Marc Scheetz | Midwestern University (original) (raw)

Papers by Marc Scheetz

Clinical Transplantation, 2013

Cyclosporine (CSA) is an immunosuppressant used for the prevention of graft rejection and graft-v... more Cyclosporine (CSA) is an immunosuppressant used for the prevention of graft rejection and graft-versus-host disease (GVHD) during hematopoietic stem cell transplantation. Therapeutic drug monitoring (TDM) is recommended to ensure efficacy and prevent toxicity. Several immunoassay assay are commercially available for measuring CSA drug concentrations. Differences in the cross-reactive metabolites measured by specific immunoassay tests contribute to the significant lack of specificity which has been reported between immunoassays and high performance liquid chromatography (HPLC) test results. Inter-assay test results can affect interpretation of CSA drug concentrations and potentially compromise patient outcomes. The current study analyzed 72 paired HPLC-monoclonal TDX (TDXm) CSA drug concentrations and calculated a clinically reliable correction factor which could be applied to HPLC-TDXm results for TDM. A unique concordance-discordance simulation model was utilized to validate the correction factor for clinical use.

Annals of Pharmacotherapy, 2010

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American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2015

A program to promote research by pharmacy students created through the collaboration of an academ... more A program to promote research by pharmacy students created through the collaboration of an academic medical center and a college of pharmacy is described. In 2009, Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital (NMH) expanded their existing partnership by establishing a program to increase opportunities for pharmacy students to conduct clinical-translational research. All professional year 1, 2, or 3 students at the college, as well as professional year 4 students on rotation at NMH, can participate in the program. Central to the program's infrastructure is the mentorship of student leads by faculty- and hospital-based pharmacists. The mentors oversee the student research projects and guide development of poster presentations; student leads mentor junior students and assist with orientation and training activities. Publication of research findings in the peer-reviewed literature is a key program goal. In the first four years after program im...

Journal of Pharmacy and Pharmacology, 2015

Centhaquin citrate is a novel agent being developed for use in the treatment of haemorrhagic shoc... more Centhaquin citrate is a novel agent being developed for use in the treatment of haemorrhagic shock. It has decreased mortality in rat, rabbit and pig models of hypovolaemic shock compared to hypertonic saline and lactated Ringer's resuscitation. The pharmacokinetics of centhaquin citrate have not been described to date. Sixteen male Sprague Dawley rats were given an intravenous bolus of 0.45 mg/kg centhaquin citrate. Rats were divided into two groups; plasma concentrations were measured at five time points for each group within 24 h after administration. Competing compartmental pharmacokinetic models were assessed. The nonparametric adaptive grid function within the Pmetrics package for R was used for parameter estimation. Predicted concentrations were calculated using population median and individual Bayesian posterior parameters. A two-compartment model of centhaquin citrate best fit the data. Median (IQR) values for elimination coefficient (Ke ), volume of distribution (V) and intercompartmental transfer rates (Kcp, Kpc ) were 8.8 (5.2-12.8) h(-1) , 6.4 (2.8-10.4) l, 11.9 (4.6-15.0) h(-1) and 3.7 (2.3-9.1) h(-1) , respectively. This is the first report of the pharmacokinetic parameters of centhaquin citrate in a rat model. Centhaquin citrate was found to have a short half-life with a large volume of distribution.

Hospital Pharmacy, 2010

... The Impact of Qualitative Respiratory Cultures on Mortality in Critically Ill Patients With H... more ... The Impact of Qualitative Respiratory Cultures on Mortality in Critically Ill Patients With Hospital-Acquired Pneumonia Sarah R. Peppard, PharmDp; Marc H. Scheetz, PharmD, MSc; Michael J. Postelnick, RPh; and Kristin M. Darin, PharmD{ ...

Background: Optimal therapy for bloodstream infection (BSI) with VRE is unknown; however, D or L ... more Background: Optimal therapy for bloodstream infection (BSI) with VRE is unknown; however, D or L are frequently used. This study examined outcomes in patients treated with D or L for VRE BSI. Methods: A multicenter, retrospective, cohort study was performed. Hospitalized patients treated for VRE BSI ( > 2 positive blood cultures) with D or L from 9/1/03 - 6/30/07 were identified with pharmacy and microbiology records. Bivariate and multivariate analyses were performed to determine the effect of drug selection on mortality and duration of BSI while controlling for covariates. Results: One-hundred and one VRE BSI cases were identified (67 D and 34 L). Baseline characteristics were similar in D- and L-treated patients except shock (p=0.049), prior vancomycin therapy (p=0.002) and prior linezolid therapy (p < 0.001) which occurred more frequently in patients receiving D. Inpatient mortality occurred in 31 (46.3%) of D-treated patients and 10 (29.4%) L-treated patients (p=0.10). Li...

Purpose: Computerized clinical decision support systems (CDSS) have improved the breadth and scop... more Purpose: Computerized clinical decision support systems (CDSS) have improved the breadth and scope of Antimicrobial Stewardship Teams (ASTs). The cost-effectiveness of ASTs using CDSS to optimize treatment for clinically significant bacteremias is explored. Methods: A model was constructed to compare the costs and outcomes of bacteremic patients receiving standard treatment versus standard treatment plus an AST consult utilizing CDSS. Patients were followed during the hospital admission of the bacteremic event, and Quality-Adjusted Life Years (QALYs) were estimated for total patient life using national life expectancy data. Model parameters and costs, along with their distributions, were obtained from the literature and were estimated by experts when unavailable. Incremental cost-effectiveness ratios (ICER) were calculated to estimate the cost per QALY gained from the hospital perspective. Probabilistic sensitivity analyses were conducted using Monte Carlo simulations to estimate th...

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, Jan 20, 2015

Obese patients display differences in vancomycin drug disposition, which may complicate attainmen... more Obese patients display differences in vancomycin drug disposition, which may complicate attainment of appropriate serum vancomycin concentrations (SVCs). This study was conducted to determine if obesity leads to trough SVCs above the therapeutic range. This retrospective cohort study sought to determine the rate and predictors of high (i.e. >20 mg/L) serum trough levels according to level of obesity. Increasing BMI predicted SVCs > 20 mg/L after controlling for dose, age, and serum creatinine. Obese patients had significantly higher mean trough SVCs compared to non-obese patients (16.5 mg/L vs 12.1 mg/L, p = 0.004) and a significantly higher proportion of obese patients had trough SVCs > 20 mg/L (18.9% vs 4.2%, p = 0.03). Increasing obesity predicted higher probabilities of SVCs > 20 mg/L. Development of alternative dosing and management strategies for vancomycin may be necessary to account for pharmacokinetic changes associated with obesity.

Diagnostic microbiology and infectious disease, Jan 10, 2015

Predicted and observed failures at higher cefepime MICs have prompted the Clinical and Laboratori... more Predicted and observed failures at higher cefepime MICs have prompted the Clinical and Laboratories Standards Institute (CLSI) to lower the susceptible breakpoint for Enterobacteriaceae to ≤2mg/L, with dose-dependent susceptibility at 4-8mg/L, while the susceptibility breakpoint for nonfermentative organisms remain unchanged at ≥8mg/L. The contribution of increasing cefepime MIC to mortality risk in the setting of aggressive cefepime dosing is not well defined. Patients who were treated with cefepime for Gram-negative blood stream infections (GNBSIs), including both Enterobacteriaceae and nonfermentative organisms, were screened for inclusion in this retrospective cohort study. Demographic and microbiologic variables were collected, including pathogen, cefepime MIC, dosage, and interval. The objective was to define a risk-adjusted mortality breakpoint for cefepime MICs. Secondarily, we looked at time to death and length of stay (LOS) postculture. Ninety-one patients were included in...

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2014

The results of a national study of projected versus actual times to resolution of temporary U.S. ... more The results of a national study of projected versus actual times to resolution of temporary U.S. shortages of antiinfective drugs are presented. Descriptive data on antiinfective drug shortages, including differences between manufacturer-estimated and actual times to shortage resolution, were collected over a one-year period via regular monitoring of the websites of ASHP and the Food and Drug Administration. Inventory data from one large hospital in the Midwest were collected in order to characterize realized shortages (i.e., those for which mitigation was required). During the study period, there were 47 transient shortages of antiinfective medications involving 381 unique products or formulations, of which 40% (n = 19) were emergent shortages. Generic-only and brand-only medications accounted for 53% (n = 25) and 21% (n = 10) of the evaluated shortages, respectively; the median shortage duration was 40 days (interquartile range [IQR], 22-91 days). The reasons for shortages most fr...

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Jan 15, 2014

Journal of managed care pharmacy : JMCP

Drug shortages pose a serious challenge for health care institutions, often interfering with pati... more Drug shortages pose a serious challenge for health care institutions, often interfering with patient care. A common practice during a drug shortage is to select an alternate therapeutic; however, these agents often present challenges and may create safety concerns. Patient harms including adverse events and medication errors may occur. Patients may also file complaints because of drug shortages. To measure the effect of drug shortages on patient outcomes, clinical pharmacy operations, patient complaints, and institutional cost. An e-mail link to an online survey was sent to pharmacy director members in the MedAssets Pharmacy Group Purchasing Organization. Data were collected within a 3-week period from October 2-23, 2012. The survey focused on 6 different domains: demographics, adverse events, medication errors, patient outcomes, patient complaints, and institutional cost. The survey was sent to 1,516 directors of pharmacy. There were 193 respondents (response rate 13%) who particip...

Infectious Diseases and Therapy, 2014