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Objective: To review the pharmacologic properties of and uses for the most commonly prescribed antiviral agents. Data Sources: A MEDLINE/PubMed search (1966–September 2010) was conducted for English-language articles using the terms HIV, hepatitis, cytomegalovirus (CMV), herpes simplex virus (HSV), antiviral agents, antiretroviral agent, acyclovir, valganciclovir, valacyclovir, interferon, ribavirin, ritonavir, efavirenz, zidovudine, darunavir, lopinavir, tenofovir, raltegravir, lamivudine, atazanavir, and emtricitabine. Book chapters and recent guidelines pertaining to the pathophysiology or pharmacologic properties of antiviral agents were also reviewed. Study Selection and Data Extraction: Articles, chapters, and guidelines pertaining to the relevant pharmacologic agents were collected for review. Data Synthesis: Viral pathogens affect multiple organs, causing direct and indirect damage by activating an immune response. Unlike bacterial infections, which can be eradicated from the host system, viral infections are not curable. Antiviral treatments are prescribed to reduce morbidity and mortality. There are many antiviral and more than 20 antiretroviral agents currently approved by the FDA. These include acyclovir, valacyclovir, and famciclovir for HSV; ganciclovir, valganciclovir, foscarnet, and cidofovir for CMV; interferon and ribavirin for hepatitis; efavirenz, tenofovir, emtricitabine, atazanavir, darunavir, lopinavir, ritonavir, raltegravir, zidovudine, and lamivudine as first-line agents for HIV. Conclusions: Viral illnesses affect a large portion of the population. Given the multitude of drugs available, pharmacists and pharmacy technicians should be educated about common treatment options. Having a strong knowledge of commonly prescribed antiviral drugs allows these frontline professionals to make a significant impact on the quality of care that they provide to their patients and community.

Objective. To implement an antimicrobial stewardship (AS) elective course for second-year and third-year pharmacy students and to assess its impact on students’ perceptions regarding the application of AS principles.Design. A 2-credit elective course focusing on principles of AS incorporated prelecture didactic recordings with primary literature and guideline-based reading assignments, in-class active-learning group work and student-led presentations, and student-generated examination items.Assessment. Perceptions were assessed by precourse and postcourse survey items. Graded course assessments included completion of preclass assignments (readings, prerecorded lecture and writing assessment items), in-class active participation and group presentations, a midpoint examination, and a final examination.Conclusion. An AS-themed elective course in a doctor of pharmacy curriculum incorporating preclass, self-directed learning and in-class group-based active-learning strategies positively impacted students’ perc...

Introduction: Vancomycin remains the mainstay in the treatment of meticillin‐resistant Staphylococcus aureus (MRSA) bacteraemia; however, concerns exist about its continued efficacy in the presence of rising MICs. Daptomycin serves as an alternative but has also witnessed increases in reduced susceptibility. Several published case reports have demonstrated the potential utility of ceftaroline as a viable therapeutic option for invasive MRSA infections, including endocarditis. Case presentation: A 23‐year‐old pregnant female presented with complaints of foot pain and fevers up to 104 °F. Her past medical history included polysubstance abuse, hepatitis C, intravenous drug use and a right arm abscess 2 years ago due to MRSA. Daptomycin was started empirically due to an allergy (angioedema) to vancomycin. Blood cultures returned positive for MRSA and remained persistently positive for 10 days at which point ceftaroline was added. Subsequent positive blood cultures on day 12 revealed daptomycin‐non‐susceptible MRSA at an MIC of 4 µg ml–1. Consequently, daptomycin was discontinued and gentamicin was added. Blood cultures were negative by day 14 and the patient completed a total of 2 weeks of gentamicin and 4 weeks of ceftaroline after the first negative blood culture. The baby was born premature at 34 weeks and 2 days due to complications of pregnancy; however, no adverse effects of antimicrobial therapy were noted. Conclusion: We describe the emergence of daptomycin‐non‐susceptibility during treatment and the successful eradication of persistent daptomycin‐non‐susceptible MRSA bacteraemia and endocarditis with a combination of ceftaroline and gentamicin in a pregnant female.

Purpose The mechanism of action, pharmacokinetics, pharmacodynamics, and clinical efficacy and safety of an investigational second-generation oxazolidinone are reviewed. Summary Tedizolid is a protein synthesis inhibitor in clinical development for the treatment of gram-positive infections. Similar to linezolid, tedizolid works by binding to the 23S ribosomal RNA of the 50S subunit, thereby preventing the formation of the 70S initiation complex and inhibiting protein synthesis. Tedizolid has demonstrated potent in vitro activity against multidrug-resistant gram-positive bacteria such as methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae , and vancomycin-resistant enterococci (VRE), including some linezolid-resistant strains. Tedizolid has a favorable pharmacokinetic profile that allows for once-daily dosing and easy i.v.-to-oral conversion. Unlike linezolid, tedizolid has not been shown to interact with serotonergic agents in clinical studies. Two Phase III studies in patients with acute bacterial skin and skin structure infections have demonstrated the noninferiority of 6 days of tedizolid therapy (200 mg i.v. or orally once daily) relative to 10 days of linezolid therapy. In clinical trials to date, overall rates of treatment-related adverse effects with linezolid and tedizolid were comparable (40.8% versus 43.3%), with nausea being the most commonly reported adverse effect associated with tedizolid use (16% of patients). Planned studies will investigate tedizolid’s potential role in the treatment of community-acquired bacterial pneumonia, hospital-acquired/ventilator-associated bacterial pneumonia, and bacteremia. Conclusion Tedizolid is an investigational oxazolidinone antibiotic for the treatment of multidrug-resistant gram-positive pathogens such as MRSA, Streptococcus pneumoniae , and VRE, including some linezolid-resistant strains.