What are the safest and most effective alternatives to meperidine for treating post-operative shivering and rigors with amphotericin?

Background

It is unknown what institutions have implemented protocols that require indications on outpatient prescriptions for antimicrobials to improve stewardship metrics. Additionally, a comprehensive literature search was unable to identify data evaluating the impact of requiring indications for outpatient antimicrobial prescriptions on antimicrobial stewardship metrics. Accurately identifying the fulfillment of diagnostic criteria with the recognition of indications for treatment with antimicrobials is an essential component of antimicrobial stewardship in the outpatient setting, but it is unknown how this strategy affects institutional metrics. Notably, data in the inpatient setting has observed improved antibiotic prescribing practices when providers are required to include an indication.

It is unknown what institutions have implemented protocols that require indications on outpatient prescriptions for antimicrobials to improve stewardship metrics. Additionally, a comprehensive literature search was unable to identify data evaluating the impact of requiring indications for outpatient antimicrobial prescriptions on antimicrobial stewardship metrics. Accurately identifying the fulfillment of diagnostic criteria with the recognition of indications for treatment with antimicrobials is an essential component of antimicrobial stewardship in the outpatient setting, but it is unknown how this strategy affects institutional metrics. Notably, data in the inpatient setting has observed improved antibiotic prescribing practices when providers are required to include an indication.

It is unknown what institutions have implemented protocols that require indications on outpatient prescriptions for antimicrobials to improve stewardship metrics. Additionally, a comprehensive literature search was unable to identify data evaluating the impact of requiring indications for outpatient antimicrobial prescriptions on antimicrobial stewardship metrics. Accurately identifying the fulfillment of diagnostic criteria with the recognition of indications for treatment with antimicrobials is an essential component of antimicrobial stewardship in the outpatient setting, but it is unknown how this strategy affects institutional metrics. Notably, data in the inpatient setting has observed improved antibiotic prescribing practices when providers are required to include an indication.

It is unknown what institutions have implemented protocols that require indications on outpatient prescriptions for antimicrobials to improve stewardship metrics. Additionally, a comprehensive literature search was unable to identify data evaluating the impact of requiring indications for outpatient antimicrobial prescriptions on antimicrobial stewardship metrics. Accurately identifying the fulfillment of diagnostic criteria with the recognition of indications for treatment with antimicrobials is an essential component of antimicrobial stewardship in the outpatient setting, but it is unknown how this strategy affects institutional metrics. Notably, data in the inpatient setting has observed improved antibiotic prescribing practices when providers are required to include an indication.

Relevant Prescribing Information

It is unknown what institutions have implemented protocols that require indications on outpatient prescriptions for antimicrobials to improve stewardship metrics. Additionally, a comprehensive literature search was unable to identify data evaluating the impact of requiring indications for outpatient antimicrobial prescriptions on antimicrobial stewardship metrics. Accurately identifying the fulfillment of diagnostic criteria with the recognition of indications for treatment with antimicrobials is an essential component of antimicrobial stewardship in the outpatient setting, but it is unknown how this strategy affects institutional metrics. Notably, data in the inpatient setting has observed improved antibiotic prescribing practices when providers are required to include an indication.

Literature Review

A search of the published medical literature revealed 1 study investigating the researchable question:

What are the safest and most effective alternatives to meperidine for treating post-operative shivering and rigors with amphotericin?

Level of evidence

C - Multiple studies with limitations or conflicting results  Read more→


Please see Table 1 for your response.

 

Enter title in bold, with all first words capitalized, and without a reference number

Design

Objective terms describing the type of study (randomized, uncontrolled, retrospective, placebo-controlled, cross-over, etc.); N= (total subjects)

Objective

State the objective (purpose) of the study using the author’s language(usually beginning with “To” and without a period, assuming a non-complete sentence)

Study Groups

Only the separate groups and their cohort number (n) should be listed. You can describe more details of the cohorts in the methods section so this section can stay very succinct.

Inclusion Criteria

Include relevant inclusion criteria (not a comprehensive list).

Exclusion Criteria

Include relevant exclusion criteria (not a comprehensive list).

Methods

This is our most important section. Data collection and any other information needed to understand the results is presented. Any loose ends from all other sections are tied up here, as concisely as possible.

Duration

Include the duration of the trial as a whole, as well as the duration of the interventions.

Outcome Measures

If the primary outcome measure isn’t explicit from the study, all outcome measures applicable to the inquiry can be listed in this section. If the primary outcome measure is explicit, then make separate sections for ‘Primary’ and ‘Secondary’ Outcome Measures.  


All outcome measures listed should correlate directly/exactly with the results presented later.

Baseline Characteristics

  

A

B

  

Age, years

      

Female

     

White

      

---

     

Include relevant baseline characteristics that will provide a general (big picture) view of the patients in the study.

Results

Endpoint

A

B

p-Value

----

      

----

      

All results listed should correlate directly/exactly with the outcome measures presented previously.Results that do not have to do with the inquiry should not be included; just the stated outcomes need corresponding results.


Tables are encouraged to display the most info using the least space/words.

Adverse Events

Common Adverse Events: (or those deemed frequent; if not listed in study, use N/A or “Not disclosed”)

Serious Adverse Events: (or those deemed high risk; if not listed in study, use N/A or “Not disclosed”)

Percentage that Discontinued due to Adverse Events: (if not listed in study, use N/A or “Not disclosed”)

Study Author Conclusions

Copy and paste the author’s conclusions on the question at hand, using full sentences. Don’t include any conclusions that don’t correspond to results we list.

InpharmD Researcher Critique

As the expert, add 1-2 sentences on strengths, weaknesses, and takeaways from this study. Focus on insight as “more research is needed” is obvious.



Table 1 References:
[5] Verrill M, Declerck P, Loibl S, Lee J, Cortes J. Future Oncol. 2019 Oct;15(28):3255-3265. doi:10.2217/fon-2019-0145
[6] Kirchhoff CF, Wang XM, Conlon HD, Anderson S, Ryan AM, Bose A. Biotechnol Bioeng. 2017 Dec;114(12):2696-2705. doi:10.1002/bit.26438