Publications (15)34.5 Total impact
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Article: [Pharmacodynamic and pharmacokinetic evaluation of respiratory fluoroquinolones. Guideline to selection of the most appropriate fluoroquinolone].
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ABSTRACT: Since its approval, fluoroquinolones have become one of the most prescribed antibacterial agents. Because of its widespread use, serious concerns about the emergence of resistance in Streptococcus pneumoniae, Pseudomonas spp, and entrobacteriaceae, has arisen, especially because of cross-resistance between fluoroquinolones. Huge efforts has been done to identify pharmacokinetic (PK) parameters like maximum serum concentration (Cmax), area under the curve of serum concentrations (AUC) and pharmacodynamic (PD) parameters like the minimum inhibitory concentration (MIC) or the mutant prevention concentration (MPC), to optimize the use of the new fluoroquinolones, especially against these difficult to treat microorganisms. The new fluoroquinolones commercially available in Spain, levofloxacin and moxifloxacin, have significant differences in their PK (Cmax, half-life, volume of distribution, etc), PD (MIC, MPC,) and in their PK/PD parameters (AUC/MIC; AUC/MPC) that allow clinicians to establish clear preference for the utilization of one of them. Proper use of these new fluoroquinolones according to these PK/PD parameters will result in better management of respiratory infections with a reduction in the emergence of resistance. Based on data reviewed in this paper moxifloxacin use, with best PK/PD characteristics, should be preferred over levofloxacin. Should levofloxacin be used, alternative dosing strategies would be recommended to avoid selection of resistant variants.Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia 12/2012; 25(4):245-51. · 0.81 Impact Factor -
Article: Safety analysis of high dose (>6 mg/kg/day) daptomycin in patients with concomitant statin therapy.
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ABSTRACT: There is a paucity of data regarding efficacy and safety of concomitant therapy of daptomycin and statins, so we reviewed patients that concomitantly received daptomycin and statins to identify any potential increase in toxicity in our cohort. This retrospective study included all patients that received >6 mg/kg/day of daptomycin along with statins and had efficacy and safety data. Patients on high dose (>6 mg/kg/day) daptomycin therapy that did not received statins served as controls. One hundred four patients were included. Median daptomycin dose was 7.8 mg/kg/day (range 6.5-10.8 mg/kg/day), for a mean duration of therapy of 17 days (range 10-51 days). Thirty-six patients received daptomycin and statins and 68 received only daptomycin. Muscular toxicity defined as CPK levels>1000 UI/L (2.5 times upper normal limit, range of determination 200-400 UI/L) was equally distributed between both groups (3/36, 8% vs 7/68, 10%; p=0.746). Despite biochemical toxicity, we did not find clinical toxicity and daptomycin treatment was completed in all cases. We did not find predictors of increased CPK during daptomycin therapy. Based on our data, concomitant administration of daptomycin and statins is safe and is not associated with an increased risk of rhabdomyolysis.European Journal of Clinical Microbiology 12/2011; 31(8):1771-4. · 2.86 Impact Factor -
Article: Clinical spectrum of fever of intermediate duration in the south of Spain.
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ABSTRACT: Fever of intermediate duration (FID) is a new nosologic entity defined as fever higher than 38 degrees C that has a duration of between 1 and 4 weeks and that after an initial approach has not been diagnosed. It has clinical similarities with fever of unknown origin, but because of characteristic etiologies it requires the term FID. We describe the clinical characteristics and etiology of FID in the south of Spain and create a treatment algorithm. Retrospective study of the medical charts of patients attending at our Service during 2000 and 2005 who had an initial diagnosis of FID and who had a complete follow-up until the resolution of symptoms. Two hundred and thirty-three patients met the inclusion criteria, of whom 164 were men. Median number of days before being referred to our service was 9 (range 2-28). Half of the patients had elevation of transaminases, and CRP and ESR were slightly elevated, 2.8 mg/dl (range 0.1-50) and 16 mm/h (range 1-131) respectively. A final diagnosis was made in 80 patients, with infection with coxiella (32 patients), CMV (16 patients), rickettsial species (11 patients), VEB virus (6 patients), and brucella (5 patients) being the more frequent entities. Doxycycline was the antibiotic most frequently prescribed. Among patients with Q fever, CMV, and rickettsial infection, the majority had abnormal hepatic function, (87%, 93%, and 55% respectively). In FID, a diagnosis is reached in a minority of patients, although the prognosis is excellent in most of them. In our patients the clinical picture of Q fever, CMV, and rickettsial infections included abnormal hepatic function. In addition, these three infections are the most frequently diagnosed so when treating a patient with FID, if elevation of liver enzymes is present patients should start on doxycycline.European Journal of Clinical Microbiology 07/2008; 27(10):993-5. · 2.86 Impact Factor -
Article: Septic arthritis due to Absidia corymbifera in a patient with HIV-1 infection.
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ABSTRACT: We report the first case described of septic arthritis caused by Absidia corymbifera in the setting of cellular immune deficiency associated with HIV-1 infection. Isolation of this organism from sterile fluids as synovial fluid should be regarded as pathogenic.Infection 07/2008; 36(3):279-81. · 2.66 Impact Factor -
Article: [Papulonecrotic cutaneous lesions in both elbows, polyarthralgias, sinusitis and renal insufficiency].
Revista Clínica Española 08/2005; 205(7):354, 356-7. · 2.01 Impact Factor -
Article: Knowledge of post-exposure prophylaxis inadequate despite published guidelines.
European Journal of Clinical Microbiology 01/2005; 23(12):930-1. · 2.86 Impact Factor -
Article: [Methotrexate in the treatment of autoimmune hepatitis].
Gastroenterología y Hepatología 06/2004; 27(5):344-5. · 0.73 Impact Factor -
Article: Antimicrobials in the treatment of orthopaedic prosthetic infections.
Journal of Antimicrobial Chemotherapy 06/2004; 53(5):886-7; author reply 887. · 5.07 Impact Factor -
Article: Inflammatory pseudotumor of lymph nodes with focal infiltration in liver and spleen.
Digestive Diseases and Sciences 11/2003; 48(10):2003-4. · 2.12 Impact Factor -
Article: Stroke prevention. Should we use perindopril?
Journal of Neurology 10/2003; 250(9):1124; author reply 1125-6. · 3.47 Impact Factor -
Article: CASE REPORT: Inflammatory Pseudotumor of Lymph Nodes with Focal Infiltration in Liver and Spleen
Digestive Diseases and Sciences 09/2003; 48(10):2003-2004. · 2.12 Impact Factor -
Article: [Subcapsular hematoma as complication of percutaneous hepatic biopsy].
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 11/2002; 94(10):634-5. · 1.55 Impact Factor -
Article: [Dermatitis in a patient with chronic myeloid leukemia].
Revista Clínica Española 05/2002; 202(4):235-6. · 2.01 Impact Factor -
Article: [Subcutaneous sarcoidosis with bracelet GA-67 uptake].
Revista Clínica Española 07/2001; 201(6):347-8. · 2.01 Impact Factor -
Article: [Prescription of generic pharmaceutic specialties in discharge reports at a university hospital].
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ABSTRACT: The use of generic pharmaceutic specialities (GPS) has risen lately as a necessary tool in the control of sanitary expenses. This use is becoming of high importance, even in the non-medical media. Our aim was to stablish its use profile in patients discharged from a University Hospital. MATERIAL and To analyse the use of GPS in 256 discharge reports, randomly chosen from the Clinical Documentation Service, belonging to eight different Units for two months (June-July 2000). A total of 1233 prescriptions were reported. Among them, there was an equivalent generic drug to the medication prescribed in 220 cases (18%), but only in five ocasions one of them was indicated (2.2%). The cost of the drugs with an equivalent form in GPS was calculated in 707,521 pts. This cost could have been reduced to 505,865 pts. taking into account the average price of the GPS. In case of indicating the cheapest one, the cost could have been 479,672 pts. There is an important proportion of GPS to indicate as an alternative to the usual medicaments prescribed. However, nowadays, the GPS prescription is not a usual practice among the hospital physicians.Medicina Clínica 04/2001; 116(11):416-7. · 1.38 Impact Factor
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Institutions
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2001–2012
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Hospital Universitario San Cecilio
Granada, Andalusia, Spain
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