DRUG UTILIZATION PATTERN IN AN INTENSIVE CARE UNIT AT A TERTIARY CARE TEACHING HOSPITAL IN OMAN

Objectives: To evaluate the drug prescribing trends in the ICU department and correlate them with the disease patterns and patients' outcomes.Methods: The case records of patients admitted to the ICU at Sultan Qaboos University Hospital (SQUH), a teaching hospital in Oman, during a 5-month period between June 1st to October 31st 2013 were analyzed. The variables collected included demographic and clinical characteristics as well as duration of hospitalization, indications and utilization of different drugs.Results: A total of 138 patients were evaluated with an average of age ‎46±19‎ years. The average length of stay at ICU‎ was ‎4.5±3.5 days. The‎ average number of drugs per prescription was ‎8.0±4.6‎. The most common route used was the parenteral route (66%) followed by the enteral route (25%). Anti-infective drugs were the most commonly prescribed class of drugs (25%) followed by gastrointestinal drugs (20%). Antibiotics accounted for 12% of the total drugs prescribed. Trauma was the most common indication for the admission to the ICU (22%).Conclusion: Drugs prescription patterns in the ICU appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of drugs in the ICU setting.Â

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

WORLD HEALTH ORGANIZATION DRUG PRESCRIBING INDICATORS AT A UNIVERSITY PRIMARY HEALTH-CARE CENTER IN OMAN

Objective: This study aimed at evaluating the prescribing patterns of drugs based on the World Health Organization (WHO) indicators at the primary health-care Family Medicine and Community Health Clinic in Sultan Qaboos University Hospital, Oman. Methods: This was a retrospective cross-sectional study covering a 6-month period in 2016 (January–June) for all patients attended Family Medicine and Community Health Clinic in Sultan Qaboos University Hospital, Oman. Data of 300 patients with 892 prescriptions were assessed during the study period. Results: The average number of drugs per encounter (2.82), the percentage of encounters with antibiotics (13.3%), and the percentage of encounters with an injection (7.6%) were within the optimal range set by the WHO. The percentage of drugs prescribed by generic name (80.1%) and the percentage of drugs prescribed from an essential drug list (EDL) (40.4%) did not reach the optimal 100% value set by the WHO. Conclusion: Most of the WHO core prescribing indicators in the study were within the optimal range. Prescribing from the WHO EDL was sub-optimal. These data will set ground to optimize rational drug prescribing in the primary health-care setting