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Article ; Online: Intermittent hemodialysis: a review of the top antimicrobial stewardship practices to be employed.

Shamas, Nour / Khamis, Faryal / Eljaaly, Khalid / Al Salmi, Zaher / Al Bahrani, Maher

Antimicrobial stewardship & healthcare epidemiology : ASHE

2024 Volume 4, Issue 1, Page(s) e2

Abstract: The vulnerability of patients on hemodialysis (HD) to infections is evident by their increased susceptibility to infections in general and to resistant organisms in particular. Unnecessary, inappropriate, or suboptimal antimicrobial prescribing is common ...

Abstract	The vulnerability of patients on hemodialysis (HD) to infections is evident by their increased susceptibility to infections in general and to resistant organisms in particular. Unnecessary, inappropriate, or suboptimal antimicrobial prescribing is common in dialysis units. This underscores the need for dedicated antimicrobial stewardship (AMS) interventions that can be implemented both in the inpatient and outpatient settings. In this review, we provide a comprehensive approach for clinicians with the most updated coordinated AMS principles in HD setting in six areas: prevention, diagnosis, treatment, education and empowerment, monitoring, and research.
Language	English
Publishing date	2024-01-11
Publishing country	England
Document type	Journal Article ; Review
ISSN	2732-494X
ISSN (online)	2732-494X
DOI	10.1017/ash.2023.525
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluation of Appropriate Use of Proton Pump Inhibitors in Non-critically Ill Patients in Tertiary Medical Center: A Retrospective Study.

Althagafi, Abdulhamid / Magbool, Nesren / Altayib, Hatoon / Bukhari, Tala / Melibari, Nawal / Bahamdain, Foud / Eljaaly, Khalid

Current drug safety

2024

Abstract: Background: There are concerns about indiscriminate prescriptions and the inappropriate use of proton pump inhibitors (PPIs) without any clear indications, especially among noncritically hospitalized patients.: Objective: This study aimed to ... ...

Abstract	Background: There are concerns about indiscriminate prescriptions and the inappropriate use of proton pump inhibitors (PPIs) without any clear indications, especially among noncritically hospitalized patients. Objective: This study aimed to characterize PPI prescriptions among non-critically hospitalized patients in a tertiary care hospital in Saudi Arabia. Methods: A retrospective cross-sectional study was conducted at the King Abdulaziz University Hospital between June and August 2021. The data of adult patients who received PPIs on hospital admission in the medical and surgical wards were collected and analyzed for appropriateness based on the current international guidelines and recommendations. Results: A total of 174 patient records were included in this study. The proportion of patients with appropriate and inappropriate PPI prescriptions was 67.24% (n=117) and 32.76% (n=57), respectively. Female patients (risk=50.00%, 95% CI: 36.89-63.11, p<0.001) were more likely to receive an inappropriate PPI prescription than their male counterparts (risk=33.33%, 95% CI: 24.56-43.43, p<0.001). Intravenous omeprazole 40 mg once daily was the most frequently prescribed PPI (n=62). The hospital length of stay differed significantly between the groups of patients who received appropriate and inappropriate PPIs (24.56 ± 47.14 vs. 13.50 ± 13.84; t=2.34, 95% CI: 1.72-20.4; p=0.02). However, there was no significant difference in the total therapy duration in both the groups (3.76 ± 2.50 vs. 4.75 ± 3.32, t=-1.62, 95%CI: -1.79-0.17; p=0.11). Conclusion: The findings show a high trend of inappropriate PPI prescriptions. Hence, educational programs are recommended to encourage healthcare professionals to stick to the approved guidelines when prescribing PPIs.
Language	English
Publishing date	2024-02-09
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2250840-5
ISSN	2212-3911 ; 1574-8863
ISSN (online)	2212-3911
ISSN	1574-8863
DOI	10.2174/0115748863284762240129092556
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Article ; Online: Antimicrobial utilization in Hajj 2022: An evaluation of quality indicators.

Thabit, Abrar K / Alfardus, Nawal / Eljaaly, Khalid / Alshennawi, Mohammed

Journal of infection and public health

2023 Volume 17 Suppl 1, Page(s) 62–67

Abstract: Background: The mass gathering in Hajj (Islamic pilgrimage) makes the spread of infectious diseases inevitable. Antibiotics are frequently prescribed during this season. We aimed to measure antimicrobial utilization during the 2022 Hajj and evaluate the ...

Abstract	Background: The mass gathering in Hajj (Islamic pilgrimage) makes the spread of infectious diseases inevitable. Antibiotics are frequently prescribed during this season. We aimed to measure antimicrobial utilization during the 2022 Hajj and evaluate the practice using quality indicators. Methods: Antimicrobial utilization by Hajj medical facilities (77 primary clinics and 7 hospitals) was measured using the anatomic therapeutic classification defined daily dose (DDD) and DDD/1,000-inhabitant/day (DID), where inhabitants were the Hajj 2022 pilgrims (n = 899,353). Quality indicators included percentages of consumption of different antibiotic classes of the total consumption of antibacterials for systemic use in DID. Results: During Hajj, there was 87,173 outpatient visits and 740 hospitalizations (215 critically ill). Amoxicillin was the most prescribed antibiotic (DID=11.708) followed by azithromycin (DID=7.395). Penicillins fell in the second quartile (i.e., highly prescribed) with a quality indicator value (J01_CE%) of 48.149. The consumption of other antibacterials, including fluoroquinolones, fell in the first quartile (<25%). The overall ratio of broad- to narrow-spectrum antibiotic prescribing (J01_B/N) was 1.49. Conclusion: Although the prescribing of β-lactams over fluoroquinolones indicates a good practice, clinicians should be reminded that most infections spreading in mass gatherings are viral; hence, do not require antibiotics. Implementation of antimicrobial stewardship is recommended to improve antimicrobial utilization.
MeSH term(s)	Humans ; Quality Indicators, Health Care ; Anti-Infective Agents ; Anti-Bacterial Agents/therapeutic use ; Communicable Diseases/drug therapy ; Fluoroquinolones
Chemical Substances	Anti-Infective Agents ; Anti-Bacterial Agents ; Fluoroquinolones
Language	English
Publishing date	2023-05-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.05.022
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Article: The effect of erythromycin and clarithromycin versus azithromycin on serum valproate concentration.

Albanji, Muradi / Alshehri, Samah / Eljaaly, Khalid

Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society

2022 Volume 30, Issue 4, Page(s) 337–339

Abstract: Introduction: Unlike azithromycin, erythromycin and clarithromycin strongly inhibit CYP450, which metabolizes valproic acid. The aim of this study was to evaluate the impact of macrolide administration on serum valproate trough levels.: Methods: This ...

Abstract	Introduction: Unlike azithromycin, erythromycin and clarithromycin strongly inhibit CYP450, which metabolizes valproic acid. The aim of this study was to evaluate the impact of macrolide administration on serum valproate trough levels. Methods: This retrospective cohort study included hospitalized adult patients who concomitantly received valproate with a macrolide. Patients who received a carbapenem, those who do not have a baseline and/or post-levels, and those who received different doses of valproate were excluded. The change in serum valproate trough level from baseline to after the occurrence of co-administration (post-level) was compared in patients who received either erythromycin or clarithromycin versus those who received azithromycin. Results: A total of thirteen patients were included in the comparison. The mean ± SD for change in serum valproate trough levels was significantly higher in the erythromycin/clarithromycin group than the azithromycin group (209.1 ± 105.9 µmol/L [equivalent to 30.1 ± 15.2 mg/L] vs. 12.7 ± 52.1 µmol/L [equivalent to 1.8 ± 7.5 mg/L]; P = 0.002). Conclusion: This study found a significantly higher increase in serum trough levels of valproate after co-administration of erythromycin/clarithromycin versus azithromycin. Clinicians should consider avoiding co-administration of erythromycin and clarithromycin with valproate if possible or close monitoring of valproate levels with dose reduction.
Language	English
Publishing date	2022-02-09
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1378024-4
ISSN	1319-0164
ISSN	1319-0164
DOI	10.1016/j.jsps.2022.02.004
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Article: Correction: Nasrullah et al. Omeprazole Prevents Colistin-Induced Nephrotoxicity in Rats: Emphasis on Oxidative Stress, Inflammation, Apoptosis and Colistin Accumulation in Kidneys.

Nasrullah, Mohammed Z / Eljaaly, Khalid / Neamatallah, Thikryat / Fahmy, Usama A / Alamoudi, Abdulmohsin J / Bakhsh, Hussain T / Abdel-Naim, Ashraf B

Pharmaceuticals (Basel, Switzerland)

2024 Volume 17, Issue 4

Abstract: ... Error in ... ...

Abstract	Error in Figure
Language	English
Publishing date	2024-04-22
Publishing country	Switzerland
Document type	Published Erratum
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph17040540
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Article ; Online: Intermittent hemodialysis

Nour Shamas / Faryal Khamis / Khalid Eljaaly / Zaher Al Salmi / Maher Al Bahrani

Antimicrobial Stewardship & Healthcare Epidemiology, Vol

a review of the top antimicrobial stewardship practices to be employed

2024 Volume 4

Abstract	The vulnerability of patients on hemodialysis (HD) to infections is evident by their increased susceptibility to infections in general and to resistant organisms in particular. Unnecessary, inappropriate, or suboptimal antimicrobial prescribing is common in dialysis units. This underscores the need for dedicated antimicrobial stewardship (AMS) interventions that can be implemented both in the inpatient and outpatient settings. In this review, we provide a comprehensive approach for clinicians with the most updated coordinated AMS principles in HD setting in six areas: prevention, diagnosis, treatment, education and empowerment, monitoring, and research.
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Cambridge University Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Evaluation of Weight-Based Co-trimoxazole Dosing in a Saudi Tertiary Hospital.

Alshehri, Samah / Alghuraybi, Rawan / Ayoub, Elaf / Bokhary, Jomana / Lashkar, Manar / Alshibani, Mohannad / Eljaaly, Khalid

Cureus

2023 Volume 15, Issue 10, Page(s) e47400

Abstract: Background: Infections caused by : Methodology: This is a single-center, cross-sectional study that included adult inpatients treated with co-trimoxazole for a weight-based dose indication (: Results: Forty-three patients were included in the ... ...

Abstract	Background: Infections caused by Methodology: This is a single-center, cross-sectional study that included adult inpatients treated with co-trimoxazole for a weight-based dose indication ( Results: Forty-three patients were included in the study. Of the 43 patients, 29 (67.4%) were using co-trimoxazole for PJP treatment, and 14 (32.6%) were using it for Conclusions: This study found a relatively high rate of underdosing of co-trimoxazole based on weight in hospitalized adults with PJP and
Language	English
Publishing date	2023-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.47400
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Article ; Online: Impact of a multidisciplinary antimicrobial stewardship program on antibiotic utilization and clinical outcomes at a tertiary hospital in Saudi Arabia: a quasi-experimental study.

Sarkhi, Khadijah A / Eljaaly, Khalid / Kaki, Reham / Bahamdan, Rahaf / Alghamdi, Sultan A / Baharith, Mohammed O / Thabit, Abrar K

Expert review of anti-infective therapy

2024 Volume 22, Issue 1-3, Page(s) 115–120

Abstract: Background: This study aims to assess the impact of a multidisciplinary antimicrobial stewardship program (ASP) intervention on various metrics.: Methods: A quasi-experimental study was performed on non-ICU patients for whom a restricted antibiotic ... ...

Abstract	Background: This study aims to assess the impact of a multidisciplinary antimicrobial stewardship program (ASP) intervention on various metrics. Methods: A quasi-experimental study was performed on non-ICU patients for whom a restricted antibiotic was ordered. In September 2020, a prospective audit and feedback was implemented involving infectious disease clinical pharmacists, utilization of electronic resources, and improved documentation. Outcomes included defined daily dose and days of therapy per 100-patient days (DDD/100PD and DOT/100PD) and patient clinical outcomes. Results: 402 episodes were evaluated for 167 and 190 unique patients in the pre- and post-intervention phases, respectively. DDD/100PD and DOT/100PD were lower in the post-phase than in the pre-phase (1.75 vs. 2.54 and 16.13 vs. 44.93). Antibiotic de-escalation and clinical cure rates were significantly higher in the post-phase than in the pre-phase (62% vs. 40.6% and 83.5% vs. 65.8%; Conclusion: The implemented multidisciplinary ASP intervention was associated with a significant improvement in antibiotic utilization and patient clinical outcomes.
MeSH term(s)	Humans ; Anti-Bacterial Agents ; Tertiary Care Centers ; Antimicrobial Stewardship ; Saudi Arabia ; Communicable Diseases/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2023.2285425
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Article ; Online: COVID-19 vaccine hesitancy among healthcare workers in Arab Countries: A systematic review and meta-analysis.

Alalawi, Mai / Alsalloum, Muath A / Garwan, Yusuf M / Abuzeid, Mya / Alalawi, Hassan / Eljaaly, Khalid / Thabit, Abrar K / Jose, Jimmy

PloS one

2024 Volume 19, Issue 1, Page(s) e0296432

Abstract: Background: Vaccine hesitancy is a major obstacle to the large efforts made by governments and health organizations toward achieving successful COVID-19 vaccination programs. Healthcare worker's (HCWs) acceptance or refusal of the vaccine is an ... ...

Abstract	Background: Vaccine hesitancy is a major obstacle to the large efforts made by governments and health organizations toward achieving successful COVID-19 vaccination programs. Healthcare worker's (HCWs) acceptance or refusal of the vaccine is an influencing factor to the attitudes of their patients and general population. This study aimed to report the acceptance rates for COVID-19 vaccines among HCWs in Arab countries and identify key factors driving the attitudes of HCWs in the Arab world toward vaccines. Methods: This systematic review and meta-analysis followed the PRISMA guidelines. PubMed and Scopus databases were searched using pre-specified keywords. All cross-sectional studies that assessed COVID-19 vaccine hesitancy and/or acceptance among HCWs in Arab countries until July 2022, were included. The quality of the included studies and the risk of bias was assessed using the JBI critical appraisal tool. The pooled acceptance rate of the COVID-19 vaccine was assessed using a random-effects model with a 95% confidence interval. Results: A total of 861 articles were identified, of which, 43 were included in the study. All the studies were cross-sectional and survey-based. The total sample size was 57,250 HCWs and the acceptance rate of the COVID-19 vaccine was 60.4% (95% CI, 53.8% to 66.6%; I2, 41.9%). In addition, the COVID-19 vaccine acceptance rate among males was 65.4% (95% CI, 55.9% to 73.9%; I2, 0%) while among females was 48.2% (95% CI, 37.8% to 58.6%; I2, 0%). The most frequently reported factors associated with COVID-19 vaccine acceptance were being male, higher risk perception of contracting COVID-19, positive attitude toward the influenza vaccine, and higher educational level. Predictors of vaccine hesitancy most frequently included concerns about COVID-19 vaccine safety, living in rural areas, low monthly income, and fewer years of practice experience. Conclusion: A moderate acceptance rate of COVID-19 vaccines was reported among HCWs in the Arab World. Considering potential future pandemics, regulatory bodies should raise awareness regarding vaccine safety and efficacy and tailor their efforts to target HCWs who would consequently influence the public with their attitude towards vaccines.
MeSH term(s)	Female ; Humans ; Male ; Arabs ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines/therapeutic use ; Health Personnel ; Vaccination Hesitancy
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0296432
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Article ; Online: Long-term gastrointestinal adverse effects of doxycycline.

Eljaaly, Khalid / Alghamdi, Haifa / Almehmadi, Hadeel / Aljawi, Fahad / Hassan, Ammar / Thabit, Abrar

Journal of infection in developing countries

2023 Volume 17, Issue 2, Page(s) 281–285

Abstract: Introduction: Doxycycline is an antibiotic with known gastrointestinal (GI) adverse effects. Esophagitis is the most pronounced among these effects, and might be associated with a prolonged duration of therapy. The aim of this study is to evaluate the ... ...

Abstract	Introduction: Doxycycline is an antibiotic with known gastrointestinal (GI) adverse effects. Esophagitis is the most pronounced among these effects, and might be associated with a prolonged duration of therapy. The aim of this study is to evaluate the incidence of esophagitis and other GI side effects in adults who received doxycycline for at least a month. Methodology: This retrospective descriptive study included adults who received oral doxycycline for at least one month between 2016 and 2018. The primary outcome was the frequency of esophagitis. The secondary outcomes were frequency of and discontinuation due to GI adverse effects. Results: A total of 189 subjects were included with a median age of 32 years. The median duration of doxycycline use was 44 days (interquartile range 30-60). Twelve patients (6.3%) reported having GI adverse effects resulting in doxycycline discontinuation in five of them (2.6%), and three patients (1.6%) had esophagitis. The incidence of GI adverse effects was significantly higher in patients who were ≥ 50 years than < 50 years old (8/50 vs. 4/139; p = 0.003) and in those who received a daily dose of 200 mg than 100 mg (12/93 vs. 0/96; p < 0.001). Conclusions: GI adverse events, including esophagitis, are not rare with long-term use of oral doxycycline, particularly in older age and a higher dose of 200 mg/day. Future large and randomized studies are needed to compare the efficacy and safety of different doxycycline doses.
MeSH term(s)	Adult ; Humans ; Doxycycline/therapeutic use ; Retrospective Studies ; Anti-Bacterial Agents/therapeutic use ; Esophagitis/chemically induced ; Esophagitis/drug therapy
Chemical Substances	Doxycycline (N12000U13O) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-02-28
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2394024-4
ISSN	1972-2680 ; 2036-6590
ISSN (online)	1972-2680
ISSN	2036-6590
DOI	10.3855/jidc.16677
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