Background: Pharmacokinetic nomograms, equations, and software are considered the main tools available for Therapeutic Drug Monitoring (TDM). Model-informed precision dosing (MIPD) is an advanced discipline of TDM that allows dose individualization, and requires a software for knowledge integration and statistical calculations. Due to its precision and extensive applicability, the use of these software is widespread in clinical practice. However, the currently available evidence on these tools remains scarce. Objectives: To review and summarize the available evidence on MIPD software tools to facilitate its identification, evaluation, and selection by users. Methods: An electronic literature search was conducted in MEDLINE, EMBASE, OpenAIRE, and BASE before July 2022. The PRISMA-ScR was applied. The main inclusion criteria were studies focused on developing software for use in clinical practice, research, or modelling. Results: Twenty-eight software were classified as MIPD software. Nine are currently unavailable. The remaining 19 software were described in depth. It is noteworthy that all MIPD software used Bayesian statistical methods to estimate drug exposure and all provided a population model by default, except NONMEN. Conclusions: Pharmacokinetic software have become relevant tools for TDM. MIPD software have been compared, facilitating its selection for use in clinical practice. However, it would be interesting to standardize the quality and validate the software tools.

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Objective: Given the increasing use of outpatient parenteral antimicrobial therapy (OPAT) and the clinical challenges posed by Pseudomonas aeruginosa infections, this study aimed to evaluate the effectiveness and safety of OPAT for the treatment of P. aeruginosa infections in a real-world cohort. Methods: We conducted a prospective observational study with retrospective analysis including adult patients with P. aeruginosa infections treated within a multidisciplinary OPAT program shared by two tertiary hospitals between November 2012 and December 2024. Clinical characteristics, infection type, antimicrobial therapy, resistance patterns, source control, and clinical outcomes were recorded. Primary outcomes were treatment failure during OPAT and within 30 days after OPAT completion. Secondary outcomes included adverse events and vascular access complications. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with treatment failure. Results: A total of 290 patients were included. The most frequent infections were bronchiectasis exacerbations (39.7%) and complicated urinary tract infections (15.2%). Most patients received monotherapy (72.8%), mainly ceftazidime, while 27.2% received combination therapy with a beta-lactam plus an aminoglycoside. Treatment failure occurred in 7.6% of patients during OPAT and in 15.5% within 30 days after OPAT completion, with an overall clinical success rate of 77%. Male sex and chronic obstructive pulmonary disease (COPD) were independently associated with failure during OPAT. At 30 days, higher Charlson comorbidity index, COPD exacerbation, and endovascular infection were associated with failure, whereas combination therapy was associated with a lower risk of failure. Antimicrobial-related adverse events were rare (3.2%). Conclusions: Our results support OPAT as an effective and safe strategy for managing P. aeruginosa infections in clinically stable patients. Patients with COPD, either as a comorbidity or during an exacerbation, and those with a higher Charlson score may require closer follow-up.

Background/Objectives: Medication reconciliation is an essential strategy to improve patient safety, especially in polymedicated and chronic patients undergoing surgery. This study describes the implementation of an electronic medication reconciliation tool, ConciliaMed, in a multidisciplinary medication reconciliation programme performed for patients undergoing elective surgery and assesses user satisfaction with the tool since its release. Methods: A prospective observational study was carried out on “high-risk” patients undergoing colorectal surgery. In the medication reconciliation programme, ConciliaMed was mainly used to obtain an optimised and reconciled patient medication list by using the “Perioperative medication reconciliation” and the “Therapeutics equivalents” modules included in the tool. Data were registered about the reconciled medications, medication discrepancies and interventions made to optimise the reconciled medication list. Concerning the users’ satisfaction analysis, data about users’ registration and feedback were collected. Results: Seventy-three patients were enrolled in this study who were mainly polymedicated. A 10.1% of medication discrepancies were identified from the total of 553 reconciled drugs. The pharmacotherapeutic groups most involved in medication discrepancies were psycholeptics or diuretics. Regarding the optimisation of the reconciled drugs, stopping medication before surgery was the most frequent recommendation provided by the tool. According to the results of the satisfaction surveys, high overall satisfaction with the tool (4.45 ± 0.80) was reported by users. Conclusions: Stopping medication before surgery was the most common preoperative medication management recommendation provided by the tool. ConciliaMed was evaluated by pharmacists, nurses and physicians who reported a high level of satisfaction with the tool. A more comprehensive evaluation of this tool in other types of scheduled surgical patients is expected.