Multidrug-Resistant Pseudomonas aeruginosa Infection in a Child with Cystic Fibrosis

ABSTRACT We describe a pediatric cystic fibrosis patient who developed a pulmonary exacerbation due to two multidrug-resistant (MDR) Pseudomonas aeruginosa isolates. In addition to these MDR organisms, the case was further complicated by β-lactam allergy. Despite the MDR phenotype, both isolates were susceptible to an antimicrobial combination

Assessment of Academic Resilience and its associated factors among Pharmacy Students in Twelve Countries

Objective Academic resilience, a critical determinant of academic achievement, is affected by various factors. There is a paucity of large-scale international assessments of academic resilience among pharmacy students. Therefore, this study aimed to assess academic resilience among pharmacy students in 12 countries and to evaluate factors associated with their academic resilience levels. Methods A cross-sectional online survey-based study was conducted among randomly selected pharmacy students in 12 countries: Egypt, Türkiye, Indonesia, Pakistan, Bangladesh, Iraq, Jordan, Nigeria, Malaysia, Saudi Arabia, Sudan, and the United Arab Emirates. After pilot testing, the validated 30-item academic resilience scale (ARS) was used for the assessment. The data were collected between November 1, 2022 and April 15, 2023. Descriptive and inferential statistics were performed, as appropriate. Results A total of 3950 were received from the 12 participating countries. The mean age was 21.68 ± 2.62 years. About two-thirds of the responses were from female participants and those studying for Bachelor of Pharmacy degrees. Overall, the findings show moderate academic resilience, which varied across countries. The median (IQR) of the total ARS-30 was 114 (103−124). Females exhibited lower negative affective and emotional response subscale levels than males. There were significant cross-country variations in the ARS-30 and all subscales. The highest overall levels were reported for Sudan, Pakistan, and Nigeria and the lowest were reported for Indonesia and Türkiye. Students in private universities tended to have higher overall ARS levels than public university students. Higher academic performance was significantly associated with ARS levels, whereas those with excellent performance exhibited the highest ARS levels. Students with exercise routines had higher ARS levels than those without exercise routines. Finally, students who were engaged in extracurricular activities had higher ARS levels than those who did not participate in these activities. Conclusion The study offers insights into the factors affecting academic resilience in pharmacy students across several countries. The findings could guide interventions and support activities to improve resilience and academic outcomes

Lack of Correlation between Bristol Stool Scale and Quantitative Bacterial Load in Infection

Decision to test for Clostridium difficile infection (CDI) is usually made when patients have loose stools with Bristol stool score of ≤5. We aimed to assess the relationship between bacterial load of C. difficile and Bristol stool scale, as well as stool frequency in stool samples collected from patients infected with the organism. Samples were collected at baseline, during therapy, and at the end of therapy. Spearman correlation test was used to evaluate these relationships. No correlation between Bristol stool scale and fecal load of C. difficile was found for both spores and vegetative cells at all time points as counts were persistently high ( P = non-significant). Weak positive correlations were found between stool frequency and fecal load of C. difficile spores and vegetative cells ( r s = 0.22 and 0.24, P = 0.04 and 0.03, respectively). These findings indicate that quantitative colony counts were sufficiently high to detect C. difficile , irrespective of stool consistency, and suggest that semiformed stool should be sought for the pathogen in symptomatic patients with frequent stools

Ceftriaxone use in brucellosis: A case series

Background: Brucellosis is a zoonotic disease caused by Brucella spp. It can be either uncomplicated or complicated when it disseminates to other organs. Treatment for brucellosis involves a combination of at least two antibiotics, or more in complicated brucellosis. Limited data exist on the use of ceftriaxone in the clinical setting. Therefore, we present patient cases in which ceftriaxone was used in brucellosis treatment regimen. Methods: Patients with documented brucellosis from January 2008 to December 2018 were evaluated for the use of ceftriaxone for treatment in King Abdulaziz Univeristy Hospital, Jeddah, Saudi Arabia. Patients’ data were evaluated retrospectively and are described. Results: Out of 94 treated brucellosis patients, six patients received ceftriaxone 2 g IV every 12 h for therapy for varied durations. Four had neurobrucellosis, one had Brucella epididymo-orchitis and one had uncomplicated brucellosis. All six patients experienced clinical cure, though one neurobrucellosis patient had complications and one had ceftriaxone stopped after one week of therapy due to presumed antibiotic-induced fever. Conclusion: Ceftriaxone represents a reasonable option for the treatment of complicated brucellosis when added to the initial regimen at a dose of 2 g IV every 12 h. Keywords: Brucella, Brucellosis, Ceftriaxone, Cases, Zoonotic infection, Saudi Arabi

COVID-19 vaccine hesitancy and acceptance among the public in the Gulf Cooperation Council countries: A review of the literature

Vaccine hesitancy has a significant impact on tackling infectious diseases as it has resulted in reemergence of vaccine-preventable diseases. This review aims to provide an up-to-date evaluation of COVID-19 vaccine hesitancy among the public in the Gulf Cooperation Council countries. We searched the PubMed and SCOPUS databases for manuscripts published on vaccine hesitancy and/or acceptance among the public in GCC countries up till April 1st, 2022. Forty-nine studies met the inclusion criteria and were reviewed. The average vaccine hesitancy rate across GCC countries was 43%. Concerns about vaccine safety (n = 32) and effectiveness (n = 26) were most frequently associated with hesitancy. Being male (n = 25) and having positive behavior regarding the influenza vaccine or vaccines in general (n = 22) were most frequently associated with acceptance. Collaborative efforts of governments, academic bodies, and the media to provide evidence of vaccines’ effectiveness throughout history and strictly manage the spread of the vaccine safety-related rumors are warranted

The Significance of Bayesian Pharmacokinetics in Dosing for Critically Ill Patients: A Primer for Clinicians Using Vancomycin as an Example

Antibiotic use is becoming increasingly challenging with the emergence of multidrug-resistant organisms. Pharmacokinetic (PK) alterations result from complex pathophysiologic changes in some patient populations, particularly those with critical illness. Therefore, antibiotic dose individualization in such populations is warranted. Recently, there have been advances in dose optimization strategies to improve the utilization of existing antibiotics. Bayesian-based dosing is one of the novel approaches that could help clinicians achieve target concentrations in a greater percentage of their patients earlier during therapy. This review summarizes the advantages and disadvantages of current approaches to antibiotic dosing, with a focus on critically ill patients, and discusses the use of Bayesian methods to optimize vancomycin dosing. The Bayesian method of antibiotic dosing was developed to provide more precise predictions of drug concentrations and target achievement early in therapy. It has benefits such as the incorporation of personalized PK/PD parameters, improved predictive abilities, and improved patient outcomes. Recent vancomycin dosing guidelines emphasize the importance of using the Bayesian method. The Bayesian method is able to achieve appropriate antibiotic dosing prior to the patient reaching the steady state, allowing the patient to receive the right drug at the right dose earlier in therapy

Factors influencing future career interests of pharmacy interns in Saudi Arabia: a survey from 25 colleges of pharmacy

Abstract Background Hundreds of pharmacists graduate from pharmacy colleges in Saudi Arabia, and various factors influence their choice of career pathway. Very few single-institution studies assessed career choices of pharmacy students with or without evaluating the influencing factors. Therefore, this study aimed to evaluate career choices and the associating factors of pharmacy interns from multiple colleges in Saudi Arabia. Methods This was a cross-sectional study that surveyed pharmacy interns from 25 pharmacy colleges in Saudi Arabia using an online questionnaire. The survey was sent during the last rotation month in the internship year (May–June 2022). Results Of 454 participants, 411 (90.5%) were enrolled in Doctor of Pharmacy programs. While most participants were interested in becoming clinical pharmacists (n = 183; 40.3%), a considerable number were also interested in working in different sectors of pharmaceutical companies and industry (n = 127; 28%). Internship training significantly correlated with selecting clinical pharmacy specialist career (r = 0.19; P = 0.0001), whereas salary/financial incentives significantly influenced the choice of working as sales and marketing representatives and pharmacy product specialists in pharmaceutical companies (r = 0.29 and 0.24; P < 0.0001 for both). College courses correlated with choosing academia in pharmaceutical sciences (r = 0.20; P < 0.0001), whereas summer training correlated with the community pharmacy career (r = 0.11; P = 0.02). Conclusion Pharmacy colleges should utilize results from this study to enhance the exposure of pharmacy students during their academic years to different pharmacy career pathways by allowing the opportunity to shadow pharmacists from different sectors as part of college courses, inviting previous graduates, and activating the role of academic advisors in career orientation

Pharmacists and pharmacy services in COVID-19 literature: A bibliometirc analysis

Background: The COVID-19 pandemic had an enormous impact on the global economy and healthcare. Pharmacists were vitalmembers of the healthcare system, and they participated in various strategies to reduce the effect of the pandemic. Numerous papers were published discussing their roles during the pandemic. Bibliometric analysis was used to measure the impact of publications on this topic and assessed them qualitatively and quantitatively over a specific time. Objective: Evaluate published literature pertaining to the roles of pharmacists and pharmacy services during the pandemic and identify gaps. Methods: An electronic search was conducted on PubMed database using a specific query. Eligible publications were published in English between January 2020 and January 2022 and discussed the role of pharmacists, pharmacies, and pharmacy departments during the pandemic. Clinical trials, studies on pharmacy education/training, and conference abstracts were excluded. Results: Of 954 records retrieved, 338 (35.4%) from 67 countries were included. Most papers (n=113; 33.4%) were from the community pharmacy sector, followed by the clinical pharmacy sector (n = 89; 26.3%). Sixty-one (18%) papers were multinational, mostly involving two countries. The average number of citations of the included papers was 6 times (range 0–89). The most common MeSH terms were ‘humans’, ‘hospitals’, and ‘telemedicine’, where the former frequently co-appeared with the terms ‘COVID-19’ and ‘pharmacists.’ Conclusions: Results fromthis study illustrate the innovative and proactive strategies developed by pharmacists during the pandemic. Pharmacists from around the world are encouraged to share their experiences for stronger healthcare systems to counter future pandemics and environmental disasters