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1.
Antibiotics (Basel) ; 12(7)2023 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-37508288

RESUMO

(1) Background: Piperacillin/tazobactam is a broad-spectrum antimicrobial encompassing most Gram-positive and Gram-negative aerobic and anaerobic bacteria. The inappropriate use of such broad-spectrum antibiotics is an important contributor to the rising rates of antimicrobial drug resistance worldwide. Drug utilization evaluation studies and pharmacists' interventions are vital to assess, develop, and promote the rational use of antibiotics. This drug utilization study aimed to evaluate the current utilization practice of piperacillin/tazobactam in a hospital setting and assess the impact of pharmacist intervention in improving its appropriate use. (2) Methodology: In this study, we used a retrospective cohort and a prospective cohort, a cross-sectional, observational method. It included a retrospective (Cycle A/pre-intervention-CycA) phase followed by an educational interventional phase conducted by the pharmacists. During the 2 months of educational intervention, pharmacists used several methods, including workshops, lectures, oral presentations, and the development and reinforcement of clinical pathways to promote the judicious use of piperacillin/tazobactam. This was followed by a prospective (Cycle B/post-intervention-CycB) phase to improve piperacillin/tazobactam usage appropriateness. The appropriateness criteria for this drug utilization evaluation were established based on antimicrobial guidelines, the published literature, the institutional antibiogram, consultation from the antimicrobial stewardship committee, and the product monograph (Tazocin). The appropriateness of CycA and CycB patients was compared using the measurable elements, including indication and dose based on renal function, timely order for cultures, de-escalation, and use of extended infusion protocol. (3) Results: The study population comprised 100 patients in both CycA and CycB. The mean age of the patients was 66.28 ± 16.15 and 67.35 ± 17.98, and the ratios of men to women were found to be 49:51 and 61:39 in CycA and CycB, respectively. It was observed that inappropriate usage was high in CycA patients, and the appropriateness was improved in CycB patients. A total of 31% of inappropriate empirical broad-spectrum use was found in CycA, and it was reduced to 12% in CycB patients. The transition of appropriateness was observed in all measurable criteria, which includes the optimized dose according to the renal function (CycA = 49% to CycB = 94%), timely bacterial culture orders (CycA = 47% to CycB = 74%), prompt de-escalation (CycA = 31% to CycB = 53%), and adherence to extended infusion institutional guidelines (CycA = 34% to CycB = 86%). (4) Conclusions: The study highlighted important aspects of inappropriate piperacillin/tazobactam use. This can be considerably improved by proper education and timely interventions based on the pharmacists' vigilant approach. The study results emphasized the need for surveillance of piperacillin/tazobactam usage by conducting similar drug utilization evaluations and practice to improve quality and safety in healthcare organizations globally.

2.
RSC Adv ; 13(19): 13183-13194, 2023 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-37124025

RESUMO

Dispersive liquid-liquid microextraction (DLLME) combined with ultra-high performance liquid chromatography-diode array detector (UHPLC-DAD) method has been developed and validated for the determination of parabens in personal care products. In this study, a natural deep eutectic solvent (NADES) composed of menthol and formic acid at a molar ratio of 1 : 2 was prepared and used as an extraction solvent. The influencing variables on the extraction efficiency such as extraction solvent type and volume, composition of NADES, salt addition, vortex and centrifugation time were investigated. The proposed method exhibited good linearity with determination coefficients of ≥0.9992. The relative recoveries for the studied analytes ranged from 82.19 to 102.45%. Limits of detection and limits of quantification were in the range of 0.17-0.33 ng mL-1 and 0.51-0.99 ng mL-1, respectively. To evaluate the applicability of the developed method, it was successfully applied to determine four parabens in personal care products. Additionally, the eco-friendliness level of the presented method was evaluated using Eco-Scale Assessment, Green Analytical Procedure Index and Analytical GREEnness metric. The developed method is simple, environmentally friendly and cost effective and it could be employed for determination of parabens in personal care products without harming the environment.

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