Nuestros investigadores

Irene Aquerreta González

Publicaciones científicas más recientes (desde 2010)

Autores: Aquerreta, Irene; Idoate, Antonio Joaquín; et al.
ISSN 2047-9956  Vol. 26  Nº 1  2019  págs. 33 - 38
Objective Electronic alert systems have shown their capacity for improving the detection of acute kidney injury (AKI). The aim of this study was to design and implement a clinical decision support system (CDSS) for improving drug selection and reducing nephrotoxic drug use in patients with AKI. Methods The study was designed as an intervention study comparing a pre and post cohort of patients admitted during April 2014 and April 2015, respectively (phase I and phase II). The intervention was a CDSS which provided kidney function and nephrotoxic drug information. Furthermore, an interruptive alert was designed to detect patients suffering an AKI event while taking a nephrotoxic drug and to see if the dose was then reduced or the drug was discontinued by the physicians. Results One-third of the inpatients were included in the analysis because they met the inclusion criteria (1004 and 1002 patients in phases I and II, respectively). 735 and 761 of them received at least one nephrotoxic alert (73% vs 76%; p=0.763). 65 and 88 patients suffered AKI during admission (6.5% vs 8.8%; p=0.051). In phase I, patients received 384 nephrotoxic alerts (55%) with 78 (20%) of them provoking a change or discontinuation of the nephrotoxic drug. In phase II this value increased to 154 out of 526 (29%) after implementation of the CDSS (p<0.01). Conclusions A CDSS with interruptive alerts that inform of the development of AKI in real time in patients with nephrotoxic drug prescription has a positive impact on the judicious use of these drugs.
Autores: Leache, Leire; Aquerreta, Irene; Aldaz, Azucena; et al.
ISSN 0934-9723  Vol. 37  Nº 5  2018  págs. 799-822
The purpose of this paper was to review the literature regarding the clinical and economic impact of pharmacist interventions (PIs) related to antimicrobials in the hospital setting. A PubMed literature search from January 2003 to March 2016 was conducted using the terms pharmacist* or clinical pharmacist* combined with antimicrobial* or antibiotic* or anti-infective*. Comparative studies that assessed the clinical and/or economic impact of PIs on antimicrobials in the hospital setting were reviewed. Outcomes were classified as: treatment-related outcomes (TROs), clinical outcomes (COs), cost and microbiological outcomes (MOs). Acceptance of pharmacist recommendations by physicians was collected. PIs were grouped into patient-specific recommendations (PSRs), policy, and education. Studies' risk of bias was analyzed using Cochrane's tool. Twenty-three studies were evaluated. All of them had high risk of bias. The design in most cases was uncontrolled before and after. PSRs were included in every study; five also included policy and four education. Significant impact of PI was found in 14 of the 18 studies (77.8%) that evaluated costs, 15 of the 20 studies (75.0%) that assessed TROs, 12 of the 22 studies (54.5%) that analyzed COs, and one of the two studies (50.0%) that evaluated MOs. None of the studies found significant negative impact of PIs. It could not be concluded that adding other strategies to PSRs would improve results. Acceptance of recommendations varied from 70 to 97.5%. Pharmacists improve TROs and COs, and decrease costs. Additional research with a lower risk of bias is unlikely to change this conclusion. Future research should focus on identifying the most efficient interventions.
Autores: Aquerreta, Irene; et al.
ISSN 0939-9437  Vol. 25  Nº 6  2017  págs. 292 - 297
Non-vitamin K oral antagonists are being increasingly used. However, broad clinical experience with them is lacking. Objectives To review guidelines and evidence for the use of non-vitamin K oral antagonists in the periprocedural environment. Results Despite the clear advantages of vitamin K oral antagonists, their use can entail risks owing to the scarcity of reversal agents. Consensus has been reached about postoperative resumption, which is recommended at 24 hours and 48-72 hours, respectively, after low-risk and high-risk bleeding surgery. Bridging with heparin is recommended in patients with a high risk of thrombosis. Urgent interventions should ideally take place 24 hours after the last dose intake. Major discrepancies exist between the American and the European recommendations for neuraxial procedures. The American proposals recommend suspending the drug for five half-lives, whereas the European approaches suggest suspension of just two half-lives. Suggestions for perioperative discontinuation vary widely. Some authors recommend a longer time of resumption for patients with renal impairment. All agree that there should be an increase in the number of days of interruption in high-risk bleeding procedures versus low-risk bleeding procedures. Conclusions A diverse number of approaches have been suggested for perioperative management of novel oral antagonists. American recommendations tend to be more rigorous than those of Europe. A need for more studies that measure health outcomes after the use of these drugs would be indispensable.
Autores:  et al.
ISSN 1130-6343  Vol. 41  Nº 5  2017  págs. 651-658
Autores: Leyre Leache Alegria; Aquerreta, Irene; Libe Moraza; et al.
ISSN 1695-0674  Vol. 73  Nº 22  2016  págs. 1840-1843
A 52-year-old man developed tinnitus and hearing loss after receiving high doses of oral morphine sulfate. His hearing loss did not fully resolve after the discontinuation of morphine, and he required the use of hearing aids.
Autores: Leache, Leire; Aquerreta, Irene; et al.
ISSN 1130-6343  Vol. 39  Nº 6  2015  págs. 320 - 332
Objective: to determine the incidence of linezolid-induced haematological toxicity and study the influence of renal clearance on its appearance and the preventive effect of pyridoxine. Methods: a retrospective observational study was conducted. Every patient treated with linezolid in a university hospital during 6 months was included. Haematological toxicity was defined as a decrease of 25% in hemoglobin, of 25% in platelets and/or 50% in neutrophils from baseline. The incidence of haematological toxicity and the percentage decrease in analytical variables were compared in patients with and without renal failure (creatinine clearance lower than 50 mL/min), using the 30 mL/min threshold, and with or without pyridoxine; using Chi -Square and U Mann-Whitney tests, respectively. Results: thirty-eight patients were evaluated. Sixteen (42%) presented haematological toxicity (2 due to a decrease in haemoglobin, 9 in platelets and 8 in neutrophils). Two patients (5%) discontinued treatment due to thrombocytopenia. Toxicity incidence was similar in patients with and without renal failure, 42% vs 42%, p = 0.970, with more or less than 30 ml/min, 67% vs 40%, p = 0.369, or with or without pyridoxine, 47.8% vs 33%, p = 0.376. Patients with renal failure had a significantly greater reduction in platelet count, p = 0.0185. Conclusion: forty-two percent of patients had haematological toxicity, being more frequent platelets and neutrophils reduction. This was not significantly higher in patients with renal failure or in those without pyridoxine. Greater reduction in platelet count was observed in patients with renal failure.
Autores: Lucena, Juan Felipe, (Autor de correspondencia); Alegre, Félix; Rodil, Raquel; et al.
ISSN 1553-5592  Vol. 7  Nº 5  2012  págs. 411 - 415
An ImCU led by hospitalists showed encouraging results regarding patient survival and SAPS II is an useful tool for prognostic evaluation in this population. Intermediate care serves as an expansion of role for hospitalists; and clinicians, trainees and patients may benefit from co-management and teaching opportunities at this unique level of care.
Autores: Yuste, JR; López, Luis Alberto; Aquerreta, Irene; et al.
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica
2018  págs. 7
Autores: Aquerreta, Irene; Yuste, JR;
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica
2018  págs. 56 - 134
Autores: Aquerreta, Irene; Yuste, JR;
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica. 2ª ed
Nº Capítulo 4  2015  págs. 42-78
Autores: Yuste, JR; Aquerreta, Irene;
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica. 2ª ed
Nº Capítulo 1  2015  págs. 9-33
Autores: Yuste, JR; Aquerreta, Irene;
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica. 1ª ed
Nº Capítulo 1  2013  págs. 7-24
Autores: Aquerreta, Irene; Serrano-Alonso, M; Yuste, JR;
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica. 1ª ed
Nº Capítulo 4  2013  págs. 31-54