Witenko, Corey J.

OBJECTIVES: A number of trials related to critical care pharmacotherapy were published in 2022. We aimed to summarize the most influential publications related to the pharmacotherapeutic care of critically ill patients in 2022. DATA SOURCES: PubMed/Medical Literature Analysis and Retrieval System Online and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update. STUDY SELECTION: Randomized controlled trials, prospective studies, or systematic review/meta-analyses of adult critically ill patients assessing a pharmacotherapeutic intervention and reporting clinical endpoints published between January 1, 2022, and December 31, 2022, were included in this article. DATA EXTRACTION: Articles from a systematic search and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update were included and stratified into clinical domains based upon consistent themes. Consensus was obtained on the most influential publication within each clinical domain utilizing an a priori defined three-round modified Delphi process with the following considerations: 1) overall contribution to scientific knowledge and 2) novelty to the literature. DATA SYNTHESIS: The systematic search and Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update yielded a total of 704 articles, of which 660 were excluded. The remaining 44 articles were stratified into the following clinical domains: emergency/neurology, cardiovascular, gastroenterology/fluids/nutrition, hematology, infectious diseases/immunomodulation, and endocrine/metabolic. The final article selected from each clinical domain was summarized following a three-round modified Delphi process and included three randomized controlled trials and three systematic review/meta-analyses. Article topics summarized included dexmedetomidine versus other sedatives during mechanical ventilation, beta-blocker treatment in the critically ill, restriction of IV fluids in septic shock, venous thromboembolism prophylaxis in critically ill adults, duration of antibiotic therapy for Pseudomonas aeruginosa ventilator-associated pneumonia, and low-dose methylprednisolone treatment in severe community-acquired pneumonia. CONCLUSIONS: This concise review provides a perspective on articles published in 2022 that are relevant to the pharmacotherapeutic care of critically ill patients and their potential impact on clinical practice.

AbstractIntroductionLetters of recommendation (LORs) are important in pharmacy residency applications. Applicant gender, among other variables, may result in implicit biases that could impact LORs and/or residency attainment. This study hypothesized that LORs have linguistic gender differences in pharmacy residency applications.ObjectivesThe primary objective was to determine if gender‐linguistic differences exist in applicants' LORs. Gender was assessed via the pronouns utilized within the applications. The secondary outcome was to assess LOR linguistic and demographic differences between candidates who did and did not receive interviews.MethodsThis was a multiyear, multicenter study involving postgraduate year one (PGY1) applicants to participating pharmacy residency programs. Demographic data were extracted using the PhORCAS (Pharmacy Online Residency Centralized Application Service) WebADMIT (Admissions Management System) portal, and LORs were analyzed by validated linguistics processing software.ResultsA total of 7529 LORs and 2383 applicants (28.5% men, 71.5% women) were included. Women candidates had higher mean number of awards (4.71 vs. 4.1, p = 0.001) and leadership positions (4.87 vs. 4.48, p = 0.019). Compared with men candidates, women had statistically significantly higher levels of clout (p < 0.001), positive emotion (p = 0.01), social processes (p < 0.001), prosocial behavior (p = 0.002), and social referents (p < 0.001). Women also had lower authenticity compared with men candidates (p < 0.001). Two thousand and one hundred twenty applicants included in the secondary analysis found no difference in offer to interview between women and men candidates (odds ratio [OR] 1.173 [95% confidence interval (CI) 0.895–1.57], p = 0.247).ConclusionsMen and women applicants' LORS differed in specific linguistic variables, although offer to interview was not significantly different based on gender. LOR writers and programs should consider implicit biases that could affect residency offers to interview.