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Omaer A, Albilali A, Bamogaddam R, Almutairi F, Alsaif R, Almohammadi O, Alhifany AA. Improvement of comorbid anxiety and depression in patients with migraine treated with injectable preventive calcitonin gene-related peptide antagonists: Review of clinical evidence. Saudi Pharm J 2024; 32:101989. [PMID: 38405041 PMCID: PMC10882171 DOI: 10.1016/j.jsps.2024.101989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/07/2024] [Indexed: 02/27/2024] Open
Abstract
Background Migraine is often associated with depression and anxiety, leading to a diminished quality of life. Calcitonin gene-related peptide (CGRP) antagonists have shown promise in treating migraines, but their effects on concurrent depression and anxiety have not been clarified. Methods A literature review was conducted on ClinicalTrials.gov, PubMed, Ovid Medline, and EMBASE focusing on phase 3 clinical trials, post-hoc analysis studies, and real-world evidence (RWE) published in the past 5 years. The review primarily utilized patient-reported outcome tools, such as the Patient Health Questionnaire-9, Hamilton Depression Rating Scale, Beck Depression Inventory-II, generalized anxiety disorder (GAD)-7, and Hamilton Anxiety Rating Scale (HARS), to assess anxiety and depression in relation to CGRP-targeted monoclonal antibodies. Results Out of 260 studies, 17 met the inclusion criteria. Eptinezumab lacked sufficient evidence regarding its impact on depression and anxiety. While sufficient evidence on its effect on comorbid anxiety was not available, fremanezumab was shown to significantly improve comorbid depression in one study while not achieving statistical significance in another. Erenumab and galcanezumab showed significant improvement in comorbid depression, implying possible benefits in patients with migraine. Galcanezumab showed faster relief from depressive symptoms than other injectable CGRP antagonists. Galcanezumab also exhibited improvements in GAD-7 scores for anxiety, although not statistically significant, whereas RWE showed promising HARS scores for both galcanezumab and erenumab. Conclusions Galcanezumab and erenumab appear to be more effective in improving concurrent depressive and anxiety symptoms in migraine patients than fremanezumab. Notably, these psychometric questionnaires were not the primary outcome measures of the trials and were not specifically designed to investigate the effects of these medications on depression or anxiety. Further research is needed to fully understand the impact of CGRP antagonists on mental health disorders associated with migraines. These findings have implications for enhancing the overall well-being and quality of life in individuals with migraines and comorbid psychiatric conditions.
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Affiliation(s)
- Abubker Omaer
- Clinical Pharmacy Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Abdulrazaq Albilali
- Neurology Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reem Bamogaddam
- Clinical Pharmacy Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Fares Almutairi
- Clinical Pharmacy Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Raghad Alsaif
- Clinical Pharmacy Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Osama Almohammadi
- Pharmacy Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdullah A Alhifany
- Pharmacy Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Almutairi H, Albahadel H, Alhifany AA, Aldalbahi H, Alnezary FS, Alqusi I, Mobark MA, Saeed Almutairi M. Prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) at a maternity and children hospital in Saudi Arabia: A cross-sectional study. Saudi Pharm J 2024; 32:102001. [PMID: 38439950 PMCID: PMC10909782 DOI: 10.1016/j.jsps.2024.102001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) pathogens are considered a serious global health threat, leading to increased mortality and antimicrobial resistance. Rates in Saudi Arabia remain high, necessitating continuous surveillance. This study investigates MRSA prevalence and susceptibility at a Saudi maternity and children's hospital. Method A cross-sectional study was conducted on pediatric (<18 years) and maternal patients with S. aureus infection from Jan. 2020 to March. 2022. Bacterial strains were obtained from patient's clinical specimens and was identified by standard method. The BD Phoenix™ M50 was used for antibiotic susceptibility tests and MRSA detection. Data were analysed using descriptive and inferential statistics (Chi-square test) with SPSS software. Results Out of 152 S. aureus cases, 114/152 (75 %) were pediatric and 38/152 (25 %) were maternal patients. The overall MRSA infection was 69/152 (45.4 %). Among pediatrics, 31/54 (57.4 %) MRSA cases were female; over 30/54 (56 %) were under 1 year old; and most MRSA infections were obtained from skin 29/54 (53.7 %) compared to other sites of infections (p = 0.024). Among maternal cases, 15/38 (39.5 %) were MRSA, primarily from wound infections 14/15 (93.3 %) compared to other sites of infections (p = 0.39). All MRSA isolates were sensitive to vancomycin and linezolid. While 51/60(85 %) were sensitive to Trimethoprim/ sulfamethoxazole. Conclusion This investigation found a high prevalence of MRSA among pediatrics and maternal inpatients, indicating a significant burden. All MRSA isolates were susceptible to vancomycin but demonstrated variable sensitivity to other antibiotics. These findings highlight the need for ongoing surveillance, infection control strategies, and research into alternative treatment options to combat this major public health threat.
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Affiliation(s)
- Hadiah Almutairi
- Department of Pharmacy Practice, College of Pharmacy, University of Hafr Albatin, Saudi Arabia
| | - Heyam Albahadel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Abdullah A. Alhifany
- Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hind Aldalbahi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Faris S. Alnezary
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah 41477, Saudi Arabia
| | - Ibrahim Alqusi
- Laboratory Department, Maternity and Children Hospital in Buraydah City, Ministry of Health, Qassim, Saudi Arabia
| | - Mugahid A. Mobark
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Masaad Saeed Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
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Alnezary FS, Alzahrani F, Alatawi Y, Alhifany AA. Evaluating preceptorship during advanced pharmacy practice experiences in Saudi Arabia: A Cross-Sectional Study. Saudi Pharm J 2024; 32:101970. [PMID: 38322148 PMCID: PMC10845055 DOI: 10.1016/j.jsps.2024.101970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/26/2024] [Indexed: 02/08/2024] Open
Abstract
Introduction Doctor of Pharmacy (PharmD) programs offer students' academic coursework and Advanced Pharmacy Practice Experiences (APPEs). APPEs are crucial for students, providing hands-on training in practice settings and enhancing clinical skills and decision-making abilities. Nevertheless, successful APPEs relies mainly on preceptorship. Hence, this study aims to evaluate preceptorship during APPEs in one of the non-major cities in Saudi Arabia. Method A Cross-Sectional survey study was conducted among 40 PharmD students at Taibah University's College of Pharmacy which involved two telephone interviews conducted seven months apart. The survey instrument consisted of 46 questions divided into eight sections which covered various aspects such as demographics, clarity of rotation objectives, clinical and communication skills, assessment of the training and learning opportunities, preceptors' feedback and evaluation, interaction with patients, healthcare providers, and preceptors. Descriptive statistics and Cronbach's alpha coefficient were utilized to analyze the collected data and to assess the internal consistency of the multi-item Likert questions. Results Preceptors were predominantly male, aged 26-35, with extensive experience in pharmacy practice and mentorship, yet they lacked specialized post-graduate training or education certification. Almost 50% of the preceptors exhibited competence in pharmacotherapy-related science, demonstrated a willingness to teach students and acknowledged the students' knowledge and skills. Furthermore, most of the students reported understanding of the APPEs objectives as the internship progressed. However, only 15% of late rotation participants strongly agreed on the safety of the learning environment, adequate time and regular contact with their preceptors. Starkly, only 3.0% of early rotation students and 6.1% of late rotation students strongly agreed with the improvement of their written and verbal communications. Conclusion This study reported a noted decline in perceived learning support and environment safety as the APPEs' year progressed. Feedback and communication skills development were areas of concern, with limited satisfaction reported. The study highlights regional disparities in training quality, emphasizing the need for structured learning experiences and re-evaluation of preceptorship. Future research should aim to better understand the challenges associated with APPEs in non-major cities and rural areas, thereby making significant contributions to the enhancement of the pharmacy profession.
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Affiliation(s)
- Faris S. Alnezary
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah 41477, Saudi Arabia
| | - Fahad Alzahrani
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah 41477, Saudi Arabia
| | - Yasser Alatawi
- Pharmacy Practice Department, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Abdullah A. Alhifany
- Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Alnuhait M, Alqurashi NF, Abdullatif GZ, Maash MS, Fagieha R, Alshareef H, Bahamdain FO, Alghamdi W, Alhifany AA. Exploring Entrepreneurship in Pharmacy: Attitudes and Perceptions Among Saudi Pharmacists and Students. Integr Pharm Res Pract 2024; 13:1-8. [PMID: 38264491 PMCID: PMC10802168 DOI: 10.2147/iprp.s441142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024] Open
Abstract
Introduction Entrepreneurship has recently become a focus in community development, innovation, and economic growth, including within pharmaceutical organizations. However, it remains a relatively new aspect of pharmacy education. For the effective incorporation of entrepreneurship in this field, a robust educational foundation is critical, one that emphasizes risk-taking, strategic planning, competitive spirit, and a sense of social responsibility. This study aims to evaluate Saudi pharmacists' attitudes towards entrepreneurship in their practice. Methods A cross-sectional survey design to assess the attitudes of pharmacists and pharmacy students in Saudi Arabia towards entrepreneurship. The study sample consisted of 302 individuals, selected through convenience sampling, all of whom were either licensed pharmacists or pharmacy students in Saudi Arabia. The survey was conducted electronically and disseminated online throughout the duration of January 2023, spanning a one-month period. The research sought to provide a deeper understanding of how entrepreneurship is perceived within the pharmacy field. Results The study involved 302 pharmacists in Saudi Arabia, with the majority being pharmacy students and Doctor of Pharmacy holders. Over 60% of the participants worked for the government sector. Results showed a strong interest in entrepreneurship, with nearly 80% expressing interest and believing in the entrepreneurial potential of pharmacists. However, there was a knowledge gap, as only 52% were familiar with entrepreneurship concepts, and most had not taken entrepreneurship courses. More than half of the participants reported insufficient institutional support for entrepreneurship. Remarkably, only 1% had started a pharmaceutical business. Conclusion In conclusion, this study emphasizes the interest in entrepreneurship among pharmacists, highlighting the need for raising familiarity and formal education in the field. Factors such as working in the government sector were associated with higher willingness to become entrepreneurs, while the lack of awareness and institutional support hindered the entrepreneurial mindset.
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Affiliation(s)
- Mohammed Alnuhait
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nada Falah Alqurashi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Manar Sami Maash
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Refal Fagieha
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Haneen Alshareef
- Clinical Pharmacy Department, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Foud O Bahamdain
- Clinical Pharmacy Department, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Waad Alghamdi
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Almutairi MS, Alnezary FS, Chestnutt J, McAllister M, Almohammed OA, Alhifany AA. Acute kidney injury associated with piperacillin-tazobactam versus other antibiotics combined with vancomycin in critically ill patients: A retrospective cohort study. Saudi Pharm J 2023; 31:101844. [PMID: 38028217 PMCID: PMC10651670 DOI: 10.1016/j.jsps.2023.101844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Evidence of acute kidney injury (AKI) induced by piperacillin-tazobactam (Piptazo) versus other broad-spectrum antibiotics (BSA) combined with vancomycin has been established in the literature. However, there is limited evidence regarding these combinations among critically ill patients. This study assessed the risk of nephrotoxicity of Piptazo versus other BSA as an add-on to vancomycin among patients admitted to an intensive care unit (ICU). Methods We have reviewed patients' charts retrospectively to investigate AKI incidence among ICU patients receiving Piptazo versus other BSA as an add-on to vancomycin. Furthermore, we have assessed the duration of AKI and ICU stay, as well as the association between patients' criteria and risk of AKI using logistic regression analyses. Results A total of 79 patients were included, 50 patients received the Piptazo combination while 29 patients received other BSA combinations. Almost 52 % of the patients in the Piptazo group developed AKI while only 37.9 % of those in the BSA group did, yet the difference was not statistically significant (p = 0.22). On the other hand, the risk of AKI was highly associated with vancomycin trough concentration above 20 mcg/mL, nephrotoxic medications, and African descent (OR 7.1, 95 %CI 1.96-25.84, OR 3.94, 95 %CI 1.27-12.2, OR 3.53, 95 %CI 1.1-11.27, respectively). Conclusion Although the difference in AKI risk was not statistically significant between Piptazo versus BSA groups, the elevated trough concentration of vancomycin and the concomitant use of nephrotoxic medications, were found to increase the risk of AKI, independently of the combined antibiotics used.
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Affiliation(s)
- Masaad S. Almutairi
- Departement of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Faris S. Alnezary
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah 41477, Saudi Arabia
| | | | | | - Omar A Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A. Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Alkhudair N, Alhifany AA, Alsubaie B, Alshubaiki L, Alrajhi AM, alnuhait M. Assessing oncology providers attitudes and practices toward nonformulary drugs and mapping current obstacles in Saudi Arabia. Saudi Pharm J 2023; 31:101840. [PMID: 37961071 PMCID: PMC10638026 DOI: 10.1016/j.jsps.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction Formulary drug list is a continually updated list of medications routinely stocked by hospitals and other healthcare facilities and deemed effective, safe, and cost saving. Non-formulary drug (NFD) refers to medications not on the formulary, due to cost or lack of clinical data. This study aimed to examine the processing of NFD requests by oncology providers (OPs) in Saudi Arabia. Method A cross-sectional survey in Saudi oncology centers gathered perspectives of healthcare practitioners, mainly oncology pharmacists and physicians, on NFDs and request processes, aiming to understand variations, reasons for NFDs, and suggestions for an improved, unified NFDs request algorithm. Result A total of 93 physicians and pharmacists responded, 57 % were pharmacists, 43 % were physicians, and 94.6 % worked in the governmental sector. Around 31.2 % reported that it takes one week to receive a decision on their NFD request, while 28 % reported it takes two weeks to one month. Furthermore, 35.5 % of participants reported that the complete NFD process, from the initial order placement to the receipt of medications, spans a duration of 2-4 months, while 8.6 % noted a longer duration exceeding six months. The participants reported that the most common obstacles while requesting NFD were procurement delays and lengthy processing times. Additionally, 26.9 % agreed that formulary restrictions hindered medical care and 40.3 % reported delays in patient care. While 33.8 % were forced to use fewer effective options, and 22.1 % referred patients to palliative care. Conclusion The current practice of NFDs has negative consequences on cancer patient outcomes due to delays in patient care or the use of less effective drugs. Thus, we recommend having a national NFD access program.
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Affiliation(s)
- Nora Alkhudair
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A. Alhifany
- Department of Pharmacy Practice, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Basha Alsubaie
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Leena Alshubaiki
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M. Alrajhi
- Clinical Pharmacy Department, King Fahad Medical City, Riyadh, Saudi Arabia
- Department of Pharmacy Practice, College of Pharmacy, AlFaisal University, Riyadh, Saudi Arabia
| | - Mohammed alnuhait
- Department of Pharmacy Practice, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Alnezary FS, Almutairi MS, Alhifany AA, Almangour TA. Assessing Galleria mellonella as a preliminary model for systemic Staphylococcus aureus infection: Evaluating the efficacy and impact of vancomycin and Nigella sativa oil on gut microbiota. Saudi Pharm J 2023; 31:101824. [PMID: 37965487 PMCID: PMC10641552 DOI: 10.1016/j.jsps.2023.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
Background Staphylococcus aureus is a Gram-positive bacterium that can cause various infections. The Galleria mellonella has been used as a preliminary test for infection model. The study aimed to evaluate the effectiveness of G. mellonella as a microbiome model and compare the efficacy of vancomycin and antimicrobial activity of Nigella sativa (NS) on the gut flora. Methods G. mellonella larvae were subjected to metagenomic analysis. The larvae's guts were collected, homogenized in phosphate-buffered saline (PBS), and the gut contents isolated for bacterial DNA extraction. Larvae were assigned into the following groups: negative control (PBS only); positive control (MRSA only); vancomycin treated group; NS oil treated group and combination (vancomycin and NS oil) treated group. Larvae were cultured, inoculated with S. aureus, and treated with vancomycin and NS oil. Larval activity, cocoon formation, growth, melanization, and survival were monitored. The toxicity of vancomycin and NS oil was tested, and S. aureus burden and natural microbiota were determined. Hemocyte density was measured. Statistical analysis was conducted using R. Results Enterococcus related species dominated approximately 90 % of the gastrointestinal tract of the larvae. The survival rate following treatment was 85 % with vancomycin, 64 % with NS oil, and 73 % with a combination of both. The count of Enterococcus Colony Forming Units (CFUs) was significantly lower in the vancomycin treatment group (8.14E+04) compared to those treated with NS oil (1.97E+06) and the combination treatment (8.95E+05). Furthermore, the S. aureus burden was found to be lower in the NS oil (1.04E+06) and combination treatment groups (9.02E+05) compared to the vancomycin treatment group (3.38E+06). Hemocyte densities were significantly higher in the NS oil (8.29E+06) and combination treatment groups (8.18E+06) compared to the vancomycin treatment group (4.89E+06). Conclusions The study supported the use of G. mellonella model as a preliminary test to assess the effect of different antimicrobials against S. aureus and gut microbiota. NS oil showed more selectivity against S. aureus and protectiveness for the natural Enterococcus gut flora.
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Affiliation(s)
- Faris S. Alnezary
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah 41477, Saudi Arabia
| | - Masaad Saeed Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Abdullah A. Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Thamer A. Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
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Alhifany AA, Ghilais AT, Jammal JA, Alfaifi FM, Khayyat SM, Alotaibi AS, Alessa M, Almangour TA. Home infusion services in Saudi Arabia: Where are we standing? Saudi Pharm J 2023; 31:101750. [PMID: 37680756 PMCID: PMC10481352 DOI: 10.1016/j.jsps.2023.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
Diseases management has reached the highest level of complexity and cost in history, worldwide, and in Saudi Arabia in particular, which led to prolonged, unnecessary hospital stays. There have been many recent innovative measures to reduce these issues. One is to provide home infusion services. Hence, this narrative review emphasizes the expected benefits and challenges of such services and the applicability of their implementation in Saudi Arabia. A literature search was conducted via PubMed database, involving all published studies from inception until March 24th, 2023. Many studies showed positive impacts of home infusion on reducing the length of hospital stays, increasing cost-saving, and leading to high patient satisfaction.
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Affiliation(s)
- Abdullah A. Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz T. Ghilais
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Jawad A. Jammal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Faisal M. Alfaifi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Sarah M. Khayyat
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulmalik S. Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohammed Alessa
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Thamer A. Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Alessa M, Almangour TA, Alhassoun A, Alajaji I, Almangour A, Alsalem A, Alhifany AA. Adherence to evidence-based guidelines for the management of pneumonia in a tertiary teaching hospital in Riyadh. Saudi Pharm J 2023; 31:101678. [PMID: 37448847 PMCID: PMC10336669 DOI: 10.1016/j.jsps.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
Background Adherence to therapeutic guidelines is crucial when treating pneumonia, as it reduces mortality rate, length of hospital stay and duration of antibiotic therapy. However, the high non-adherence rate to treatment guidelines, in general, and to the Infectious Disease Society of America (IDSA) guidelines, are still reported globally. According to our knowledge, no existing data is available regarding the rate of physicians' adherence to the IDSA guidelines for managing pneumonia in Saudi Arabia. Therefore, we aim to assess the adherence rate and the clinical outcomes among patients treated according to the IDSA guidelines, in a tertiary care center in Riyadh. Methods A single-centered, retrospective, cross-sectional, observational study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia. All data were extracted from the hospital's electronic information system, known as Esihi. Adult patients (≥18 years old) diagnosed and treated in the hospital for community-acquired pneumonia, hospital-acquired pneumonia, or ventilator-associated pneumonia from Nov 2019 to Nov 2021 were included. Results A total of 148 patients were included in this study, and the management of 50% of them (74 patients) adhered to the guidelines' recommendations. Even though the patients who received guidelines-adhered management were older (70 ± 16 vs 59 ± 22; p = 0.001), and had a higher CURB-65 score for pneumonia severity (1.86 ± 1.03 vs 1.39 ± 1.26; p = 0.026) and an average calculated Charlson comorbidity index (4.62 ± 2.19 vs 3.28 ± 2.80; p = 0.001) than patients who were treated irrespectively of the guidelines, yet they had a better cure rate (95% vs 84%; adjusted OR, 3.9; 95% CI, 0.82-18.58), lower mortality (5% vs 14%; adjusted OR, 0.38; 95% CI, 0.04-4.05) and shorter length of hospital stay (LOS) (6.5 vs 8 days; p = 0.082); compared to patients who were treated irrespectively of the guidelines. Conclusions Comparable to previous literature, non-adherence to evidence-based guidelines has been observed in 50% of patients treated for pneumonia. Despite being nonsignificant, higher clinical cure rates, shorter LOS, and lower mortality rates have been observed in patients who were treated based on evidence-based guidelines. Further measures to improve guidelines compliance in pneumonia treatment are needed.
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Affiliation(s)
- Mohammed Alessa
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Thamer A. Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Alhassoun
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Alajaji
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Almangour
- Department of Clinical Pharmacy, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdulaziz Alsalem
- Department of Clinical Pharmacy, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Alotaibi AS, Shalabi HA, Alhifany AA, Alotaibi NE, Alnuhait MA, Altheaby AR, Alhazmi AY. Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1166. [PMID: 37514982 PMCID: PMC10384009 DOI: 10.3390/vaccines11071166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/10/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Solid organ transplant (SOT) recipients are at increased risk of COVID-19 infection because of their suppressed immunity. The available data show that COVID-19 vaccines are less effective in SOT recipients. We aimed to assess the cellular and humoral immunogenicity with an increasing the number of doses of COVID-19 vaccines in SOT recipients and to identify factors affecting vaccine response in this population. A systematic review and meta-analysis were conducted to identify ongoing and completed studies of humoral and cellular immunity following COVID-19 vaccines in SOT recipients. The search retrieved 278 results with 45 duplicates, and 43 records did not match the inclusion criteria. After title and abstract screening, we retained 189 records, and 135 records were excluded. The reasons for exclusion involved studies with immunocompromised patients (non-transplant recipients), dialysis patients, and individuals who had already recovered from SARS-CoV-2 infection. After full-text reading, 55 observational studies and randomized clinical trials (RCTs) were included. The proportion of responders appeared higher after the third, fourth, and fifth doses. The risk factors for non-response included older age and the use of mycophenolate mofetil, corticosteroids, and other immunosuppressants. This systematic review and meta-analysis demonstrates the immunogenicity following different doses of COVID-19 vaccines among SOT patients. Due to the low immunogenicity of vaccines, additional strategies to improve vaccine response may be necessary.
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Affiliation(s)
- Abdulmalik S Alotaibi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Heba A Shalabi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Nouf E Alotaibi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Mohammed A Alnuhait
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Abdulrahman R Altheaby
- Organ Transplant Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Abdulfattah Y Alhazmi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
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11
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Halloush S, Alhifany AA, Alkhatib NS, Al Bawab AQ, Al-Qawasmeh B, Al Shawakri E, Koeller J. Cost-effectiveness of palonosetron and dexamethasone-based triple and quadruple regimens in preventing highly emetogenic chemotherapy-induced nausea and vomiting. Curr Med Res Opin 2022; 38:571-577. [PMID: 35068277 DOI: 10.1080/03007995.2022.2033011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Cost-effectiveness analyses that consider all currently used antiemetics in the case of emetogenic chemotherapy-induced nausea and vomiting (CINV) have not been performed yet. We aim to compare the cost-effectiveness of olanzapine (OLA), or/and neurokinin-1 receptor antagonists (NK-1-RAs), in combination with palonosetron (PAL) and dexamethasone (DEX) in preventing highly emetogenic CINV. METHODS Two decision analytic models were constructed. The first model was based on overall complete response (CR); the second model was based on rate of absence of nausea. Four antiemetic regimens PAL + DEX, NK-1-RAs + PAL + DEX, OLA + PAL + DEX, and PAL + NK-1-RA + DEX + OLA were compared in terms of cost, overall CR and rate of absence of nausea. Base case incremental cost-effectiveness ratio (ICER) estimates were calculated. The study was from the US payer perspective. RESULTS In terms of CR, the PAL + NK-1-RA + DEX + OLA was associated with the highest gains in the percentage of CR among all treatment regimens at base case ICERs of $4220 versus PAL + DEX, $4656 versus NK-1-RA + PAL + DEX, $16,471 versus OLA + PAL + DEX. In term of rate of absence of nausea, the PAL + NK-1-RA + DEX + OLA was associated with the highest rate of absence of nausea among all the treatment regimens at base case ICERs of $2291 versus PAL + DEX, $1304 versus NK-1-RA + PAL + DEX, $2657 versus OLA + PAL + DEX. CONCLUSION from an economic perspective, our study revealed that whether to use overall CR or/and rate of absence of nausea as determinants in the antiemetic decision for the CINV patients, the CR-based-, and rate of absence of nausea-based cost-effectiveness analyses, showed negotiable ICER estimates for the treatment PAL + NK-1-RA + DEX + OLA over the combinations PAL + DEX, NK-1-RA + PAL + DEX, and OLA + PAL + DEX regimens.
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Affiliation(s)
- Shiraz Halloush
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nimer S Alkhatib
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
- Center for Health Outcomes and PharmacoEconomic Evaluation, University of Arizona, Tucson, AZ, USA
| | | | - Batool Al-Qawasmeh
- College of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Jim Koeller
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
- Pharmacotherapy Education and Research Center, UT Health, TX, USA
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12
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Almangour TA, Ghonem L, Aljabri A, Alruwaili A, Al Musawa M, Damfu N, Almalki MS, Alattas M, Abed H, Naeem D, Almalki N, Alhifany AA. Ceftazidime-Avibactam versus Colistin for the Treatment of Infections Due to Carbapenem-Resistant Enterobacterales: A Multicenter Cohort Study. Infect Drug Resist 2022; 15:211-221. [PMID: 35125877 PMCID: PMC8807865 DOI: 10.2147/idr.s349004] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background The aim of this study was to compare the safety and effectiveness of ceftazidime-avibactam (CAZ-AVI) to colistin-based regimen in the treatment of infections caused by carbapenem-resistant Enterobacterales (CRE). Methods This was a retrospective, multicenter, observational cohort study of inpatients who received either CAZ-AVI or intravenous colistin for treatment of infections due to CRE. The study was conducted in 5 tertiary care hospitals in Saudi Arabia. Main study outcomes included in-hospital mortality, clinical cure at end of treatment, and acute kidney injury (AKI). Univariate analysis and multivariate logistic regression model were conducted to assess the independent impact of CAZ-AVI on the clinical outcome. Results A total of 230 patients were included in this study: 149 patients received CAZ-AVI and 81 patients received colistin-based regimen. Clinical cure (71% vs 52%; P = 0.004; OR, 2.29; 95% CI, 1.31–4.01) was significantly more common in patients who received CAZ-AVI. After adjusting the difference between the two groups, treatment with CAZ-AVI is independently associated with clinical cure (adjusted OR, 2.75; 95% CI, 1.28–5.91). In-hospital mortality (35% vs 44%; P = 0.156; OR, 0.67; 95% CI, 0.39–1.16) was lower in patients who received CAZ-AVI but the difference was not significant. AKI (15% vs 33%; P = 0.002; OR, 0.37; 95% CI, 0.19–0.69) was significantly less common in patients who received CAZ-AVI. Conclusion CAZ-AVI is associated with higher rate of clinical cure and lower rate of AKI compared to colistin. Our findings support the preferential use of CAZ-AVI over colistin-based regimen for treating these infections.
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Affiliation(s)
- Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
- Correspondence: Thamer A Almangour, Email
| | - Leen Ghonem
- Clinical Pharmacy Services, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Aljabri
- Clinical Pharmacy Services, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Alya Alruwaili
- Infectious Diseases Services, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Al Musawa
- Pharmaceutical Care Division, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia
| | - Nader Damfu
- Pharmaceutical Care Department, King Abdul Aziz Medical City, Jeddah, Saudi Arabia
| | - Mesfer S Almalki
- Pharmaceutical Services, Security Forces Hospital, Makkah, Saudi Arabia
| | - Majda Alattas
- Pharmaceutical Care Division, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia
| | - Hossam Abed
- Pharmaceutical Care Division, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia
| | - Doaa Naeem
- Pharmaceutical Care Department, King Abdul Aziz Medical City, Jeddah, Saudi Arabia
| | - Nawaf Almalki
- Pharmaceutical Care Department, King Abdul Aziz Medical City, Jeddah, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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13
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Alshehri AF, Almangour TA, Alhifany AA, Alhossan A. Assessment of Caspofungin use at a Tertiary Teaching Hospital and compliance with IDSA guidelines and FDA labeling. Saudi Pharm J 2022; 30:212-216. [PMID: 35498226 PMCID: PMC9051971 DOI: 10.1016/j.jsps.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/27/2021] [Indexed: 12/04/2022] Open
Abstract
Objective The aim of this study is to evaluate the utilization pattern of Caspofungin in an academic tertiary care hospital in Riyadh, Saudi Arabia. Methods This is a retrospective study, conducted at King Saud University Medical City, Riyadh, Saudi Arabia. Adult patients who received Caspofungin from January 2015 to December 2018 were included. The appropriate use of Caspofungin was evaluated according to the international guidelines and approved recommendations. Caspofungin doses were assessed according to the FDA-approved loading and maintenance doses as well as dose-adjustment per hepatic function for cirrhotic patients and drug-drug interactions. Cultures and laboratory tests were used to evaluate the appropriate duration of Caspofungin therapy. Results 388 patients were included. Caspofungin was inappropriately used in 253 (64%) patients. This included 78 (20%) due to inappropriate indication, 165 (42%) due to wrong dosage, and 10 (2%) patients who had a wrong duration of therapy. Conclusion The rate of inappropriate use of Caspofungin was high. Hence, developing antifungal stewardship and drug restriction program is highly recommended.
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Affiliation(s)
- Abrar F. Alshehri
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
- Corresponding author at: College of Pharmacy, Umm Al-Qura University, P.O. Box: 13578, Zip Code: 21955, Saudi Arabia.
| | - Thamer A. Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A. Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz Alhossan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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14
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Alhifany AA, Bifari N, Alatawi Y, Malik SU, Almangour TA, Altebainawi AF, Alshammari TM, Alotaibi AF, Mahrous AJ, Alshehri FS, Cheema E. Efficacy and safety of delafloxacin, ceftaroline, ceftobiprole, and tigecycline for the empiric treatment of acute bacterial skin and skin structure infections: A network meta-analysis of randomized controlled trials. Saudi Pharm J 2022; 30:195-204. [PMID: 35498222 PMCID: PMC9051976 DOI: 10.1016/j.jsps.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/27/2021] [Indexed: 11/02/2022] Open
Abstract
Background Method Results Conclusion
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15
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Kabrah SM, Abuzerr SS, Baghdadi MA, Kabrah AM, Flemban AF, Bahwerth FS, Assaggaf HM, Alanazi EA, Alhifany AA, Al-Shareef SA, Alsabban WH, Khan AA, Alzhrani H, Jambi LK, Alsafi RT, Aslam A, Kabrah HM, Babalghith AO, Halawani AJ. Susceptibility of ABO blood group to COVID-19 infections: clinico-hematological, radiological, and complications analysis. Medicine (Baltimore) 2021; 100:e28334. [PMID: 34967364 PMCID: PMC8718246 DOI: 10.1097/md.0000000000028334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/30/2021] [Indexed: 01/05/2023] Open
Abstract
In the wake of the COVID-19 pandemic, research indicates that the COVID-19 disease susceptibility varies among individuals depending on their ABO blood groups. Researchers globally commenced investigating potential methods to stratify cases according to prognosis depending on several clinical parameters. Since there is evidence of a link between ABO blood groups and disease susceptibility, it could be argued that there is a link between blood groups and disease manifestation and progression. The current study investigates whether clinical manifestation, laboratory, and imaging findings vary among ABO blood groups of hospitalized confirmed COVID-19 patients.This retrospective cohort study was conducted between March 1, 2020 and March 31, 2021 in King Faisal Specialist Hospital and Research Centre Riyadh and Jeddah, Saudi Arabia. Demographic information, clinical information, laboratory findings, and imaging investigations were extracted from the data warehouse for all confirmed COVID-19 patients.A total of 285 admitted patients were included in the study. Of these, 81 (28.4%) were blood group A, 43 (15.1%) were blood group B, 11 (3.9%) were blood group AB, and 150 (52.6%) were blood group O. This was almost consistent with the distribution of blood groups among the Saudi Arabia community. The majority of the study participants (79.6% [n = 227]) were asymptomatic. The upper respiratory tract infection (P = .014) and shortness of breath showed statistically significant differences between the ABO blood group (P = .009). Moreover, the incidence of the symptoms was highly observed in blood group O followed by A then B except for pharyngeal exudate observed in blood group A. The one-way ANOVA test indicated that among the studied hematological parameters, glucose (P = .004), absolute lymphocyte count (P = .001), and IgA (P = .036) showed statistically significant differences between the means of the ABO blood group. The differences in both X-ray and computed tomography scan findings were statistically nonsignificant among the ABO age group. Only 86 (30.3%) patients were admitted to an intensive care unit, and the majority of them were blood groups O 28.7% (n = 43) and A 37.0% (n = 30). However, the differences in complications' outcomes were statistically nonsignificant among the ABO age group.ABO blood groups among hospitalized COVID-19 patients are not associated with clinical, hematological, radiological, and complications abnormality.
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Affiliation(s)
- Saeed M. Kabrah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Samer S. Abuzerr
- Visiting Scholar with the School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
- Quality Improvement and Infection Control Unit, Ministry of Health, Gaza, Palestine
| | - Mohammed A. Baghdadi
- Research Centre, King Faisal Specialist Hospital and Research Centre Jeddah, Kingdom of Saudi Arabia
| | - Ahmed M. Kabrah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Arwa F. Flemban
- Pathology Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Fayez S. Bahwerth
- Laboratory and Blood Bank Department, King Faisal Hospital, Makkah, Kingdom of Saudi Arabia
| | - Hamza M. Assaggaf
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Eisa A. Alanazi
- Computer Science Department, Faculty of Computer and Information System, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Abdullah A. Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Sarah A. Al-Shareef
- Computer Science Department, Faculty of Computer and Information System, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Wesam H. Alsabban
- Information System Department, Faculty of Computer and Information Systems, Umm Al Qura University, Makkah, Kingdom of Saudi Arabia
| | - Anmar A. Khan
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Hissah Alzhrani
- Mathematical Sciences Department, Faculty of Applied Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Layal K. Jambi
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Radi T. Alsafi
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Akhmed Aslam
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Hebah M. Kabrah
- Laboratory and Blood Bank Department, Al Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia
| | - Ahmad O. Babalghith
- Medical Genetic Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Amr J. Halawani
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
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16
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Alshaya OA, Arab OO, Alhifany AA, Alhossan A, Alomar M, Alqahtani AG, Almolaiki MA, Mubarki S, Alruwaisan R, Alturaiki A, Alzuman S, Alsaqer AI, Korayem GB. Ambulatory care pharmacy in Saudi Arabia; definition, history, present, future potentials, and expected challenges. J Am Coll Clin Pharm 2021. [DOI: 10.1002/jac5.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Omar A. Alshaya
- Department of Pharmacy Practice, College of Pharmacy King Saud bin Abdulaziz University for Health Sciences Riyadh Saudi Arabia
- Pharmaceutical Care Services King Abdulaziz Medical City, Ministry of National Guard Health Affairs Riyadh Saudi Arabia
- King Abdullah International Medical Research Center Riyadh Saudi Arabia
| | - Omaima Osama Arab
- King Faisal Specialist Hospital and Research Center Riyadh Saudi Arabia
| | | | - Abdulaziz Alhossan
- Department of Clinical Pharmacy, College of Pharmacy King Saud University Riyadh Saudi Arabia
| | - Mukhtar Alomar
- Clinical Pharmacy Section, Pharmaceutical Care Services Dammam Health Network, Eastern Health Cluster Dammam Saudi Arabia
| | | | - Maha A. Almolaiki
- Pharmaceutical Care Services King Abdulaziz Medical City, Ministry of National Guard Health Affairs Riyadh Saudi Arabia
| | | | - Rana Alruwaisan
- Pharmacy Services Administration, King Fahad Medical City Riyadh Saudi Arabia
| | - Abdulrahman Alturaiki
- Department of Pharmacy Practice, College of Pharmacy King Saud bin Abdulaziz University for Health Sciences Riyadh Saudi Arabia
- Pharmaceutical Care Services King Abdulaziz Medical City, Ministry of National Guard Health Affairs Riyadh Saudi Arabia
- King Abdullah International Medical Research Center Riyadh Saudi Arabia
| | - Sitah Alzuman
- Pharmacy Services, King Khalid Eye Specialist Hospital Riyadh Saudi Arabia
| | | | - Ghazwa B. Korayem
- Department of Pharmacy Practice, College of Pharmacy Princess Nourah bint Abdulrahman University Riyadh Saudi Arabia
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17
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Korayem GB, Badreldin HA, Eljaaly K, Aldemerdash A, Al-Suhaibani LK, Joharji H, Aljuhani O, Al-Omari BA, Almudaiheem HY, Alhifany AA, Alawagi M, Al-Mowaina SM, Al-Jazairi AS, Albekairy AM, Al-Jedai A. Clinical pharmacy definition, required education, training and practice in Saudi Arabia: A position statement by the Saudi society of clinical pharmacy. Saudi Pharm J 2021; 29:1343-1347. [PMID: 34819795 PMCID: PMC8596147 DOI: 10.1016/j.jsps.2021.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/13/2021] [Indexed: 11/08/2022] Open
Abstract
The Saudi Society of Clinical Pharmacy (SSCP) is a scientific and professional society in the field of clinical pharmacy that operates under the Saudi Commission for Health Specialties governance. The SSCP believes that there is a need to define and describe many aspects related to the clinical pharmacy profession in Saudi Arabia. Moreover, there is an increasing demand for promoting the concept of clinical pharmacy and developing a consensus regarding the scope of practice and clinical pharmacist's required postgraduate education and training in Saudi Arabia. This paper is intended to present several position statements by the SSCP that define the concept of clinical pharmacy, describe the required education and training, and highlight clinical pharmacists' scope of practice in Saudi Arabia. This paper calls for further investigations that examine the impact of clinical pharmacists on individual and population health levels.
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Affiliation(s)
- Ghazwa B Korayem
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Hisham A Badreldin
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Pharmaceutical Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Khalid Eljaaly
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.,Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, United States.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Ahmed Aldemerdash
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Lujain K Al-Suhaibani
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,College of Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Hala Joharji
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,College of Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Bedor A Al-Omari
- Pharmaceutical Care Services, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Hajer Y Almudaiheem
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Mohammad Alawagi
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Sahar M Al-Mowaina
- Pharmaceutical Care Services, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Abdulrazaq S Al-Jazairi
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,College of Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Abdulkareem M Albekairy
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmed Al-Jedai
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,College of Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia.,Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia.,The Saudi Society of Clinical Pharmacy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
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18
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Almarzoky Abuhussain SS, Elrggal ME, Salamatullah AK, Althobaity AA, Alotaibi AF, Almeleebia TM, Almangour TA, Alhifany AA. Work readiness scale for pharmacy interns and graduates: A cross-sectional study. Saudi Pharm J 2021; 29:976-980. [PMID: 34588843 PMCID: PMC8463463 DOI: 10.1016/j.jsps.2021.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction As the number of unemployment among pharmacy graduates increases, the Saudi Ministry of Labor implemented extra measures to facilitate their training and hiring by the private sectors. Nevertheless, there is a paucity of data regarding pharmacy graduates’ work readiness (WR). Hence, we aim to assess their WR and identify predicting factors associated with WR among pharmacy graduates’ in Saudi Arabia. Methods A 46-item self-reported pre-validated anonymous work readiness scale (WRS) survey with a 5-point Likert scale was administered to pharmacy senior students and graduates using Qualtrics XM® survey tool over the month of May 2020. The main outcome was to assess WRS for pharmacy interns and graduates and identify factors associated with work readiness. Results A total of 617 participants have participated in this survey, out of which 46.5% were freshly graduated pharmacists and 19.6% were pharmacy interns. Most participants (82.3%) were PharmD candidates or graduates. Around two-third of participants (63%) have successfully completed all survey items. The maximum points scored was 223 out of 230, and the median overall score was found to be 175. There was no significant association with gender, age, or type of university regarding overall scores. However, a statistically significant odds ratio was observed with PharmD program type and previous pharmaceutical marketing training (OR = 1.778, 95% CI = 1.143–2.765: OR = 0.618, 95% CI = 0.432–0.884, respectively). Conclusion The overall median score shows a good work readiness level among pharmacy students/graduates in Saudi Arabia; however, PharmD program graduates exposed to advance pharmacy training, including the pharmaceutical marketing experience, have higher work readiness odds than Bpharm graduates. Further studies involving other related perspectives, such as stakeholders, employers, and preceptors, would give a clear image of pharmacy graduates’ job readiness levels.
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Affiliation(s)
| | - Mahmoud E Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz K Salamatullah
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Assma A Althobaity
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Amal F Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Tahani M Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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19
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Abstract
Osteomyelitis is one of the most challenging infectious diseases to treat and is associated with a significant burden to healthcare systems. There are limited available therapeutic options to treat osteomyelitis caused by Gram-positive pathogens and these are not without limitations. Dalbavancin is a long-acting lipoglycopeptide, approved for the treatment of acute bacterial skin and skin structure infections caused by designated susceptible strains of Gram-positive microorganisms. It demonstrated promising pharmacokinetic/pharmacodynamic properties and safety data to be considered for the treatment of bone infections. However, information on the effectiveness and safety of dalbavancin in the treatment of invasive Gram-positive infections, such as osteomyelitis, is very limited. In this review, we describe the novel characteristics and potential utility of dalbavancin in the treatment of osteomyelitis and summarize its long-term clinical outcomes from published case reports, series and comparative studies.
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Affiliation(s)
- Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, PO Box 2457, Riyadh 11451, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, PO Box 13578, Makkah 21955, Saudi Arabia
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Alharaibi MA, Alhifany AA, Asiri YA, Alwhaibi MM, Ali S, Jaganathan PP, Alhawassi TM. Prescribing errors among adult patients in a large tertiary care system in Saudi Arabia. Ann Saudi Med 2021; 41:147-156. [PMID: 34085548 PMCID: PMC8176371 DOI: 10.5144/0256-4947.2021.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN Retrospective database review. SETTING Large tertiary care setting in Riyadh. PATIENTS AND METHODS We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE 315 166 prescriptions screened. RESULTS Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, P<.001) and prescribing anti-infective medications (adjusted odds ratio 2.9; 95% CI 1.3-5.7, P<.01). CONCLUSION Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors. LIMITATIONS Polypharmacy was not considered; the data are from a single healthcare system. CONFLICT OF INTEREST None.
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Affiliation(s)
- Maryam Ali Alharaibi
- From the Department of Pharmaceutical Services, King Saud Medical City, Riyadh, Saudi Arabia.,From the College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- From the Clinical Pharmacy Department, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Yousif A Asiri
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Monira M Alwhaibi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sheraz Ali
- From the School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | | | - Tariq M Alhawassi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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21
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Almeleebia TM, Alhifany AA, Almutairi F, Alshibani M, Alhossan AM. Regulating antimicrobial sales in Saudi Arabia: Achievements and challenges. Int J Clin Pract 2021; 75:e13833. [PMID: 33202479 DOI: 10.1111/ijcp.13833] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Antimicrobials save millions of lives annually from dying because of bacterial infections, but the rapid emergence of antimicrobial resistance (AMR) becomes a global threat. The Saudi Ministry of Health (MOH) has taken containment measures to limit the misuse of antimicrobials via implementing restrictions on dispensing without prescriptions. Hence, we aim to evaluate the impact of regulating antimicrobial sales and identify challenges that pharmacists are facing to prevent self-medication with antimicrobial agents. MATERIALS AND METHODS A cross-sectional study was conducted using two sources of data: sales reports from 3000 pharmacies in Saudi Arabia and a self-designed questionnaire. The questionnaire consists of 24 items written in English and Arabic languages, went through multiple steps to ensure validity and reliability and then distributed online. Descriptive analyses were used to present the results. RESULTS A total of 106 pharmacists completed the questionnaire. Sixty-three per cent of the respondents observed a reduction of 40% in sales, which was consistent with pharmacies' sales reports, which revealed a 50% reduction in 2018 as compared to 2017. Seventy-six per cent of respondents agreed that antimicrobials' sales restrictions were frustrating to patients. The percentage of pharmacists who reported receiving prescriptions with complete information about patients, prescribers, medications and issue date was 70%, 54%, 86% and 77%, respectively. And 69% of respondents revealed receiving support from their employers to prevent dispensing antimicrobial agents without prescription. CONCLUSION Restriction measures implemented by the Saudi MOH led to a 40% to 50% reduction in inappropriate sales of antimicrobials. Further studies are needed to investigate the methods for improving documentation and prescribing practices.
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Affiliation(s)
- Tahani Musleh Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Fahdah Almutairi
- Department of Clinical Pharmacy Services, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Mohannad Alshibani
- Faculty of Pharmacy, Department of Pharmacy Practice, King Abdulaziz University, Jeddah, Saudi Arabia
- College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Abdulaziz M Alhossan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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22
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Almangour TA, Kaye KS, Alessa M, Eljaaly K, Sfouq Aleanizy F, Alsharidi A, Al Majid FM, Alotaibi NH, Alzeer AA, Alnezary FS, Alhifany AA. Efficacy of clotrimazole for the management of oral candidiasis: A meta-analysis of randomized clinical trials. Saudi Pharm J 2021; 29:315-323. [PMID: 33994826 PMCID: PMC8093540 DOI: 10.1016/j.jsps.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/06/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To assess the efficacy and safety of topical application of clotrimazole versus others in the treatment of oropharyngeal candidiasis (OPC). Method Four electronic databases, registries of ongoing trials, and manual search were used to identify randomized controlled trials (RCTs) that compared the efficacy of clotrimazole to other antifungal agents in patients who were clinically diagnosed with oral candidiasis up to November 1st, 2019. Primary outcomes were clinical response and mycological cure rates. Secondary outcomes include relapse rate, incidence of systemic infections, and compliance. Adverse effects were also evaluated. Results Sixteen RCTs with a total of 1685 patients were included. Half of the eligible studies were considered at high risk of performance bias and more than a third, at high risk of reporting bias. Our analysis showed no significant difference in clinical response between clotrimazole and all other antifungal agents. However, clotrimazole was less effective in terms of mycologic cure and relapse rate. Sensitivity analysis comparing clotrimazole to other topical antifungal agents only showed no differences in clinical response, microbiologic cure or relapse. Further sensitivity analysis showed significant efficacy of fluconazole over clotrimazole. Conclusion This meta-analysis indicated that clotrimazole is less effective than fluconazole but as effective as other topical therapies in treating OPC. Well-designed high-quality RCT is needed to validate these findings.
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Affiliation(s)
- Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Keith S Kaye
- Director of Clinical Research, Division of Infectious Diseases, University of Michigan Medical School, 5510A MSRB I, SPC 5680, 1150 W. Medical Center Drive, Ann Arbor, MI 48109-5680, United States
| | - Mohammed Alessa
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Khalid Eljaaly
- Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.,Pharmacy College, University of Arizona, Tucson, AZ, United States
| | - Fadilah Sfouq Aleanizy
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 22452, Riyadh 11495, Saudi Arabia
| | - Aynaa Alsharidi
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 7805, Riyadh 11472, Saudi Arabia
| | - Fahad M Al Majid
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 7805, Riyadh 11472, Saudi Arabia
| | - Naif H Alotaibi
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 7805, Riyadh 11472, Saudi Arabia
| | - Abdullah A Alzeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Faris S Alnezary
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Medinah, Saudi Arabia.,University of Houston College of Pharmacy, Pharmacy Practice and Translational Research, 4901 Calhoun Rd #3044, Houston, TX 77204, United States
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University P.O. Box 13578 Makkah 21955, Saudi Arabia
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Alessa M, Gramish J, Almodaimegh H, Khobrani MA, Hornsby L, Alhifany AA. Utilization of adjusted body weight for dosing unfractionated heparin in obese patients with venous thromboembolism: A retrospective matched cohort study. TROP J PHARM RES 2021. [DOI: 10.4314/tjpr.v20i1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To evaluate the effectiveness of adjusted body weight (AjBW)-based dosing of unfractionated heparin (UFH) in obese patients vis a vis actual body weight (ABW)-based dosing in non-obese patients with venous thromboembolism (VTE).Methods: A retrospective chart review was conducted for obese and non-obese patients initiated on UFH for treating VTE from September 2013 to December 2014. Patients were excluded from the study if they were under 18 years old, developed heparin-induced thrombocytopenia during treatment, received thrombolytic therapy prior to UFH, or received UFH at a dose that did not follow the institution’s protocol. The primary objective was to assess the efficacy of dosing UFH based on AjBW in achieving a therapeutic activated partial thromboplastin time (aPTT) within the first 24 h in obese patients, in comparison to the standard ABW-dosing for non-obese.Results: Of the 57 patients included in the study, 27 patients (47.4 %) were obese, and 30 patients (52.6 %) were non-obese; 16 (59.25 %) of the obese patients achieved a therapeutic aPTT within the first 24 h of AjBW-based dosed UFH, while 18 (60 %) of the non-obese patients achieved a therapeutic aPTT within the first 24 h of ABW-based dosed UFH (p = 0.45).Conclusion: AjBW-based dosing of UFH in obese patients demonstrates comparable efficacy to ABWbased dosing in non-obese patients.
Keywords: Obesity, Unfractionated heparin, Venous thromboembolism, Adjusted body weight, Ideal body weight
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Alhifany AA, Almalki FA, Alatawi YM, Basindowh LA, Almajnoni SS, Elrggal ME, Alotaibi AF, Almarzoky Abuhussain SS, Almangour TA. Association between graduates' factors and success rate on the Saudi Pharmacist Licensure Examination: A single-Institution cross-sectional study. Saudi Pharm J 2021; 28:1830-1833. [PMID: 33424271 PMCID: PMC7783223 DOI: 10.1016/j.jsps.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction The Saudi Pharmacists Licensure Examination’s (SPLE) initial results were revealed in February 2020, which showed enormous inconsistency with the passing rates. Hence, we aimed to investigate the predictors of pharmacy graduates’ success rate on the SPLE of a single-college in Saudi Arabia. Methods In a cross-sectional study of 2019-graduates, data were collected via-phone interviews and retrieved from the college’s database. Graduates’ data were retrieved from the college’s database, which includes high school grade point average (GPA), General Aptitude Test, Scholastic Achievement Admission Test, preparatory year GPA, pharmacy GPA, and all courses' grades. The data collected via-phone interview includes information that was not recorded in the college’s database, such as date of birth, SPLE score, and the number of SPLE attempts. We only included students who agreed to be interviewed and had attempted the SPLE at least once. We developed a prediction model using correlational analyses and stepwise multiple linear regression to examine graduates’ factors in predicting success on the SPLE. Results Out of the 149 graduates, 105 fulfilled the inclusion criteria. Around 84% of them passed the SPLE. Correlation analyses showed a significant direct correlation between preparatory year GPA and pharmacy GPA with SPLE scores (r = 0.228, P = 0.0193 and r = 0.533, P < 0.0001, respectively). In addition, the results showed that all of the four SPLE content areas were positively correlated with SPLE scores (P < 0.0001). The stepwise multivariable regression showed that being a male graduate and scoring high-grade points in pharmacology and therapeutics courses were significantly associated with high SPLE scores (P = 0.0053, P = 0.0256, and P = 0.0001, respectively). Conclusion This single cross-sectional study found that being a male, pharmacology GPA, and therapeutics GPA were significantly associated with a higher SPLE score. Further studies should focus on the GPA cut off below which we should give remediation to improve SPLE passing rate.
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Affiliation(s)
- Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Faisal A Almalki
- Department of Pharmaceutical Chemistry, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Yasser M Alatawi
- Department of Clinical Pharmacy, College of Pharmacy, Tabuk University, Tabuk, Saudi Arabia
| | - Linah A Basindowh
- College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | | | - Mahmoud E Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Amal F Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | | | - Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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25
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Almalki AH, Alzahrani MS, Alshehri FS, Alharbi A, Alkhudaydi SF, Alshahrani RS, Alzaidi AH, Algarni MA, Alsaab HO, Alatawi Y, Althobaiti YS, Bamaga AK, Alhifany AA. The Psychological Impact of COVID-19 on Healthcare Workers in Saudi Arabia: A Year Later Into the Pandemic. Front Psychiatry 2021; 12:797545. [PMID: 34975592 PMCID: PMC8718633 DOI: 10.3389/fpsyt.2021.797545] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/22/2021] [Indexed: 12/14/2022] Open
Abstract
Objective: The COVID-19 pandemic poses unprecedented challenges to healthcare workers worldwide. This study sought to estimate the prevalence of depression, anxiety, and stress among healthcare workers in Saudi Arabia, and to identify the factors associated with these psychological disorders. Methods: A cross-sectional questionnaire-based study was conducted from January 21 to March 2, 2021. Physicians, pharmacists, nurses, and other healthcare workers from different parts of Saudi Arabia were recruited through snowball sampling. Psychological outcomes were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Pearson's chi-square test was used to explore the bivariate association between diverse characteristics and each outcome. Multiple logistic regression analyses were performed to identify factors associated with depression, anxiety, and stress. Results: A total of 501 healthcare workers completed the survey, of whom 60% were female and nearly half were pharmacists. The majority (76.25%) of respondents reported that a family member, friend, or colleague had contracted COVID-19, and more than one-third (36%) knew someone who died due to COVID-19. Overall, the estimated prevalence rates of depression, anxiety, and stress were 54.69, 60.88, and 41.92%, respectively. The multivariate analysis revealed that healthcare workers with chronic diseases, nurses, and healthcare workers from the southern region were more likely to suffer from depression and stress. Further, individuals with positive COVID-19 test results showed a greater proportion of depressive symptoms compared to others. In addition, knowing someone who died due to COVID-19 and having a chronic illness were predisposing factors for anxiety. Conclusion: After more than a year, the prevalence of depression, anxiety, and stress remains substantial among healthcare workers in Saudi Arabia. The findings can help guide efforts to mitigate the psychological impact of the pandemic.
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Affiliation(s)
- Atiah H Almalki
- Department of Pharmaceutical Chemistry, College of Pharmacy, Taif University, Taif, Saudi Arabia.,Addiction and Neuroscience Research Unit, Health Science Campus, Taif University, Taif, Saudi Arabia
| | - Mohammad S Alzahrani
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Fahad S Alshehri
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Adnan Alharbi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | | | | | - Majed A Algarni
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Hashem O Alsaab
- Department of Pharmaceutics and Pharmaceutical Technology, Taif University, Taif, Saudi Arabia
| | - Yasser Alatawi
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Yusuf S Althobaiti
- Addiction and Neuroscience Research Unit, Health Science Campus, Taif University, Taif, Saudi Arabia.,Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Ahmed K Bamaga
- Neurology Division, Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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26
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Alatawi Y, Alshehri FS, Alhifany AA, Alharbi A, Alghamdi BS. Health Literacy, Perceived Threat, and Posttraumatic Stress Disorder During the COVID-19 Pandemic in Saudi Arabia. Risk Manag Healthc Policy 2020; 13:3147-3153. [PMID: 33402853 PMCID: PMC7778676 DOI: 10.2147/rmhp.s290181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/17/2020] [Indexed: 12/23/2022] Open
Abstract
Purpose This study aimed to investigate the prevalence of and factors associated with posttraumatic stress disorder (PTSD) during the COVID-19 pandemic in Saudi Arabia. Materials and Methods This was a cross-sectional online survey that targeted adults over the age of 18 residing in Saudi Arabia. The data collection began June 1, 2020 and continued for four weeks. The Posttraumatic Stress Disorder Checklist-Specific, the Brief Illness Perception Questionnaire version BIP-Q5, and a 9-item health literacy measure were used. Results There were 1249 participants, of which 62.21% were under the age of 34. The prevalence of PTSD was 19.5% among all participants. The results showed that both the perception of threat (OR =1.17, 95% CI = 1.13−1.19) and health literacy (OR =0.97, 95% CI = 0.95−0.99) were associated with PTSD symptoms. Conclusion This study highlights important findings that the level of an individual’s perception of threat and health literacy is associated with symptoms of PTSD. Thus, an understanding of these constructs in the target population will enable the development of better measures designed to reduce the psychological impact of the COVID-19 pandemic.
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Affiliation(s)
- Yasser Alatawi
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Fahad S Alshehri
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Adnan Alharbi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Badrah S Alghamdi
- Department of Physiology, Neuroscience Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Cheema E, McGuinness K, Hadi MA, Paudyal V, Elnaem MH, Alhifany AA, Elrggal ME, Al Hamid A. Causes, Nature and Toxicology of Fentanyl-Associated Deaths: A Systematic Review of Deaths Reported in Peer-Reviewed Literature. J Pain Res 2020; 13:3281-3294. [PMID: 33324089 PMCID: PMC7732170 DOI: 10.2147/jpr.s280462] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/12/2020] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Fentanyl poisoning has been widely reported, yet there is a lack of systematic evaluation of the nature and toxicology of associated deaths in the published literature. This article aims to systematically review the nature, causes, routes of administration and toxicology of fentanyl-associated deaths using case studies and case series in peer-reviewed published literature. METHODS Four electronic databases including Embase, Medline (via Ovid), Scopus and Google Scholar were searched from inception until October 2019 to identify the studies reporting fentanyl related deaths. Two independent reviewers screened and selected the titles and then evaluated the full texts. Only case studies and case series were included. A structured data extraction tool was used to extract data on the number of deaths, routes of administration, concomitant drug use and toxicological data. The Joanna Briggs Institute quality assessment tool was used to evaluate the quality of included studies. Data were synthesized narratively. RESULTS Of 1251 articles identified during initial search, 8 case reports and 9 case series met the inclusion criteria. A total of 1969 deaths were reported in the included studies. Deaths were concentrated in the north American region (n = 1946) and the Nordic region (n = 22). Reported causes of death included fentanyl overdose (n = 321, 56.4%), mixed drug toxicity (n = 196, 34.5%), natural (n = 28, 4.9%), other drug toxicity (n = 10, 1.8%), fentanyl and ethanol intoxication (n = 8, 1.4%), incidental (n = 5, <1%) and aspiration (n = 1). Most common routes of use were intravenous (70.5%) and transdermal routes (23.0%). Deaths came swiftly via the intravenous route. Mean level of blood fentanyl amongst all reported deaths was 0.024 µg/mL. CONCLUSION Literature related to fentanyl-associated deaths predominantly come from North America. Deaths are comparatively lower or not reported in peer-reviewed publications from the rest of the world. Abuse through intravenous administration, mixed drug toxicities and self-treatment of breakthrough pain are mainly responsible for majority of the reported deaths.
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Affiliation(s)
- Ejaz Cheema
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | | | | | - Vibhu Paudyal
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Mohammed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University, Kuantan, Malaysia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Mahmoud E Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
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28
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Alshehri FS, Alatawi Y, Alghamdi BS, Alhifany AA, Alharbi A. Prevalence of post-traumatic stress disorder during the COVID-19 pandemic in Saudi Arabia. Saudi Pharm J 2020; 28:1666-1673. [PMID: 33424259 PMCID: PMC7783103 DOI: 10.1016/j.jsps.2020.10.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/25/2020] [Indexed: 01/04/2023] Open
Abstract
Background The coronavirus diseases of 2019 (COVID-19) pandemic was classified as one of the worst pandemics in the 21st century. Its rapid transmission, unpredicted mortality rate, and the uncertainty surrounding its transmission method have evoked additional fear and anxiety. Nonetheless, to the best of our knowledge, no prior study has explored PTSD prevalence three months after the start of the quarantine procedures in Saudi Arabia nor has examined PTSD prevalence by three different methods. Objective This observational cross-sectional study aimed to identify the prevalence, severity, and influencing factors of PTSD in different regions of Saudi Arabia three months after the onset of the quarantine procedures related to the COVID-19 pandemic. Methods Through the month of June 2020, 1374 people (49.05% men and 50.95% women) completed a 35-item, 10-minute online. The prevalence of PTSD was measured using PCL-S (specific for COVID-19) that assesses the 17 symptoms of PTSD. Resilience was measured using 2-items Arabic version of the Connor-Davidson Resilience Scale 2 (CD-RISC 2). Results We calculated the prevalence by three methods, namely, PTSD cut-off score, criteria, and combined, and the prevalence was 22.63%, 24.8%, and 19.6%, respectively. Female participants showed higher prevalence than male. As well, participants who were either tested positive or suspected of having been infected with COVID-19 showed higher PTSD prevalence. Higher resilience was associated with lower PTSD prevalence. Conclusions This was the first study to report PTSD prevalence by three differential methods three months after the onset of the quarantine procedures related to the COVID-19 pandemic in Saudi Arabia. We observed a significant impact of the COVID-19 pandemic in the Saudi population; therefore, great attention should be performed in implementing new procedures that deal with the highlighted risk factors, especially in vulnerable groups, to overcome the psychological impact of the COVID-19 pandemic.
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Affiliation(s)
- Fahad S Alshehri
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Yasser Alatawi
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Badrah S Alghamdi
- Department of Physiology, Neuroscience Unit, Faculty of Medicine, King Abdulaziz University, Jeddah , Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Adnan Alharbi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Alhifany AA, McAllister MW. Assessment of Granulocyte-Colony Stimulating Factors Use at a community-based teaching hospital and compliance with National Comprehensive Cancer Network guidelines. J Taibah Univ Med Sci 2020; 15:321-324. [PMID: 32982636 PMCID: PMC7479154 DOI: 10.1016/j.jtumed.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives Methods Results Conclusion
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Elnaem MH, Rosley NFF, Alhifany AA, Elrggal ME, Cheema E. Impact of Pharmacist-Led Interventions on Medication Adherence and Clinical Outcomes in Patients with Hypertension and Hyperlipidemia: A Scoping Review of Published Literature. J Multidiscip Healthc 2020; 13:635-645. [PMID: 32764955 PMCID: PMC7381776 DOI: 10.2147/jmdh.s257273] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of this study was to provide a scoping review of the impact of pharmacist-led interventions on medication adherence and clinical outcomes in patients with hypertension and hyperlipidemia. METHODS A scoping review was conducted using pre-defined search terms in three scientific databases, including Google Scholar, ScienceDirect, and PubMed. A multi-stage screening process that considered relevancy, publication year (2009-2019), English language, and article type (original research) was followed. Review articles, meta-analysis studies, and conference proceedings were excluded. Data charting was done in an iterative process using a study-specific extraction form. RESULTS Of the initially identified 681 studies, 17 studies with 136,026 patients were included in the review. Of these, 16 were randomized controlled trials, while the remaining study was a retrospective cohort study. The majority of pharmacist-led interventions were face-to-face counseling sessions (n=8), followed by remote- or telephone-based interventions (n=5) and multi-faceted interventions (n=4). The majority of the studies (n=7) used self-reported adherence measures and pharmacy refill records (n=8) to measure the rate of adherence to prescribed medications. Eleven of the included studies reported a statistically significant (P<0.05) impact on medication adherence. Overall, twelve studies assessed the effect of the interventions on the clinical outcome measures; of these, only four studies were associated with significant impact. CONCLUSION Pharmacist-led interventions were associated with improved patients' adherence to their medications but were less likely to be consistently associated with the attainment of clinical outcomes. Face-to-face counseling was the most commonly used intervention; while, the multi-faceted interventions were more likely to be effective in improving the overall outcome measures. The rigorous design of targeted interventions with more frequent follow-ups, careful consideration of the involved medications, and patients' characteristics could increase the effectiveness of these interventions.
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Affiliation(s)
- Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
- Quality Use of Medicines Research Group, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Nor Fatin Farahin Rosley
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Malaysia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Mahmoud E Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Ejaz Cheema
- School of Pharmacy, University of Birmingham, BirminghamB15 2TT, UK
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Alhifany AA, Alqurashi AF, Al-Agamy MH, Alkhushaym N, Alhomoud F, Alhomoud FK, Almangour TA. Employment of Mapping Technology in Antimicrobial Resistance Reporting in Saudi Arabia. Geospat Health 2020; 15. [PMID: 32575972 DOI: 10.4081/gh.2020.868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
Although Antimicrobial Resistance (AMR) is a worldwide threat, local AMR databases do not exist. Unlike other health disasters, developing containment strategies for AMR cannot be started without a representative, local, updated AMR data. However, Geographical Information Systems (GIS) mapping technology is capable of visualizing AMR data integrated with geographical regions. Due to the absence of AMR databases in Saudi Arabia, we searched Medline and Embase databases from inception until May 28, 2018, including literature that reported AMR data on the most prevalent gram-negative bacterial strains in Saudi Arabia. These data were extracted into Microsoft Excel file and inserted into STATA software, version 13 and ArcMap 10.6 software platform for mapping. We found particularly high levels of AMR in Makkah (Mecca), possibly due to high antibiotic consumption because of the influx of pilgrims, with Pseudomonas aeruginosa isolates showing the highest resistance rate against amikacin, aztreonam, cefepime, ceftazidime, ciprolfloxacin, gentamicin, imipenem, meropenem and pipracillin/tazobactam, and Enterobacteriaceae isolates against cefuroxime, ciprofloxacin, ampicillin, imipenem and ertapenem. The cause is, however, multifactorial since Acinetobacter baumannii isolates showed a variable resistance rate throughout the country. The employment of mapping technology in displaying AMR data extracted from published literature is a practically useful approach, and advanced GIS analyses should help stakeholders create containment strategies and allocate resources to slow down the emergence of AMR.
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Affiliation(s)
- Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah.
| | | | - Mohamed H Al-Agamy
- Microbiology and Immunology Department, College of Pharmacy, King Saud University, Riyadh.
| | - Nasser Alkhushaym
- Department of Clinical Pharmacy; Royal Commission Health Services Program; Jubail.
| | - Faten Alhomoud
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam.
| | - Farah K Alhomoud
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam.
| | - Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh.
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Abstract
Objectives: To assess the public knowledge and perception about generic medications in Saudi Arabia, and their willingness to use generic medications. Methods: This cross-sectional, online-questionnaire-based study was conducted between May and July 2019, including participants who can read and complete an Arabic online survey. Chi-square test and contingency coefficient were used to investigate differences in different segments of participants and assess the association between knowledge and perception. Results: A total of 397 participants have completed the survey. One-half of them were female, the majority were of young age (<35 years), and 40% of them were buying their medications independently. Only 40.5% of participants had adequate knowledge and 60% of them had positive perception on generics. Participants with higher level of education were more likely to have adequate knowledge (p=0.002) and positive perception (p=0.006). The study found a moderate relationship between knowledge and perception about generics (standardized C=0.35, p<0.001). The country of origin for medications was a significant indicator of quality for two-thirds of participants, and one-half of them believed that local generics can compete with imported ones. About one-half of participants used generics and the majority of them were satisfied with their experience. Conclusion: There is a general lack of knowledge, while having a positive perception on generic medications among the general public in Saudi Arabia. Future studies should focus on strategies to improve it and assess its cost-savings consequences while maintaining quality of care.
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Affiliation(s)
- Omar A Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-amil.
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Almalki HH, Alshibani TM, Alhifany AA, Almohammed OA. Comparative efficacy of statins, metformin, spironolactone and combined oral contraceptives in reducing testosterone levels in women with polycystic ovary syndrome: a network meta-analysis of randomized clinical trials. BMC Womens Health 2020; 20:68. [PMID: 32248801 PMCID: PMC7132972 DOI: 10.1186/s12905-020-00919-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/06/2020] [Indexed: 02/01/2023]
Abstract
Background Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting about 10% of women in reproductive age and associated with a variety of hormonal abnormalities, including hyperandrogenemia and infertility, all of which could lead to PCOS. Statins were previously introduced as a therapeutic option for reducing testosterone levels in women with PCOS, either alone or in combination. The aim of this study is to evaluate the effectiveness of different statins alone or in combination with metformin in reducing testosterone levels in women with PCOS. Methods Medline, Embase, and clinicaltrials.gov were searched for studies that investigated the efficacy of statins, metformin, spironolactone, or combined oral contraceptives (COCs), individually or in combination, in reducing the testosterone level in patients with PCOS. The search was limited to randomized clinical trials and conducted according to the preferred reporting items for systematic reviews and meta-analyses - extension statement for network meta-analyses (PRISMA-NMA). The quality of included studies was assessed using the Cochrane Collaboration risk of bias (RoB) assessment tool. A frequentist network meta-analysis using random-effects models was used to assess the efficacy in reducing testosterone level and were expressed as odds ratios (OR) and 95% credible interval (95%Crl). All statistical analyses were performed using netmeta Version 1.0 on R statistical package. Result Nine RCTs involving 613 patients were included. Atorvastatin showed greater reduction in testosterone level compared to COC (MD −2.78, 95%CrI −3.60, −1.97), spironolactone plus metformin (MD −2.83, 95%CrI −3.80, −1.87), simvastatin (MD −2.88, 95%CrI −3.85, −1.92), spironolactone (MD −2.90, 95%CI −3.77, −2.02), simvastatin plus metformin (MD −2.93, 95%CrI −3.79, −2.06), metformin (MD −2.97, 95%CrI −3.69, −2.25), lifestyle modification (MD −3.02, 95%CrI −3.87, −2.18), and placebo (MD −3.04, 95%CrI −3.56, −2.53). Conclusion Atorvastatin was found to be more effective than the other management strategies in reducing the total testosterone level for patients with PCOS. Future studies should focus on the optimal dose.
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Affiliation(s)
- Hussain H Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, 13578 Taif Rd, Makkah, 21955, Saudi Arabia
| | - Turki M Alshibani
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, 13578 Taif Rd, Makkah, 21955, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, 13578 Taif Rd, Makkah, 21955, Saudi Arabia
| | - Omar A Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia.
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Altebainawi AF, Alrashidi MN, Aljbreen MK, Aziz MM, Alhifany AA, Aljofan M, Alshammari TM. Association of medication storage with diabetes control: A cross-sectional study from Saudi Arabia. Saudi Pharm J 2020; 28:452-459. [PMID: 32273804 PMCID: PMC7132604 DOI: 10.1016/j.jsps.2020.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/12/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND In addition to diet restriction and physical activity, diabetes mellitus is managed by the chronic use of medications that require appropriate storage conditions to maintain their stability and effectiveness. However, there is a lack of information regarding patients' knowledge of medication storage and practices in Saudi Arabia. Therefore, the objective of this study was to determine the diabetics' knowledge about medication storage requirements and to evaluate the impact of antidiabetic medications storage on the blood glucose levels. METHODS This study was a cross-sectional in the form of an interviewer-guided interview using a close-ended questions. The study was conducted among patients diagnosed with diabetes at diabetic clinics of public hospitals and other diabetic specialized clinics in Hail region of Saudi Arabia, over a period of four months between January to April 2019. RESULTS A total of 501 completed questionnaires were returned. Of the respondents, 51.5% were males and 48.5% were females. Of the total participants 52.7% never achieved normal blood glucose range, which was associated with health literacy and medication storage knowledge. Almost half of the participants stored the medication correctly and others have poor knowledge and practice of medication storage, of whom 7.8% always store their medicines in their cars. CONCLUSION Almost half of the participants lack the knowledge of appropriate storage conditions of diabetes medications, which was shown to have a significant association with blood glucose levels.
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Affiliation(s)
- Ali F. Altebainawi
- Clinical Pharmacy Department, Pharmaceutical Care Services, King Khalid Hospital, Ministry of Health, Hail, Saudi Arabia
- Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia
- Department of Pharmacovigilance, AJA Pharmaceutical Industries Co. Ltd., Hail, Saudi Arabia
| | | | | | | | - Abdullah A. Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohamad Aljofan
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan
| | - Thamir M. Alshammari
- Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia
- Saudi Food and Drug Authority, Riyadh, Saudi Arabia
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Eljaaly K, Alkhalaf A, Alhifany AA, Alshibani M. Photosensitivity induced by lomefloxacin versus other fluoroquinolones: A meta-analysis. J Infect Chemother 2020; 26:535-539. [PMID: 32081646 DOI: 10.1016/j.jiac.2020.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/08/2020] [Accepted: 01/21/2020] [Indexed: 12/12/2022]
Abstract
Lomefloxacin may be more likely than other fluoroquinolones to cause photosensitivity. However, the rate of photosensitivity is variable and a meta-analysis has yet to be performed. The aim of this meta-analysis is to compare the rate of photosensitivity between outpatients who received lomefloxacin and those who received other fluoroquinolones. PubMed, EMBASE, Cochrane Library databases and trial registries were searched for randomized controlled trials (RCTs) of outpatients through June 12, 2019. The study outcome was the rate of photosensitivity based on the intention-to-treat principle, estimated by risk difference (RD) as the primary analysis and Peto odds ratio (Peto OR) as the secondary analysis, with 95% confidence intervals (CIs) using random-effects models. Four RCTs (total of 2295 patients) were included in this meta-analysis. A statistically higher risk of photosensitivity was found with lomefloxacin than with other fluoroquinolones (RD, 3.4%; 95% CI, 0.7%-6.2%; P-value = 0.013; I2 = 10.9%). The odds of photosensitivity was also significantly higher with lomefloxacin (Peto OR, 5.81; 95% CI, 3.34 to 10.11; P-value <0.001; I2 = 0%). This meta-analysis of RCTs found significantly higher photosensitivity with lomefloxacin compared to other fluoroquinolones. Considering this finding and given its lack of additional efficacy compared to other fluoroquinolones, lomefloxacin as a fluoroquinolone option should potentially be reconsidered.
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Affiliation(s)
- Khalid Eljaaly
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, USA.
| | - Amina Alkhalaf
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohannad Alshibani
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, USA
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Almangour TA, Perry GK, Alhifany AA. Dalbavancin versus standard of care for the treatment of osteomyelitis in adults: A retrospective matched cohort study. Saudi Pharm J 2020; 28:460-464. [PMID: 32273805 PMCID: PMC7132597 DOI: 10.1016/j.jsps.2020.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/12/2020] [Indexed: 12/17/2022] Open
Abstract
Objective To assess the safety and effectiveness of dalbavancin compared to standard of care (SOC) in the treatment of osteomyelitis in adults. Method A retrospective cohort study of patients with osteomyelitis due to S. aureus treated with dalbavancin was conducted. Patients who received at least 2 doses of dalbavancin for the treatment of osteomyelitis between January 1, 2015 to January 31, 2018 in a single center in Texas, USA were identified and matched in 1:1 ratio with controls who received SOC. The primary efficacy outcome was the clinical success at the end of treatment. Secondary efficacy outcome was the clinical success continued for at least 3 months after the completion of the antimicrobial therapy. Results During study period, 21 patients received dalbavancin for the treatment of osteomyelitis; however, only 11 patients were eligible for inclusion and matched to 11 others who received SOC. Primary outcome was achieved in all 11 patients who received dalbavancin and all those patients subsequently attained the secondary outcome. In SOC group, primary outcome occurred in 82% (9/11) of patients in which 8 out of 9 patients subsequently achieved the secondary outcome. No adverse reaction noted in either group. Conclusion Dalbavancin appears to be safe and effective for the management of osteomyelitis in adults. Further studies are needed to confirm these findings.
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Affiliation(s)
- Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Gregory K Perry
- Hendrick Medical Center, 1900 Pine Street, Abilene, TX 79601, United States
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, P.O. Box 13578, Makkah 21955, Saudi Arabia
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Alhifany AA, McBride A, Almutairi AR, Cheema E, Shahbar A, Alatawi Y, Alharbi AS, Babiker H, MacDonald K, Aapro M, Abraham I. Efficacy of olanzapine, neurokinin-1 receptor antagonists, and thalidomide in combination with palonosetron plus dexamethasone in preventing highly emetogenic chemotherapy-induced nausea and vomiting: a Bayesian network meta-analysis. Support Care Cancer 2019; 28:1031-1039. [PMID: 31823054 DOI: 10.1007/s00520-019-05210-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 11/24/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Olanzapine, neurokinin-1-receptor-antagonists (NK-1-RA), and thalidomide added to palonosetron + dexamethasone (PALO-DEX) have been evaluated in separate studies as prophylaxis for chemotherapy-induced nausea and vomiting (CINV) due to highly emetogenic chemotherapy (HEC). We conducted a Bayesian network meta-analysis to compare the prophylactic efficacy of these agents in combination with PALO-DEX. METHODS PubMed, Medline/Ovid, Embase, and Clinicaltrials.gov were searched from inception through 22 Mar 2018. Study quality was assessed using the Cochrane methodology. A Bayesian network meta-analysis using random-effects models was used to asses complete response (CR) and rate of no nausea (RNN) in acute, delayed, and overall phases and were expressed as odds ratios (OR) and 95% credible interval (95% CrI). Ranking probabilities of treatments were calculated using the surface under the cumulative ranking curve (SUCRA) to identify the probability of a given treatment as the best option against the worst option. RESULTS Nine RCTs involving two thousand nine hundred fifty-nine patients were included. The olanzapine-based regimen showed greater CR in the acute, delayed, and overall-phases versus the PALO-DEX regimen (OR = 3.97, 95% CrI = 1.02-19.13; OR = 5.62, 95% CrI = 1.66-28.58; OR = 4.79, 95% CrI = 1.40-24.02, respectively). Additionally, it showed greater RNN than the NK-1-RA-based and the PALO-DEX regimens in the delayed phase only (OR = 2.90, 95% CrI = 1.34-5.15; OR = 4.53, 95% CrI = 1.89-10.55, respectively). Olanzapine-, NK-1-RA-, and thalidomide-based regimens did not differ in CR in the three phases. SUCRA probabilities ranked the olanzapine-based regimen as the best option in terms of CR and RNN, while ranking the NK-1-RA-based regimens as the second best option in terms of CR throughout the three phases. CONCLUSION Based on the data included in the analyses, there is insufficient evidence to support adding thalidomide or NK-1-RA to PALO-DEX in preventing CINV induced by HEC. However, adding olanzapine to PALO-DEX achieves better CR and RNN. Olanzapine side-effects and the absence of direct comparisons explain why some guidelines are cautious in suggesting the use of olanzapine.
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Affiliation(s)
- Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia. .,Center for Health Outcomes and Pharmaco-Economic Research, University of Arizona, Tucson, AZ, USA.
| | - Ali McBride
- Center for Health Outcomes and Pharmaco-Economic Research, University of Arizona, Tucson, AZ, USA.,Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA.,University of Arizona Cancer Center, Tucson, AZ, USA
| | - Abdulaali R Almutairi
- Center for Health Outcomes and Pharmaco-Economic Research, University of Arizona, Tucson, AZ, USA.,Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Ejaz Cheema
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Alaa Shahbar
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Yasser Alatawi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Adnan S Alharbi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hani Babiker
- University of Arizona Cancer Center, Tucson, AZ, USA
| | | | - Matti Aapro
- Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland
| | - Ivo Abraham
- Center for Health Outcomes and Pharmaco-Economic Research, University of Arizona, Tucson, AZ, USA.,Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA.,University of Arizona Cancer Center, Tucson, AZ, USA.,Matrix45, Tucson, AZ, USA.,Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, USA
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Alhifany AA, Almutairi AR, Almangour TA, Shahbar AN, Abraham I, Alessa M, Alnezary FS, Cheema E. Comparing the efficacy and safety of faecal microbiota transplantation with bezlotoxumab in reducing the risk of recurrent Clostridium difficile infections: a systematic review and Bayesian network meta-analysis of randomised controlled trials. BMJ Open 2019; 9:e031145. [PMID: 31699731 PMCID: PMC6858162 DOI: 10.1136/bmjopen-2019-031145] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The risk of recurrent Clostridium difficile infections (RCDIs) is high when treated with standard antibiotics therapy (SAT) alone. It is suggested that the addition of faecal microbiota transplantation (FMT) or bezlotoxumab after SAT reduces the risk of RCDI. In the absence of head-to-head randomised controlled trials (RCTs), this review attempts to compare the efficacy and safety of bezlotoxumab with FMT in reducing the risk of RCDI in hospitalised patients. DESIGN A systematic review and Bayesian network meta-analysis. DATA SOURCE A comprehensive search from inception to 30 February 2019 was conducted in four databases (Medline/PubMed, Embase, Scopus, ClinicalTrials.gov). ELIGIBILITY CRITERIA RCTs reporting the resolution of diarrhoea associated with RCDI without relapse for at least 60 days after the end of treatments as the primary outcome. DATA EXTRACTION AND SYNTHESIS We extracted author, year of publication, study design and binomial data that represented the resolution of diarrhoea or adverse events of monoclonal antibodies and FMT infusion. Random-effects models were used for resolution rate of RCDI and adverse events. The Cochrane Risk of Bias tool was used to assess the quality of included RCTs. RESULTS Out of 1003 articles identified, seven RCTs involving 3043 patients contributed to the review. No difference was reported between single or multiple infusions of FMT and bezlotoxumab in resolving RCDI, (OR 1.53, 95% credible interval (CrI) 0.39 to 5.16) and (OR 2.86, 95% CrI 1.29 to 6.57), respectively. Patients treated with SAT alone or bezlotoxumab with SAT showed significantly lower rates of diarrhoea than FMT (OR 0, 95% CrI 0 to 0.09) and (OR 0, 95% CrI 0 to 0.19), respectively. There was no difference in terms of other adverse events. CONCLUSIONS This is the first network meta-analysis that has compared the recently Food and Drug Administration-approved monoclonal antibody bezlotoxumab with FMT for resolving RCDI. The quality of the included RCTs was variable. The findings of this study suggested no difference between single or multiple infusions of FMT and bezlotoxumab. However, FMT was associated with a higher rate of non-serious diarrhoea as opposed to SAT used alone or in combination with bezlotoxumab.
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Affiliation(s)
| | | | - Thamer A Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | - Ivo Abraham
- Pharmacy, University of Arizona, Tucson, Arizona, USA
| | - Mohammed Alessa
- College of Pharmcy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Ejaz Cheema
- Pharmacy, University of Birmingham Edgbaston Campus, Birmingham, UK
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Alhifany AA, Bifari N, Alatawi Y, Ullah Malik S, Almangour T. 465. Comparative Efficacy of Double vs. Single Antibiotic Regimens for the Empiric Treatment of MRSA-Induced Acute Bacterial Skin and Skin Structure Infection. Open Forum Infect Dis 2019. [PMCID: PMC6810020 DOI: 10.1093/ofid/ofz360.538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The initial management of Acute bacterial skin and skin structure infection (ABSSSI) is burdensome. It requires empirical antibiotic therapy that covers both gram-positive and gram-negative bacteria. Vancomycin plus aztreonam are the most commonly used antibiotic combination, nonetheless, they have many limitations which limits their use. Hence, many new single agents with MRSA and gram-negative coverage, oral options, and/or good safety profile have been developed to be a potential alternative such as: ceftaroline, ceftobiprole, tigecycline and the recent FDA approved antibiotic (delafloxacin). In the absence of head-to-head trials comparing these agents, we decided to conduct a network meta-analysis for these therapeutic regimens. Methods A Bayesian network meta-analysis of randomized clinical trials identified in PubMed/Medline and Embase databases was conducted. We performed both fixed and random effect models for clinical cure as the primary outcome of interest. Additionally, rankograms were generated using the surface under the cumulative ranking curve (SUCRA) to obtain the treatment ranking probabilities in relation to their relative effect. Results We identified 10 eligible studies involving 4,914 patients. The indirect comparison demonstrated that delafloxacin showed no difference in terms of clinical cure compared with ceftaroline (OR, 0.82, 95% Cr.I 0.39–1.8), ceftobiprole (OR, 0.79, 95% Cr.I 0.32–1.9), SOC (OR, 1.2, 95% Cr.I 0.62–2.4) and tigecycline (OR, 1.0, 95% Cr.I 0.45–2.2) in the fixed effect analysis, nor in the random-effect analysis (OR, 0.8, 95% Cr.I 0.26–2.2; OR, 0.78, 95% Cr.I 0.2–3.0; OR, 1.2, 95% Cr.I 0.51–3.1; and OR, 0.96, 95% Cr.I 0.30–3.0), respectively. Furthermore, the ranking probabilities in the fixed-effect and random-effect analysis showed that ceftaroline was ranked the first in terms of clinical cure (SUCRA, 40.02%) followed by ceftobiprole (SUCRA, 22.80%), delafloxacin (SUCRA, 16.60%), SOC (SUCRA, 13.80%), and then tigecycline (SUCRA, 6.70%). Conclusion Ceftaroline, ceftbiprole, delafoxacin, SOC and tigecycline are similarly effective. However, delafloxacin provides better convenience. Further comparative studies regarding their safety are needed. ![]()
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Disclosures All authors: No reported disclosures.
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Bilal J, Berlinberg A, Riaz IB, Faridi W, Bhattacharjee S, Ortega G, Murad MH, Wang Z, Prokop LJ, Alhifany AA, Kwoh CK. Risk of Infections and Cancer in Patients With Rheumatologic Diseases Receiving Interleukin Inhibitors: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e1913102. [PMID: 31626313 PMCID: PMC6813598 DOI: 10.1001/jamanetworkopen.2019.13102] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE The safety profile of interleukin (IL) inhibitors is not well established. OBJECTIVE To assess the risk of serious infections, opportunistic infections, and cancer in patients with rheumatologic diseases treated with IL inhibitors. DATA SOURCES Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations; Ovid MEDLINE Daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; and Scopus were searched (inception to November 30, 2018). STUDY SELECTION Randomized, placebo-controlled trials that evaluated IL inhibitor therapies in rheumatic diseases and reported safety data were included in the analyses. DATA EXTRACTION AND SYNTHESIS This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Two investigators independently extracted study data and assessed risk of bias and certainty in the evidence. Fixed-effects meta-analysis was conducted to pool odds ratios (ORs) for serious infections, opportunistic infections, and cancers for IL inhibitors vs placebo. MAIN OUTCOMES AND MEASURES The outcomes of interest were the number of serious infections, opportunistic infections, and cancers in individuals receiving IL inhibitor therapies compared with placebo. RESULTS In this meta-analysis, 74 studies comprising 29 214 patients (24 236 patients for serious infections, 9998 for opportunistic infections, and 21 065 for cancer [number of patients overlaps for each outcome]) were included. Patients receiving IL inhibitors had a higher risk of serious infections (OR, 1.97; 95% CI, 1.58-2.44; P < .001, I2 = 0%; high certainty), opportunistic infections (OR, 2.35; 95% CI, 1.09-5.05; P = .03, I2 = 0%; moderate certainty), and cancer (OR, 1.52; 95% CI, 1.05-2.19; P = .03, I2 = 11%; moderate certainty). CONCLUSIONS AND RELEVANCE The risk of serious infections, opportunistic infections, and cancer appears to be increased in patients with rheumatologic diseases who are treated with IL inhibitors compared with placebo.
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Affiliation(s)
- Jawad Bilal
- Division of Rheumatology, Department of Medicine, University of Arizona, Tucson
| | - Adam Berlinberg
- Division of Rheumatology, Department of Medicine, University of Colorado, Denver
| | - Irbaz Bin Riaz
- Division of Hematology/Oncology, Department of Medicine, Mayo Clinic Rochester, Rochester, Minnesota
| | - Warda Faridi
- Division of Hematology/Oncology, Department of Medicine, University of Arizona, Tucson
| | - Sandipan Bhattacharjee
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Arizona, Tucson
| | | | - Mohammad H. Murad
- Evidence-Based Practice Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Zhen Wang
- Evidence-Based Practice Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Larry J. Prokop
- Mayo Clinic Libraries, Mayo Clinic Rochester, Rochester, Minnesota
| | - Abdullah A. Alhifany
- College of Pharmacy, Department of Clinical Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - C. Kent Kwoh
- Division of Rheumatology, Department of Medicine, University of Arizona, Tucson
- University of Arizona Arthritis Center, University of Arizona, Tucson
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Almangour TA, Perry GK, Terriff CM, Alhifany AA, Kaye KS. Dalbavancin for the management of gram-positive osteomyelitis: Effectiveness and potential utility. Diagn Microbiol Infect Dis 2019; 93:213-218. [DOI: 10.1016/j.diagmicrobio.2018.10.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 11/27/2022]
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Almangour TA, Fletcher V, Alessa M, Alhifany AA, Tabb D. Multiple Weekly Dalbavancin Dosing for the Treatment of Native Vertebral Osteomyelitis Caused by Methicillin-Resistant Staphylococcus Aureus: A Case Report. Am J Case Rep 2017; 18:1315-1319. [PMID: 29222405 PMCID: PMC5737230 DOI: 10.12659/ajcr.905930] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Patient: Male, 58 Final Diagnosis: Vertebral osteomyelitis Symptoms: Back pain Medication: Dalbavancin Clinical Procedure: — Specialty: Infectious Disease
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Affiliation(s)
- Thamer A Almangour
- Department of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, NC, USA
| | | | - Mohammed Alessa
- College of Pharmacy, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Deanne Tabb
- Department of Infectious Diseases Pharmacy, Midtown Medical Center, Columbus Regional Health, Columbus, GA, USA
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Abstract
Patient: Female, 17-days-old Final Diagnosis: Cardiac arrest Symptoms: Lower abdominal pain and contractions Medication: — Clinical Procedure: Prematurity treatment and Management of neonatal septicemia Specialty: Pediatrics and Neonatology
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Affiliation(s)
- Abdullah A Alhifany
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Thamer A Almangour
- Department of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Deanne E Tabb
- Midtown Medical Center, Columbus Regional Health, Columbus, GA, USA
| | - David H Levine
- Midtown Medical Center, Columbus Regional Health, Columbus, GA, USA
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