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OBJECTIVE: Determine the impact of prematriculation course withdrawals on first year pharmacy school (P1) success, defined as on-time progression to the second (P2) year without remediation. METHODS: A retrospective review of students matriculating to a four-year private institution from 2018 to 2021 was conducted. Potential predictors of P1 year success including age, sex, highest degree achieved, prematriculation grade point average (GPA), and course withdrawals were collected. RESULTS: Bivariate analysis indicates that age, cumulative GPA, science GPA, and prematriculation course withdrawals were significantly different between students who were successful vs unsuccessful in the first year of pharmacy school. Out of 220 students analyzed, 40.9% (n = 90) were unsuccessful in the first year. Of those 90 P1 students, 52% did not progress to the P2 year, and 48% progressed but required course remediation. Multivariate analysis demonstrated that independent predictors of P1 success included cumulative GPA and having less than two prematriculation course withdrawals. In addition, the number of prematriculation course withdrawals, cumulative GPA, and having a bachelor's degree or higher were independent predictors of P1 GPA. CONCLUSION: Prematriculation course withdrawal was an independent predictor of both P1 success and P1 GPA. Students with less than two prematriculation course withdrawals were more likely to be successful during the first year of pharmacy school. College of pharmacy admission committees may consider prematriculation course withdrawal frequency when making admission decisions or to identify students that may need additional academic support during the first year of pharmacy school.
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Educación en Farmacia , Farmacia , Estudiantes de Farmacia , Humanos , Evaluación Educacional , Facultades de Farmacia , Logro , Criterios de Admisión EscolarRESUMEN
INTRODUCTION: Men who have sex with men (MSM), especially Black MSM, are disproportionately affected by HIV and experience disparate prescription of pre-exposure prophylaxis (PrEP) for HIV prevention compared to White MSM. While pharmacists are essential in efforts to scale-up PrEP, little is known about the role of knowledge and implicit biases in pharmacy students' decision-making regarding PrEP, which may elucidate mechanisms for improving PrEP access and addressing disparities. METHODS: A nationwide, cross-sectional study of pharmacy students in the United States was conducted. A fictional White or Black MSM seeking PrEP was presented. Participants completed measures of PrEP/HIV knowledge, implicit racism and heterosexism, assumptions about the patient's behavior (condomless sex, extra-relational sex, adherence to PrEP), and confidence providing PrEP-related care. RESULTS: A total of 194 pharmacy students completed the study. Compared to the White patient, the Black patient was assumed to be less adherent to PrEP if prescribed. In contrast, assumptions of sexual risk behaviors if prescribed PrEP and confidence providing PrEP-related care did not differ. Additionally, implicit racism was associated with lower confidence providing PrEP-related care, whereas PrEP/HIV knowledge, implicit sexual orientation bias, and assumed sexual risk behaviors if prescribed PrEP were not associated with confidence. CONCLUSIONS: Pharmacists are essential in efforts to scale-up PrEP prescription, making pharmacy education about PrEP for HIV prevention critical. These findings suggest that implicit bias awareness training is needed. This training may reduce the influence of implicit racial bias on confidence providing PrEP-related care and improve knowledge of HIV and PrEP.
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Infecciones por VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Estudiantes de Farmacia , Humanos , Masculino , Femenino , Homosexualidad Masculina , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Sesgo Implícito , Estudios Transversales , SesgoRESUMEN
BACKGROUND: The Biofire® FilmArray® Pneumonia Panel (PN Panel) provides a more rapid and sensitive method of respiratory pathogen detection than standard culture. However, it is often unclear how to apply the results clinically, especially in the case of discordant culture results. We evaluated the concordance of bacterial organism and resistance gene identification between the PN Panel and standard culture methods in hospitalized patients with a clinical diagnosis of pneumonia. METHODS: This single-center retrospective observational study of 274 inpatients assessed the positive predictive value (PPV) and described the prevalence of individual bacterial organism and resistance marker targets on the PN Panel. RESULTS: The overall PPV of the PN Panel in identifying bacteria was 70.1%, with individual organism PPV ranging from 50.0% to 90.9%. For resistance gene identification, the PN Panel's PPV ranged from 46.2% for CTX-M to 68.4% for mecA/C and the staphylococcal cassette chromosome mec element right extremity junction (MREJ), although resistance was uncommon. Staphylococcus aureus was the most common bacterial pathogen detected by the PN Panel (38.7%), followed by Pseudomonas aeruginosa (22.3%), and Haemophilus influenzae (12.0%). CONCLUSIONS: The PN Panel detected more bacteria and resistance gene targets than standard culture methods. To optimize the use of this technology for both patient care and antimicrobial stewardship, results should be coupled with clinical assessment and clinician education.
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Neumonía , Infecciones Estafilocócicas , Humanos , Patología Molecular , Neumonía/diagnóstico , Bacterias/genética , Staphylococcus aureusRESUMEN
ABSTRACT: In this case series of 20 ambulatory and hospitalized adult patients treated for monkeypox virus at a large academic medical center in Chicago, Illinois, tecovirimat use was reserved for those with or at high risk of severe disease, delayed because of logistical and clinical factors, but well tolerated.
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Monkeypox virus , Mpox , Adulto , Humanos , Benzamidas , ChicagoRESUMEN
Antibiotic administration in the perioperative period is the foundation of preventing surgical site infections. ß-Lactam antibiotics, notably the first-generation cephalosporin cefazolin, are the drugs of choice for this indication. However, reported antibiotic allergies often result in the use of suboptimal alternative agents that can lead to an increased risk of infection and adverse effects. A comprehensive allergy history and risk stratification should be completed preoperatively to determine whether or not a patient can be rechallenged with a ß-lactam antibiotic and what testing may be necessary prior to administration. Nursing staff can play a critical role in understanding the implications and management of reported antibiotic allergies in surgical patients in order to optimize patient care.
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Antibacterianos/efectos adversos , Hipersensibilidad/diagnóstico , Aminoglicósidos/administración & dosificación , Aminoglicósidos/efectos adversos , Antibacterianos/administración & dosificación , Aztreonam/administración & dosificación , Aztreonam/efectos adversos , Cefazolina/administración & dosificación , Cefazolina/efectos adversos , Clindamicina/administración & dosificación , Clindamicina/efectos adversos , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/inmunología , Humanos , Estudios Retrospectivos , Vancomicina/administración & dosificación , Vancomicina/efectos adversos , beta-Lactamas/administración & dosificación , beta-Lactamas/efectos adversosRESUMEN
Alternative antibiotics for surgical prophylaxis are associated with increased adverse events and surgical site infection compared to cefazolin. In a sample of perioperative inpatients from 100 hospitals in the United States, cefazolin was 9-fold less likely to be used in patients with a documented ß-lactam allergy whereas clindamycin was 45-fold more likely.