Background: Detecting and managing antimicrobial drug interactions (ADIs) is one of the facets of prudent antimicrobial prescribing. Our aim is to compare the capability of several electronic drug–drug interaction (DDI) checkers to detect and report ADIs. Methods: Six electronic DDI checking platforms were evaluated: Drugs.com^®, Medscape^®, Epocrates^®, Medimecum^®, iDoctus^®, and Guía IF^®. Lexicomp^® Drug Interactions was selected as the gold standard. Ten ADIs addressing different mechanisms were evaluated with every electronic DDI checker. For each ADI, we assessed five dimensions and calculated an overall performance score (maximum possible score: 10 points). The explored dimensions were sensitivity (capability to detect ADI), clinical effect (type and severity), mechanism of interaction, recommended action(s), and documentation (quality of evidence and availability of references). Results: The electronic DDI checkers did not detect a significant proportion of the ADI assessed. The overall performance score ranged between 4.4 (Medimecum) and 8.8 (Drugs.com). Drugs.com was the highest ranked platform in four out of five dimensions (sensitivity, effect, mechanism, and recommended action). Conclusions: There is significant variability in the performance of the available platforms in detecting and assessing ADI. Although some ADI checkers have proven to be very accurate, others missed almost half of the explored interactions.

Introduction: This systematic review aimed to identify, evaluate, and critically an-alyze pharmacokinetic models of vancomycin in adult populations published in PubMed and EMBASE between 2020 and 2024. Materials and Methods: Twenty-two studies were included, describing 24 models character-ized by substantial heterogeneity in terms of study populations, methodological design, and covariate selection. Most models were developed in Asia and focused on hospitalized patients, particularly those in intensive care units (ICUs). Data from 2150 patients were analyzed, with an average of 93 patients per model. Results: The models demonstrated high variability in pharmacokinetic parameters, such as vancomycin clearance (Cl) and volume of distribution (Vd), influenced by factors, such as renal function, weight, age, and comorbidities. The meta-analysis conducted on clearance and interindividual variability in clearance (IIV Cl) revealed high heterogeneity among the ana-lyzed studies. The average vancomycin clearance was 4.23 L/h, with higher values observed in neurosurgical, oncohematologic patients, and those with increased renal function. The vol-ume of distribution showed greater variability in obese patients and those undergoing continu-ous renal replacement therapy. Creatinine clearance (ClCr) was identified as a significant co-variate in 66% of the models, while weight was significant in 33%. Other important covariates included age, sex, serum creatinine, serum urea, and the hospital admission unit. The meta-analysis of Cl and IIV Cl showed high heterogeneity among the studies, with I² values of 0.83 for Cl and 0.98 for IIV Cl, indicating substantial variability. Discussion: The limitations of this study included the diversity of the analyzed populations, which made it challenging to assess the model's suitability. While the models showed advances in precision, challenges, such as the lack of external validation and discrepancies in dosing recommendations, remain. Conclusion: This review paper has highlighted the need to validate models in diverse popula-tions and clinical settings to optimize personalized vancomycin therapy in adults. The findings have highlighted the importance of validating or adapting pharmacokinetic models to the spe-cific characteristics of each hospital population.

Dalbavancin is a lipoglycopeptide indicated for the treatment of acute bacterial skin and skin structure infections. The aim of this study is to describe the cases in which dalbavancin has been used as an off-label treatment for infections by Gram-positive microorganisms. Methods: we carried out a case report series study of all patients treated with dalbavancin as an off-label treatment from January 2017 to March 2022. Results: Dalbavancin was administered to seventeen patients. The most frequent diagnosis was osteoarticular infection in 52.94% of patients. The principal isolated microorganism was Staphylococcus epidermidis (47.00%). The posology of dalbavancin was highly variable and the median number of days of treatment was 14 (1–56). At 3 months of treatment, only two patients died for other reasons and no patient experienced reinfection. Conclusion: dalbavancin is an antibiotic with a novel dosage in infectious diseases by Gram-positive microorganisms that has proven to be highly effective, since there have been no manifested symptoms of reinfection in patients.

A retrospective comparative study was conducted to compare the efficacy of monoclonal antibody drugs against the calcitonin gene-related peptide pathway in migraine and to establish whether they can be considered equivalent therapeutic alternatives for this pathology. A total of 21 patients with chronic migraine were treated with Fremanezumab 225 mg/30 days and 24 patients treated with Erenumab 70 mg/30 days for at least 6 months. Data were collected at baseline and at six months using the following scales: Headache Impact Test (HIT), Migraine Disability Assessment Scale (MIDAS), and a numerical scale of pain intensity (0 (no pain) and 10 (unbearable pain)). Days of migraine per month were recorded. Mean HIT at baseline and 6 months for Fremanezumab and Erenumab was 68.6 (62–76) and 54 (36–70) and 66 (42–78) and 53 (9–72), respectively. In both cases, it decreased by more than 6 points (efficacy criteria). Mean MIDAS at baseline and 6 months for Fremanezumab and Erenumab was 70 (25–127) and 25 (0–135) and 73.3 (19–150) and 23 (0–68), respectively. In both cases, it decreased by more than 30% (efficacy criteria). Mean pain intensity at baseline and 6 months for Fremanezumab and Erenumab was 8.8 (6–10) and 6(5–8) and 8.6 (7–10) and 6 (10–0), respectively. Mean number of migraine days in a month at baseline and 6 months for Fremanezumab and Erenumab were 16.6 (10–30) and 5.3 (0–11) days and 17 (3–30) and 5.8(–15) days, respectively. In both cases, the reduction was > 50%. It can be concluded that the initial values of the scales are very similar. The initial situation of the patient is not a trigger for the use of one drug or the other. Clinically, there is no difference between the two drugs.