or deceased), participation in a therapeutic patient education (TPE) programme, management of end-stage renal disease (with or without dialysis) and the date of transplant. RESULTS 327 individuals completed the questionnaires (mean age 63.3±12.7 years, mean time post-transplant 13.1±12.1 years). From 2 years after transplantation, the patients' score decreases significantly compared with the score obtained at hospital discharge. Patients who received TPE had significantly higher scores than patients who did not receive it, but only in the first 2 years post-transplant. The scores were different depending on the organs transplanted. Patients' knowledge varied according to the theme; the percentage of errors being higher for questions related to hygienic and dietary rules. CONCLUSION These findings highlight the importance of the role of the clinical pharmacist in maintaining the transplant recipient's health literacy level over time to increase graft life. We show the topics on which pharmacists must acquire solid knowledge to best meet the needs of transplant patients.
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Affiliation(s)
- Clara Lebret
- Centre Hospitalier Universitaire de Rennes, Service Hospitalo-Universitaire de Pharmacie, Rennes, France
| | - Brendan Le Daré
- Centre Hospitalier Universitaire de Rennes, Service Hospitalo-Universitaire de Pharmacie, Rennes, France
- INSERM, INRAE, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Université de Rennes 1, Rennes, France, NuMeCan, Rennes, France, France
| | - Florian Laval
- Centre Hospitalier Universitaire de Rennes, Service Hospitalo-Universitaire de Pharmacie, Rennes, France
| | - Cécile Vigneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Faculté de Pharmacie, Université de Rennes 1, Laboratoire de Biopharmacie et Pharmacie Clinique, Rennes Cedex, France
| | - Astrid Bacle
- Centre Hospitalier Universitaire de Rennes, Service Hospitalo-Universitaire de Pharmacie, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Faculté de Pharmacie, Université de Rennes 1, Laboratoire de Biopharmacie et Pharmacie Clinique, Rennes Cedex, France
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Corso B, Bacle A, Demay E, Mercerolle M, Pelletier R, Gicquel T, Le Daré B. Place of therapeutic cannabis in France and safety data: A literature review. Ann Pharm Fr 2023:S0003-4509(23)00021-4. [PMID: 36841395 DOI: 10.1016/j.pharma.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES To date, very few cannabis-based specialities are authorised on the French market despite a growing demand from patients and health professionals. The objective of this study is to review the tolerance profile and the French legislative status of the two main cannabinoids used for therapeutic purposes: tetrahydrocannabiol (THC) associated with psychoactive effects and non-psychoactive cannabidiol (CBD). METHODS This review is based on relevant articles retrieved by a search in Google Scholar and PubMed databases and on an assessment of the legal texts and summaries of product characteristics available in France. RESULTS Evidence for the tolerability of CBD during chronic use is reassuring, but a significant risk of drug interactions exists. THC use appears to be associated with a higher proportion of serious adverse effects, including neuropsychological and cardiovascular effects. Inhaled cannabis appears to be associated with greater toxicity than the oral route. These data are presented together with the pharmacokinetic and pharmacodynamic data of THC and CBD. CONCLUSION The literature reports several frequent but rarely serious adverse effects of CBD during chronic use as well as a significant risk of drug interactions. THC use seems to be associated with a higher proportion of serious adverse effects compared to CBD, particularly at the neuropsychological and cardiovascular levels. Health professionals should be up to date on the particularities of therapeutic cannabis in terms of efficacy, safety and drug interactions.
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Affiliation(s)
- B Corso
- Université de Rennes 1, 35000 Rennes, France
| | - A Bacle
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France
| | - E Demay
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France
| | - M Mercerolle
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France
| | - R Pelletier
- Centre hospitalier universitaire de Rennes, laboratoire de toxicologie biologique et médico-légale, biochimie-toxicologie, 35000 Rennes, France; Université Rennes, Inserm, INRAE, CHU de Rennes, Institut NuMeCan (Nutrition, Métabolismes et Cancer), Réseau PREVITOX, 35000 Rennes, France
| | - T Gicquel
- Centre hospitalier universitaire de Rennes, laboratoire de toxicologie biologique et médico-légale, biochimie-toxicologie, 35000 Rennes, France; Université Rennes, Inserm, INRAE, CHU de Rennes, Institut NuMeCan (Nutrition, Métabolismes et Cancer), Réseau PREVITOX, 35000 Rennes, France
| | - B Le Daré
- Service pharmacie, centre hospitalier universitaire de Rennes, 35000 Rennes, France; Université Rennes, Inserm, INRAE, CHU de Rennes, Institut NuMeCan (Nutrition, Métabolismes et Cancer), Réseau PREVITOX, 35000 Rennes, France.
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Lhermitte R, Le Daré B, Laval F, Lemaitre F, Troussier B, Morin MP, Vigneau C, Chemouny JM, Bacle A. A pharmacist-led intervention to improve kidney transplant recipient outcomes and identify patients at risk of highly variable trough tacrolimus levels: a cohort study. Eur J Hosp Pharm 2023:ejhpharm-2022-003625. [PMID: 36737230 DOI: 10.1136/ejhpharm-2022-003625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Given the positive impact of appropriate medication management on graft outcome and therefore of patient survival and graft function, the pharmacist's role in the kidney transplantation team has evolved over recent decades. The primary objective of this study was to determine whether pharmacist-led intervention after kidney transplantation is associated with a lower graft rejection rate and intra-patient variation in tacrolimus trough concentrations (Cmin). The study's secondary objective was to develop a questionnaire to identify patients at risk for highly variable Cmin. METHODS We retrospectively analysed kidney transplant recipients at Rennes University Hospital (France) between January 2013 and December 2020. Patients who received pharmacist-led education (intervention group, n=139) were compared with patients who did not (control group, n=131), according to graft survival at 1 year post-transplant, coefficient of variation (%CV) for the tacrolimus Cmin, age, sex, length of hospital stay post-transplantation, body mass index, and Charlson Comorbidity Index. In the intervention group, a questionnaire assessing patient knowledge was introduced to compare scores with the %CV. RESULTS In the intervention group, 1 year post-transplant graft survival was higher (95.7% vs 88.5%, p=0.0289) and patients had fewer variabilities in Cmin. The %CV was correlated with questionnaire scores (r=-0.9758, p<0.0001). CONCLUSIONS Pharmacist-led interventions may have contributed to improved graft survival and patient management of immunosuppressants. Because %CV correlates with the patient questionnaire score, its introduction could be useful in identifying kidney transplant patients who would benefit most from a pharmacist-led patient education.
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Affiliation(s)
| | - Brendan Le Daré
- Service Hospitalo-Universitaire de Pharmacie, Rennes, France
- NuMeCan, Rennes, France
| | - Florian Laval
- Service Hospitalo-Universitaire de Pharmacie, Rennes, France
| | - Florian Lemaitre
- Department of Clinical and Biological Pharmacology and Pharmacovigilance, Clinical Investigation Center CIC-P 1414, Rennes, France
| | | | | | - Cécile Vigneau
- Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, 35000, Rennes, France, Rennes, France
| | - Jonathan M Chemouny
- Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, 35000, Rennes, France, Rennes, France
| | - Astrid Bacle
- Service Hospitalo-Universitaire de Pharmacie, Rennes, France
- Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, 35000, Rennes, France, Rennes, France
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10
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Boivin E, Le Daré B, Bellay R, Vigneau C, Mercerolle M, Bacle A. Long-term lithium therapy and risk of chronic kidney disease, hyperparathyroidism and hypercalcemia: a cohort study. Int J Bipolar Disord 2023; 11:4. [PMID: 36709463 PMCID: PMC9884717 DOI: 10.1186/s40345-023-00286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Lithium is well recognized as the first-line maintenance treatment for bipolar disorder (BD). However, besides therapeutic benefits attributed to lithium therapy, the associated side effects including endocrinological and renal disorders constitute important parameters in prescribing patterns and patient adherence. The objectives of this study is to (i) determine whether long-term lithium therapy is associated with a decrease in renal function, hyperparathyroidism and hypercalcemia and (ii) identify risk factors for lithium-induced chronic kidney disease (CKD). METHODS We conducted a single-centered cohort study of adult patients (≥ 18 years) treated with lithium, who were enrolled at Rennes University Hospital in France between January 1, 2018 and June 1, 2020. Required data were collected from the patient's medical records: demographics characteristics (age, sex, body mass index), biologic parameters (GFR, lithium blood level, PTH and calcium), medical comorbidities (hypertension and diabetes), lithium treatment duration and dosage, and length of hospitalization. RESULTS A total of 248 patients were included (mean age: 60.2 ± 16.5 years). Duration of lithium treatment correlated with (i) deterioration of renal function estimated at - 2.9 mL/min/year (p < 0.0001) and (ii) the development of hyperparathyroidism (p < 0.01) and hypercalcemia (p < 0.01). We also noted that patients with lithium blood level > 0.8 mEq/mL had significantly lower GFR than patients with lithium blood level < 0.8 mEq/mL (61.8 mL/min versus 77.6 mL/min, respectively, p = 0.0134). Neither diabetes mellitus nor hypertension was associated with more rapid deterioration of renal function. CONCLUSION This study suggests that the duration of lithium treatment contribute to the deterioration of renal function, raising the question of reducing dosages in patients with a GFR < 60 mL/min. Overdoses has been identified as a risk factor for CKD, emphasizing the importance of regular re-evaluation of the lithium dose regimen. Also, long-term lithium therapy was associated with hyperparathyroidism and hypercalcemia. Particular vigilance is required on these points in order to limit the occurrence of endocrinological and renal lithium adverse effects.
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Affiliation(s)
- Elise Boivin
- grid.411154.40000 0001 2175 0984Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000 Rennes, France
| | - Brendan Le Daré
- grid.411154.40000 0001 2175 0984Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000 Rennes, France ,grid.410368.80000 0001 2191 9284Institut NuMeCan (Nutrition, Metabolismes et Cancer), Réseau PREVITOX, INSERM, INRAE, Université de Rennes 1, Rennes, France
| | - Romain Bellay
- grid.488406.60000 0000 9139 4930Service Pharmacie, Centre Hospitalier Guillaume Regnier, Rennes, France
| | - Cécile Vigneau
- grid.414271.5Service de Néphrologie, Centre Hospitalier Universitaire Pontchaillou, Rennes, France
| | - Marion Mercerolle
- grid.411154.40000 0001 2175 0984Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000 Rennes, France
| | - Astrid Bacle
- grid.411154.40000 0001 2175 0984Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, 35000 Rennes, France ,grid.410368.80000 0001 2191 9284Univ Rennes, CHU Rennes, INSERM, EHESP, Irset-UMR_S 1085, 35000 Rennes, France
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11
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Bories M, Bacle A, Gilardi H, Le Corre P. Risk of acute kidney injury by initiation of non-steroidal anti-inflammatory drugs in hospitalised patients treated with diuretics and renin-angiotensin-aldosterone system inhibitors. Eur J Hosp Pharm 2022; 29:359-361. [PMID: 33478983 PMCID: PMC9614135 DOI: 10.1136/ejhpharm-2020-002550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) with diuretics and renin-angiotensin-aldosterone system inhibitors (RAASI) has been associated with an increased risk of developing acute kidney injury (AKI) in the ambulatory setting. There is currently no information on AKI prevalence in hospitalised patients where initiation of NSAID prescription is quite frequent. The aim of our study was to assess the prevalence of AKI in patients treated with diuretics and/or RAASI in the hospital setting when NSAIDs are initiated. METHODS This was a retrospective single centre study on inpatients receiving triple or dual association treatment. AKI was established according to evidence-based clinical practice guidelines in kidney disease (Kidney Disease Improving Global Outcome, KDIGO) using the following criteria : increase in serum creatinine (SCr) by ≥0.3 mg/dL (or ≥26.5 µmol/L) within 48 hours, or increase in SCr to ≥1.5 times baseline occurring within the last 7 days. RESULTS AKI was identified in 5 of 151 patients (3.3%) treated with both diuretics and RAASI in whom NSAIDs were initiated, with a 49 µM average increase in SCr within 48 hours compared with baseline. AKI was identified in 2 of 117 (1.7%) patients treated with diuretics and NSAIDs, and in 1 of 427 (0.23%) patients treated with RAASI and NSAIDs. The average increase in SCr within 2 days was 29 µM. No AKI was identified in a control group of 1886 patients treated with diuretics and RAASI but with no initiation of NSAIDs during their hospitalisation. CONCLUSION Initiation of NSAID therapy in hospitalised patients already being treated with diuretics and RAASI is a risk factor for AKI. The risk of AKI with the triple association appeared higher than with the dual association treatment.
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Affiliation(s)
- Mathilde Bories
- Laboratoire de Biopharmacie et Pharmacie Clinique, Faculté de Pharmacie, Université de Rennes 1, Rennes, France
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, Rennes, France
| | - Astrid Bacle
- Laboratoire de Biopharmacie et Pharmacie Clinique, Faculté de Pharmacie, Université de Rennes 1, Rennes, France
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset - UMR_S 1085, Université de Rennes 1, Rennes, France
| | - Helene Gilardi
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, Rennes, France
| | - Pascal Le Corre
- Laboratoire de Biopharmacie et Pharmacie Clinique, Faculté de Pharmacie, Université de Rennes 1, Rennes, France
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset - UMR_S 1085, Université de Rennes 1, Rennes, France
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12
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Cambien G, Dupuis A, Belmouaz M, Bauwens M, Bacle A, Ragot S, Albouy M, Migeot V, Ayraud-Thevenot S. Exposition des patients dialysés au Bisphénol A : impact du traitement par hémodialyse. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Boissière C, Rallon T, Demay E, Mercerolle M, Vigneau C, Chatron C, Bacle A. Pratiques d’éducation thérapeutique du patient greffé rénal : mise en place d’un projet d’harmonisation au niveau national. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Le Daré B, Bacle A, Lhermitte R, Lesourd F, Lurton Y. Erratum to 'Increasing vaccine supply with low dead-volume syringes and needles' [Int. J. Pharmaceut. 608 (2021) 121053]. Int J Pharm 2022; 613:121443. [PMID: 35012794 PMCID: PMC8740948 DOI: 10.1016/j.ijpharm.2021.121443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Brendan Le Daré
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France; Univ Rennes, INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Rennes, France.
| | - Astrid Bacle
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000 Rennes, France
| | - Roxane Lhermitte
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France
| | - François Lesourd
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France
| | - Yves Lurton
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France
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15
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Bacle A, Malledant Y, Mercerolle M, Pronier C, Nesseler N, Barbazan C, Garlantezec R. Thyroid substitution may be a risk factor for Covid-19. Endocrine 2021; 73:507-508. [PMID: 34212315 PMCID: PMC8248755 DOI: 10.1007/s12020-021-02791-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Astrid Bacle
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000, Rennes, France.
| | - Yannick Malledant
- Surgical Intensive Care Unit, Hôpital Pontchaillou, and NuMeCan U-1241 Inserm, Université de Rennes 1, Rennes, France
| | - Marion Mercerolle
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, 35033, Rennes, France
| | - Charlotte Pronier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000, Rennes, France
| | - Nicolas Nesseler
- Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Rennes, France
- Univ Rennes, CHU de Rennes, Inra, Inserm, Institut NUMECAN-UMR_A 1341, UMR_S 1241, CIC 1414 (Centre d'Investigation Clinique de Rennes), F-35000, Rennes, France
| | - Camille Barbazan
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, 35033, Rennes, France
| | - Ronan Garlantezec
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000, Rennes, France
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16
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Le Boedec A, Anthony N, Vigneau C, Hue B, Laine F, Laviolle B, Bonnaure-Mallet M, Bacle A, Allain JS. Gender inequality among medical, pharmaceutical and dental practitioners in French hospitals: Where have we been and where are we now? PLoS One 2021; 16:e0254311. [PMID: 34242351 PMCID: PMC8270123 DOI: 10.1371/journal.pone.0254311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/23/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Women are under-represented in senior academic and hospital positions in many countries. The authors aim to assess the place and the evolution of all appointed female and male health practitioners' working in French public Hospitals. MATERIALS AND METHODS Data of this observational study were collected from the National Management Centre (Centre National de Gestion) from 2015 up to January 1, 2020. First, the authors described demographic characteristics and specialties of all appointed medicine, pharmacy, and dentistry doctors' working as Hospital Practitioners, Associate Professors, and Full Professors in French General and University-affiliated Hospitals in 2020. Then, they retrospectively reported the annual incidence of new entrance according to gender and professional status from 1999 to 2019 thanks to the appointment date of all practitioners in activity between 2015 and 2020. RESULTS In 2020, 51 401 appointed practitioners (49.7% of female) were in activity in French public hospitals with a large majority being medical doctors (92.4%) compared to pharmacists (6%) and dentists (1.6%). Women represented 52.5% of the Hospital Practitioners, 48.6% of the Associate Professors, and 22.0% of the Full Professors (p < 0.001). There were disparities between the rates of female Full Professors in medicine (20.6%), pharmacy (36.1%), and dentistry (44.3%, p < 0.001). Women were appointed Hospital Practitioners and Associate Professors earlier than men (respectively 37.1 versus 38.8 years, p < 0.001 and 36.1 versus 36.5 years, p = 0.04), and at a later age among Full Professors (43.7 versus 41.9 years, p < 0.001). Compared to men, the annual proportion of appointed women varied significantly between 1999 and 2019 from 47.6% to 60.4% for Hospital Practitioners, from 50.0% to 44.6% for Associate Professors, and from 11.2% to 33.3% for Full Professors (p < 0.001 for trend). CONCLUSIONS Although more and more women occupy positions in French hospitals, there is still a gender gap regarding access to Full Professor status in medicine and pharmacy, but not in dentistry. The disparity in numbers makes comparison difficult. Despite a trend towards gender equality during the last twenty years, it has not yet been achieved regarding access to the highest positions.
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Affiliation(s)
- Antoine Le Boedec
- Department of Ophthalmology, Rennes University Hospital, Rennes, France
- Rennes 1 University, France
| | - Norah Anthony
- Methodological Support and Biostatistics Unit, University Hospital, Saint Denis, Reunion Island, France
- National Institute of Health and Medical Research (INSERM), Clinical Investigation Center 1410 Saint Pierre, Reunion Island, France
| | - Cécile Vigneau
- Rennes 1 University, France
- Department of Nephrology, Rennes University Hospital, Rennes, France
- National Institute of Health and Medical Research (INSERM), IRSET-UMR_S 1085, France
| | - Benoit Hue
- Department of Pharmacy, Rennes University Hospital, Rennes, France
| | - Fabrice Laine
- Clinical Investigation Unit, Rennes University Hospital, Rennes, France
- Department of Hepatology, Rennes University Hospital, Rennes, France
- National Institute of Health and Medical Research (INSERM), Clinical Investigation Center1414, France
| | - Bruno Laviolle
- Rennes 1 University, France
- Clinical Investigation Unit, Rennes University Hospital, Rennes, France
- National Institute of Health and Medical Research (INSERM), Clinical Investigation Center1414, France
| | - Martine Bonnaure-Mallet
- Rennes 1 University, France
- Department of Dental Surgery, Rennes University Hospital, Rennes, France
- National Institute of Health and Medical Research (INSERM), U1241 NuMeCAn, France
| | - Astrid Bacle
- Rennes 1 University, France
- National Institute of Health and Medical Research (INSERM), IRSET-UMR_S 1085, France
- Department of Pharmacy, Rennes University Hospital, Rennes, France
| | - Jean-Sébastien Allain
- Clinical Investigation Unit, Rennes University Hospital, Rennes, France
- National Institute of Health and Medical Research (INSERM), Clinical Investigation Center1414, France
- Internal Medicine, Cardiovascular and Metabolism Division, Saint Malo Hospital, Saint Malo, France
- * E-mail:
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17
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Le Daré B, Bacle A, Lhermitte R, Lesourd F, Lurton Y. Maximizing number of doses drawn from multi-dose COVID-19 vaccines by minimizing dead-volume. J Travel Med 2021; 28:6189153. [PMID: 33772277 PMCID: PMC8083767 DOI: 10.1093/jtm/taab049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Brendan Le Daré
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France.,INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Univ Rennes, Rennes, France
| | - Astrid Bacle
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France.,CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Univ Rennes, F-35000 Rennes, France
| | - Roxane Lhermitte
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France
| | - François Lesourd
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France
| | - Yves Lurton
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, F-35000 Rennes, France
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18
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Reizine F, Pinceaux K, Lederlin M, Autier B, Guegan H, Gacouin A, Luque-Paz D, Boglione-Kerrien C, Bacle A, Le Daré B, Launey Y, Lesouhaitier M, Painvin B, Camus C, Mansour A, Robert-Gangneux F, Belaz S, Le Tulzo Y, Tadié JM, Maamar A, Gangneux JP. Influenza- and COVID-19-Associated Pulmonary Aspergillosis: Are the Pictures Different? J Fungi (Basel) 2021; 7:jof7050388. [PMID: 34063556 PMCID: PMC8156373 DOI: 10.3390/jof7050388] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
Invasive pulmonary aspergillosis (IPA) in intensive care unit patients is a major concern. Influenza-associated acute respiratory distress syndrome (ARDS) and severe COVID-19 patients are both at risk of developing invasive fungal diseases. We used the new international definitions of influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) to compare the demographic, clinical, biological, and radiological aspects of IAPA and CAPA in a monocentric retrospective study. A total of 120 patients were included, 71 with influenza and 49 with COVID-19-associated ARDS. Among them, 27 fulfilled the newly published criteria of IPA: 17/71 IAPA (23.9%) and 10/49 CAPA (20.4%). Kaplan–Meier curves showed significantly higher 90-day mortality for IPA patients overall (p = 0.032), whereas mortality did not differ between CAPA and IAPA patients. Radiological findings showed differences between IAPA and CAPA, with a higher proportion of features suggestive of IPA during IAPA. Lastly, a wide proportion of IPA patients had low plasma voriconazole concentrations with a higher delay to reach concentrations > 2 mg/L in CAPA vs. IAPA patients (p = 0.045). Severe COVID-19 and influenza patients appeared very similar in terms of prevalence of IPA and outcome. The dramatic consequences on the patients’ prognosis emphasize the need for a better awareness in these particular populations.
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Affiliation(s)
- Florian Reizine
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
- Correspondence: (F.R.); (J.-P.G.)
| | - Kieran Pinceaux
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Mathieu Lederlin
- CHU Rennes, Service d’Imagerie Médicale, F-35033 Rennes, France;
| | - Brice Autier
- CHU Rennes, Service de Parasitologie-Mycologie, F-35033 Rennes, France; (B.A.); (H.G.); (F.R.-G.); (S.B.)
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France;
| | - Hélène Guegan
- CHU Rennes, Service de Parasitologie-Mycologie, F-35033 Rennes, France; (B.A.); (H.G.); (F.R.-G.); (S.B.)
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France;
| | - Arnaud Gacouin
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - David Luque-Paz
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | | | - Astrid Bacle
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France;
- CHU Rennes, Service de Pharmacie, F-35033 Rennes, France;
| | | | - Yoann Launey
- CHU Rennes, Service de Réanimation Chirurgicale, F-35033 Rennes, France;
| | - Mathieu Lesouhaitier
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Benoit Painvin
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Christophe Camus
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Alexandre Mansour
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Florence Robert-Gangneux
- CHU Rennes, Service de Parasitologie-Mycologie, F-35033 Rennes, France; (B.A.); (H.G.); (F.R.-G.); (S.B.)
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France;
| | - Sorya Belaz
- CHU Rennes, Service de Parasitologie-Mycologie, F-35033 Rennes, France; (B.A.); (H.G.); (F.R.-G.); (S.B.)
| | - Yves Le Tulzo
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Jean-Marc Tadié
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Adel Maamar
- CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; (K.P.); (A.G.); (D.L.-P.); (M.L.); (B.P.); (C.C.); (A.M.); (Y.L.T.); (J.-M.T.); (A.M.)
| | - Jean-Pierre Gangneux
- CHU Rennes, Service de Parasitologie-Mycologie, F-35033 Rennes, France; (B.A.); (H.G.); (F.R.-G.); (S.B.)
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-35000 Rennes, France;
- Correspondence: (F.R.); (J.-P.G.)
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Le Daré B, Boglione-Kerrien C, Reizine F, Gangneux JP, Bacle A. Toward the personalized and integrative management of voriconazole dosing during COVID-19-associated pulmonary aspergillosis. Crit Care 2021; 25:152. [PMID: 33879175 PMCID: PMC8056831 DOI: 10.1186/s13054-021-03568-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/05/2021] [Indexed: 12/01/2022] Open
Affiliation(s)
- Brendan Le Daré
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, 35000, Rennes, France. .,INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Univ Rennes, Rennes, France.
| | - Christelle Boglione-Kerrien
- Department of Clinical and Biological Pharmacology and Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Rennes University Hospital, 35033, Rennes, France
| | - Florian Reizine
- Service des Maladies Infectieuses et Réanimation Médicale, CHU Rennes, 35033, Rennes, France.,Faculté de Médecine, Biosit, Université Rennes 1, 35043, Rennes, France
| | - Jean-Pierre Gangneux
- Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, CHU Rennes, Univ Rennes, 35000, Rennes, France
| | - Astrid Bacle
- Centre Hospitalier Universitaire de Rennes, Service Pharmacie, 35000, Rennes, France.,Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, CHU Rennes, Univ Rennes, 35000, Rennes, France
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20
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Binson G, Venisse N, Sauvaget A, Bacle A, Lazaro P, Dupuis A. Preparation and physicochemical stability of 50 mg/mL hydroxychloroquine oral suspension in SyrSpend Ⓡ SF PH4 (dry). Int J Antimicrob Agents 2020; 56:106201. [PMID: 33075513 PMCID: PMC7566679 DOI: 10.1016/j.ijantimicag.2020.106201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 12/15/2022]
Abstract
In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, hydroxychloroquine has been proposed as a potential agent to treat patients with COVID-19 (coronavirus disease 2019) caused by SARS-CoV-2 infection. Older adults are more susceptible to COVID-19 and some patients may require admission to the intensive care unit, where oral drug administration of solid forms may be compromised in many COVID-19 patients. However, a liquid formulation of hydroxychloroquine is not commercially available. This study describes how to prepare a 50 mg/mL hydroxychloroquine oral suspension using hydroxychloroquine sulfate powder and SyrSpendⓇ SF PH4 (dry) suspending vehicle. Moreover, a fully validated stability-indicating method has been developed to demonstrate the physicochemical stability of the compounded hydroxychloroquine oral suspension over 60 days under refrigeration (5 ± 3 °C). Finally, use of the proposed oral suspension provides a reliable solution to perform safe and accurate administration of hydroxychloroquine to patients with SARS-CoV-2 infection.
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Affiliation(s)
- Guillaume Binson
- University Hospital of Poitiers, Pharmacy Department, 2 rue de la milétrie, 86021 Poitiers, France; CIC Inserm 1402, HEDEX Group, 2 rue de la milétrie, 86021 Poitiers, France, and School of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Nicolas Venisse
- CIC Inserm 1402, HEDEX Group, 2 rue de la milétrie, 86021 Poitiers, France, and School of Medicine and Pharmacy, University of Poitiers, Poitiers, France; University Hospital of Poitiers, Pharmacokinetics Department, 2 rue de la milétrie, 86021 Poitiers, France
| | - Alexis Sauvaget
- University Hospital of Poitiers, Pharmacy Department, 2 rue de la milétrie, 86021 Poitiers, France; CIC Inserm 1402, HEDEX Group, 2 rue de la milétrie, 86021 Poitiers, France, and School of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Astrid Bacle
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France, and Pôle Pharmacie, Centre Hospitalier Universitaire, 2 rue Henri Le Guilloux, 35033 Rennes, France
| | - Pauline Lazaro
- University Hospital of Poitiers, Pharmacy Department, 2 rue de la milétrie, 86021 Poitiers, France
| | - Antoine Dupuis
- University Hospital of Poitiers, Pharmacy Department, 2 rue de la milétrie, 86021 Poitiers, France; CIC Inserm 1402, HEDEX Group, 2 rue de la milétrie, 86021 Poitiers, France, and School of Medicine and Pharmacy, University of Poitiers, Poitiers, France.
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21
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Alix L, Bajeux E, Hubert J, Cador B, Josselin JM, Tuffier S, Gicquel V, Somme D, Jego P, Bacle A, Hue B. Medication reconciliation in hospital patients over the age of 65: How long does it take and how much does it cost? A time-motion study in an internal medicine ward. Eur J Intern Med 2020; 73:100-102. [PMID: 31859024 DOI: 10.1016/j.ejim.2019.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/04/2019] [Accepted: 12/07/2019] [Indexed: 11/21/2022]
Affiliation(s)
- L Alix
- Service de Médecine Interne et Immunologie clinique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - E Bajeux
- Service d'Epidémiologie et de Santé Publique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - J Hubert
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - B Cador
- Service de Médecine Interne et Immunologie clinique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - J M Josselin
- Faculté de Sciences Economiques de Rennes 1 - 7 place Hoche - 35000 Rennes, France.
| | - S Tuffier
- Service d'Epidémiologie et de Santé Publique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - V Gicquel
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - D Somme
- Service de Gériatrie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - P Jego
- Service de Médecine Interne et Immunologie clinique - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - A Bacle
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
| | - B Hue
- Service de Pharmacie - CHU Rennes 2 rue Henri Le Guilloux - 35000 Rennes, France.
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22
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Bacle A, Belaz S, Potin S, Gangneux JP. A case report of photodermatoses induced by the antifungal drug terbinafine. Eur J Hosp Pharm 2019; 26:288-289. [PMID: 31656618 DOI: 10.1136/ejhpharm-2018-001683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/18/2018] [Indexed: 11/03/2022] Open
Abstract
Terbinafine is an antifungaldrug(inhibitor of ergosterol synthesis) known to induce skin reactions. A 58-year-old female was treated with terbinafine for onychomycosis. On the fifth day of treatment a skin rash emerged on her sun-exposed areas. Biological testing did not find any allergic signs. Other skin reactions are well known with terbinafine, but we depict here, a case of photosensitisation induced by treatment, generally unknown for this antifungal. This side effect can be prevented by medication reconciliation and pharmaceutical advice from the clinical pharmacist.
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Affiliation(s)
- Astrid Bacle
- Service Hospitalo-Universitaire de Pharmacie, Centre Hospitalier Universitaire de Rennes, Rennes, France.,Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Univ Rennes, CHU Rennes, F-35000 Rennes, France
| | - Sorya Belaz
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Univ Rennes, CHU Rennes, F-35000 Rennes, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Sophie Potin
- Service Hospitalo-Universitaire de Pharmacie, Centre Hospitalier Universitaire de Rennes, Rennes, France.,Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Univ Rennes, CHU Rennes, F-35000 Rennes, France
| | - Jean-Pierre Gangneux
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Univ Rennes, CHU Rennes, F-35000 Rennes, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
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23
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Le Vée M, Bacle A, Bruyere A, Fardel O. Neonicotinoid pesticides poorly interact with human drug transporters. J Biochem Mol Toxicol 2019; 33:e22379. [DOI: 10.1002/jbt.22379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/26/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Marc Le Vée
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)Univ Rennes Rennes France
| | - Astrid Bacle
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), CHU RennesUniv Rennes Rennes France
| | - Arnaud Bruyere
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)Univ Rennes Rennes France
| | - Olivier Fardel
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), CHU RennesUniv Rennes Rennes France
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24
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Bacle A, Pronier C, Gilardi H, Polard E, Potin S, Scailteux LM. Hepatotoxicity risk factors and acetaminophen dose adjustment, do prescribers give this issue adequate consideration? A French university hospital study. Eur J Clin Pharmacol 2019; 75:1143-1151. [PMID: 30972451 DOI: 10.1007/s00228-019-02674-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/21/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The hepatotoxicity of acetaminophen is recognised worldwide. Unfavourable prognoses relating to overdose include liver transplantation and/or death. Several hepatotoxicity risk factors (HRFs) should motivate the adjustment of acetaminophen daily intake (to < 4 g/day): advanced age, weight < 50 kg, malnutrition, chronic alcoholism, chronic hepatitis B and C and HIV infection, severe chronic renal failure and hepatocellular insufficiency. METHOD Over a 7-day period in Rennes University Hospital in December 2017, using DxCare® software, with an odds ratio estimation, we analysed all acetaminophen prescriptions, to assess to what extent the presence of HRFs altered the prescribers' choice of acetaminophen dose (< 4 g/day versus 4 g/day). RESULTS Among 1842 patients, considering only the first acetaminophen prescription, 73.7% were on 4 g/day. Almost half this population had at least 1 HRF. Whereas around 80% of the prescriptions in the < 4 g/day group were for patients with at least 1 HFR, only 53% of the prescriptions in the 4 g/day group concerned patients without HFRs (p < 0.001). Age > 75 and low weight were associated with the prescriber's choice of dose. Neither chronic alcoholism nor hepatocellular insufficiency influenced the acetaminophen doses prescribed. CONCLUSION Considering the widespread use of acetaminophen and its favourable safety profile compared with other analgesic drugs, it appears urgent to remind prescribers of the maximum daily dose recommendations for acetaminophen for patients with HRFs, especially those with chronic alcoholism and hepatocellular insufficiency.
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Affiliation(s)
- Astrid Bacle
- Pharmacy Department, CHU Rennes, Rennes, France.,Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Charlotte Pronier
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France.,Virology Department, CHU Pontchaillou, Rennes, France
| | | | - Elisabeth Polard
- Pharmacovigilance and Pharmacoepidemiology Centre, Pharmacology Department, CHU Rennes, 2, rue Henri Le Guilloux, 35000, Rennes, France.,Univ Rennes, REPERES ([Pharmacoepidemiology and Heath Services Research]) - EA 7449, F-35000, Rennes, France
| | - Sophie Potin
- Pharmacy Department, CHU Rennes, Rennes, France.,Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Lucie-Marie Scailteux
- Pharmacovigilance and Pharmacoepidemiology Centre, Pharmacology Department, CHU Rennes, 2, rue Henri Le Guilloux, 35000, Rennes, France. .,Univ Rennes, REPERES ([Pharmacoepidemiology and Heath Services Research]) - EA 7449, F-35000, Rennes, France.
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25
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Le Vée M, Bacle A, Jouan E, Lecureur V, Potin S, Fardel O. Induction of multidrug resistance-associated protein 3 expression by diesel exhaust particle extract in human bronchial epithelial BEAS-2B cells. Toxicol In Vitro 2019; 58:60-68. [PMID: 30898553 DOI: 10.1016/j.tiv.2019.03.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/08/2019] [Accepted: 03/17/2019] [Indexed: 01/09/2023]
Abstract
Diesel exhaust particles (DEPs) are common environmental air pollutants known to impair expression and activity of drug detoxifying proteins, including hepatic ATP-binding cassette (ABC) drug transporters. The present study was designed to determine whether organic DEP extract (DEPe) may also target ABC drug transporters in bronchial cells. DEPe (10 μg/mL) was demonstrated to induce mRNA and protein expression of the multidrug resistance-associated protein (MRP) 3 in cultured bronchial epithelial BEAS-2B cells, whereas mRNA levels of other MRPs, multidrug resistance gene 1 or breast cancer resistance protein were unchanged, reduced or not detected. DEPe also increased MRP3 mRNA expression in normal human bronchial epithelial cells. Inhibition of the aryl hydrocarbon receptor (AhR) pathway by AhR antagonist or AhR silencing, as well as the silencing of nuclear-factor-E2-related factor 2 (Nrf2) repressed DEPe-mediated MRP3 induction. This underlines the implication of the AhR and Nrf2 signaling cascades in DEPe-mediated MRP3 regulation. DEPe was additionally demonstrated to directly inhibit MRP activity in BEAS-2B cells, in a concentration-dependent manner. Taken together, these data indicate that DEPs may impair expression and activity of MRPs, notably MRP3, in human bronchial cells, which may have consequences in terms of lung barrier and toxicity for humans exposed to diesel pollution.
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Affiliation(s)
- Marc Le Vée
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France
| | - Astrid Bacle
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France; Pôle Pharmacie, Centre Hospitalier Universitaire, 2 rue Henri Le Guilloux, 35033 Rennes, France
| | - Elodie Jouan
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France
| | - Valérie Lecureur
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France
| | - Sophie Potin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France; Pôle Pharmacie, Centre Hospitalier Universitaire, 2 rue Henri Le Guilloux, 35033 Rennes, France
| | - Olivier Fardel
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France; Pôle Biologie, Centre Hospitalier Universitaire, 2 rue Henri Le Guilloux, 35033 Rennes, France.
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26
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Sanchez L, Bacle A, Lamy T, Le Corre P. Potential drug-drug interactions and nephrotoxicity in hematopoietic stem cell transplant adult recipients during bone marrow transplantation unit stay. Cancer Chemother Pharmacol 2019; 83:827-835. [PMID: 30758649 DOI: 10.1007/s00280-019-03791-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/31/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE Studies have documented potential drug-drug interactions (pDDIs) occurring in cancer patients mainly with solid malignancies, either in the ambulatory or hospital settings. While hematopoietic stem cell transplant (HSCT) patients during their bone marrow transplantation unit (BMTU) stay have rather complex medical regimens combining chemotherapy, anti-infectious agents, immunosuppressive agents, and supportive-care drugs, studies on potential DDIs are lacking. Our objective was to evaluate the prevalence and the density of pharmacokinetic and pharmacodynamic potential DDIs, and the evolution of the renal function in hematopoietic stem cell transplant (HSCT) adult recipients during their BMTU stay. METHODS Retrospective study in 31 adult patients consecutively admitted to the BMTU. RESULTS Prevalence of pharmacokinetic interactions was ten times lower than the pharmacodynamic interactions. The contraindications were rare, and only of pharmacokinetic origin. The main drugs involved in pharmacokinetic DDIs were ciclosporine, methotrexate, esomeprazole, tramadol, and vincristine. The median number of potential nephrotoxicity-related DDIs per patient was 7 and the median number of days during which nephrotoxicity-related DDIs potentially occurred was 77 days per patient. The decrease in glomerular filtration rate (GFR) throughout the BMTU stay (mean decrease of 13 ml/min) was correlated with the number of days of potential nephrotoxic drug interactions. CONCLUSIONS Potential DDIs in HCST patients in BMTU were quite common. The DDIs from pharmacokinetic origin were less frequent, but of higher grade, than those of pharmacodynamic origin. The decrease in GFR suggests that the density of potential nephrotoxic drug interactions may be an issue to be considered in these patients.
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Affiliation(s)
- Lydia Sanchez
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, 35033, Rennes, France.,Pharmacia Del Carre López, 48012, Bilbao, Spain
| | - Astrid Bacle
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, 35033, Rennes, France.,Laboratoire de Biopharmacie et Pharmacie Clinique, Faculté de Pharmacie, Université de Rennes 1, 35043, Rennes Cedex, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset-UMR_S 1085, 35000, Rennes, France
| | - Thierry Lamy
- Pôle Médecines Spécialisées, Service d'Hématologie Clinique, CHU de Rennes, 35033, Rennes, France.,Univ Rennes 1, INSERM, EFS Bretagne, UMR U1236, 35033, Rennes, France
| | - Pascal Le Corre
- Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, 35033, Rennes, France. .,Laboratoire de Biopharmacie et Pharmacie Clinique, Faculté de Pharmacie, Université de Rennes 1, 35043, Rennes Cedex, France. .,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset-UMR_S 1085, 35000, Rennes, France.
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Chedik L, Bruyere A, Bacle A, Potin S, Le Vée M, Fardel O. Interactions of pesticides with membrane drug transporters: implications for toxicokinetics and toxicity. Expert Opin Drug Metab Toxicol 2018; 14:739-752. [DOI: 10.1080/17425255.2018.1487398] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Lisa Chedik
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Arnaud Bruyere
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Astrid Bacle
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
- Pôle Pharmacie, Centre Hospitalier Universitaire, Rennes, France
| | - Sophie Potin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
- Pôle Pharmacie, Centre Hospitalier Universitaire, Rennes, France
| | - Marc Le Vée
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Olivier Fardel
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
- Pôle Biologie, Centre Hospitalier Universitaire, Rennes, France
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Binson G, Venisse N, Bacle A, Beuzit K, Dupuis A. Preparation and Physico-Chemical Stability of Dexamethasone Oral Suspension. Pharmaceutical Technology in Hospital Pharmacy 2017. [DOI: 10.1515/pthp-2017-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractBackgroundDexamethasone is commonly used to treat a wide variety of diseases including oncological disorders. The aim of this study was to propose a liquid formulation of dexamethasone. Therefore we have developed and assessed the stability of a 5 mg/mL dexamethasone oral suspension.MethodsA stability-indicating analytical method, using HPLC-UV, was developed and fully validated according to well-recognized international guidelines. The dexamethasone suspension was prepared using dexamethasone acetate powder and Ora-SweetResultsThe mean dexamethasone concentration of the compounded oral suspensions was equal to 5.07±0.17 mg/mL. No colour modifications, precipitate or suspending troubles was observed throughout the storage period and the pH of the oral suspensions was decreased slightly, from 4.41±0.01 to 4.20±0.02. According to the dexamethasone content determined by HPLC-UV, whatever storage condition was used, no significant degradation of dexamethasone occurred over the 60 days of the study period.ConclusionDexamethasone oral suspension prepared according to our conditions is stable over 60 days under regular storage temperatures (at 4±2 °C or at 21±3 °C).
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29
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Bacle A, Thevenot S, Grignon C, Belmouaz M, Bauwens M, Teychene B, Venisse N, Migeot V, Dupuis A. Determination of bisphenol A in water and the medical devices used in hemodialysis treatment. Int J Pharm 2016; 505:115-21. [PMID: 27012980 DOI: 10.1016/j.ijpharm.2016.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 12/22/2022]
Abstract
Bisphenol A (BPA) is an endocrine disruptor found in food containers and plastic beverages and also in medical devices such as dialyzers. The aim of this study is while taking into account the BPA originating in medical devices and the water used in dialysate production, to provide the first published investigation of overall potential exposure to BPA during hemodialysis treatment in patients suffering from end-stage renal disease. BPA concentration in water (at each step of purification treatment) and in dialysate and BPA leaching from dialyzers were determined using solid-phase extraction coupled to ultra-high-performance-liquid chromatography tandem mass spectrometry. We have corroborated the hypothesis that a significant amount of BPA may migrate from dialyzers and also demonstrated that BPA is provided by the water used in dialysate production (8.0±5.2ngL(-1) on average) and by dialysis machine and dialysate cartridges, leading to dialysate contamination of 22.7±15.6ngL(-1) on average. Taking into account all the sources of BPA contamination that may come into play during a hemodialysis session, the highest exposure could reach an estimated 140ng/kg b.w./day for hemodialyzed patients, directly available for systemic exposure. Finally, BPA contamination should be taken into account as concerns both the medical devices commonly used in hemodialysis and purified water production systems.
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Affiliation(s)
- Astrid Bacle
- University of Poitiers, CNRS-UMR 7285 IC2MP, School of Medicine and Pharmacy (Department of Analytical Chemistry, Pharmaceutics and Epidemiology), 6 rue de la Milétrie, 86034 Poitiers Cedex, France; University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Sarah Thevenot
- University of Poitiers, CNRS-UMR 7285 IC2MP, School of Medicine and Pharmacy (Department of Analytical Chemistry, Pharmaceutics and Epidemiology), 6 rue de la Milétrie, 86034 Poitiers Cedex, France; University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Claire Grignon
- University of Poitiers, CNRS-UMR 7285 IC2MP, School of Medicine and Pharmacy (Department of Analytical Chemistry, Pharmaceutics and Epidemiology), 6 rue de la Milétrie, 86034 Poitiers Cedex, France; University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Mohamed Belmouaz
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Marc Bauwens
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Benoit Teychene
- University of Poitiers, CNRS-UMR 7285 IC2MP, ENSIP, 1 rue Marcel Doré, 86022 Poitiers Cedex, France
| | - Nicolas Venisse
- University of Poitiers, CNRS-UMR 7285 IC2MP, School of Medicine and Pharmacy (Department of Analytical Chemistry, Pharmaceutics and Epidemiology), 6 rue de la Milétrie, 86034 Poitiers Cedex, France; University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Virginie Migeot
- University of Poitiers, CNRS-UMR 7285 IC2MP, School of Medicine and Pharmacy (Department of Analytical Chemistry, Pharmaceutics and Epidemiology), 6 rue de la Milétrie, 86034 Poitiers Cedex, France; University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Antoine Dupuis
- University of Poitiers, CNRS-UMR 7285 IC2MP, School of Medicine and Pharmacy (Department of Analytical Chemistry, Pharmaceutics and Epidemiology), 6 rue de la Milétrie, 86034 Poitiers Cedex, France; University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France.
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Grignon C, Venisse N, Rouillon S, Brunet B, Bacle A, Thevenot S, Migeot V, Dupuis A. Erratum to: Ultrasensitive determination of bisphenol A and its chlorinated derivatives in urine using a high-throughput UPLC-MS/MS method. Anal Bioanal Chem 2016; 408:2375. [DOI: 10.1007/s00216-016-9378-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 11/27/2022]
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Grignon C, Venisse N, Rouillon S, Brunet B, Bacle A, Thevenot S, Migeot V, Dupuis A. Ultrasensitive determination of bisphenol A and its chlorinated derivatives in urine using a high-throughput UPLC-MS/MS method. Anal Bioanal Chem 2016; 408:2255-63. [DOI: 10.1007/s00216-015-9288-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 12/07/2015] [Accepted: 12/21/2015] [Indexed: 01/21/2023]
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Venisse N, Grignon C, Brunet B, Thévenot S, Bacle A, Migeot V, Dupuis A. Reliable quantification of bisphenol A and its chlorinated derivatives in human urine using UPLC–MS/MS method. Talanta 2014; 125:284-92. [DOI: 10.1016/j.talanta.2014.02.064] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/20/2014] [Accepted: 02/25/2014] [Indexed: 11/25/2022]
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Bacle A, Diot P, Lemarié E. [Anti-pneumococcal vaccine: justifications and results]. Rev Pneumol Clin 1997; 53:128-137. [PMID: 9296113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The frequency and severity of pneumococci infections, the isolation of invasive serotypes and the fact that certain serotypes develop cross-resistance to antibiotics constitute justifications for anti-pneumococci vaccination. A 23-valence vaccine (Pneumo 23) has been marketed since 1983. A meta-analysis of 9 randomized studies concluded that anti-pneumococci vaccination reduces the overall incidence of pneumococci pneumonia with bacteremia. The efficacy of the vaccine was demonstrated on 4 parameters: proven pneumococci pneumonia, proven pneumococci pneumonia and serotypes contained in the anti-pneumococci vaccine, presumed pneumococci pneumonia, presumed pneumococci pneumonia and serotypes contained in the anti-pneumococci vaccine. The efficacy of the vaccine was significant only for low-risk subjects. The protective effect was not demonstrated against pneumonia whatever the cause and against bronchitis. Other case-control or retrospective studies have also been reported. The results have been somewhat contradictory but there is a demonstration of the usefulness of vaccination in patients over 65 years of age with a moderate risk (living in institution, obstructive bronchopneumonary disease, heart failure). Vaccination is advocated not only after splenectomy and in subjects with sickle cell anemia, but also in frequently hospitalized subjects, particularly those with respiratory failure and smokers. Vaccination is also recommended in case of nephrotic syndrome or an osteomeningeal breach. In at-risk children under 2 years of age, antibiotic prophylaxis is recommended in association with vaccination. The data of revaccination is not clearly determined.
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Affiliation(s)
- A Bacle
- Service de Pneumologie, CHU Bretonneau, Tours
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