RESUMEN
Introduction: Medication use during pregnancy is limited by the scarcity of safety data for many drugs. The use of certain drugs during pregnancy can be teratogenic. Overestimating teratogenic medication risk could have serious consequences from drug non-adherence. Assessing and understanding the knowledge, attitude, and practice of medication use among pregnant women is crucial to optimizing the health of pregnant women and their fetuses. Methodology: An observational cross-sectional study used convenience and snowball sampling with a self-administered online questionnaire in 562 pregnant women from Riyadh City. The questionnaire used was adapted from previously published surveys. The survey included sections on sociodemographic background, awareness of medication risks, medication use during pregnancy, sources of drug information, and statements from the Beliefs about Medicines Questionnaire (BMQ), both general and pregnancy-specific. Results: Medication use during pregnancy was reported by 44.7%. The primary source for medication information for the majority was the physician. Over 58% indicated inadequate or inconsistent information about medication from physicians. Additionally, 65.7% confirmed not receiving sufficient or inconsistent information from pharmacists during medication dispensing. The responses to the questionnaire reveal a commendable level of knowledge and positive attitude and practice. However, variations could be found in these responses. Overall, no evident relationships were observed between predictors and responses, except in specific statements that indicated a positive association between beliefs and higher levels of education and youth. Conclusion: The results suggest a positive knowledge, attitude, and practice level. However, there was hesitancy and a restrictive attitude towards medication during pregnancy. The study identified inadequate education provided by healthcare professionals, thus presenting an area for improvement to enhance the safety and efficacy of medication use during pregnancy.
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We present the case of an 8-year-old immunocompromised boy with invasive pulmonary aspergillosis, complicated with pleural empyema and disseminated to the bone and central nervous system (CNS). The patient was treated with combined systemic antifungal agents (voriconazole and caspofungin) and intrapleural instillation of liposomal amphotericin B, in addition to surgical intervention. The treatment was well tolerated and resulted in remarkable clinical and radiological pulmonary improvement.
Asunto(s)
Antifúngicos/uso terapéutico , Empiema Pleural/tratamiento farmacológico , Aspergilosis Pulmonar Invasiva/tratamiento farmacológico , Anfotericina B/administración & dosificación , Anfotericina B/uso terapéutico , Antifúngicos/administración & dosificación , Caspofungina , Niño , Manejo de la Enfermedad , Quimioterapia Combinada , Equinocandinas/administración & dosificación , Equinocandinas/uso terapéutico , Empiema Pleural/microbiología , Humanos , Huésped Inmunocomprometido , Aspergilosis Pulmonar Invasiva/sangre , Aspergilosis Pulmonar Invasiva/microbiología , Lipopéptidos/administración & dosificación , Lipopéptidos/uso terapéutico , Masculino , Voriconazol/administración & dosificación , Voriconazol/uso terapéuticoRESUMEN
BACKGROUND/AIM: Parenteral nutrition (PN) is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN) an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs). The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN. PATIENTS AND METHODS: A retrospective chart review was conducted for patients enrolled in the HPN program between 2006 and 2012. Data on the demographic characteristics, indications and duration of PN therapy, catheter type, number of admissions because of CRBSI, and blood culture results were recorded. RESULTS: Eight pediatric patients were included (mean age of 3.5 years at the start of HPN). Microvillus inclusive disease was noted in 50% of these patients, and 75% of them received HPN under parents' care. CRBSI resulted in 60 admissions with a median of 182 days of hospital stay and 74 changes of central venous catheters. The rate of CRBSI was 2.9 per 1000 catheter days. Staphylococcus species were the most prevalent pathogens (32%), followed by Klebsiella pneumoniae (5%). CONCLUSION: In this small group of HPN patients, the BSI rate was 2.9 infections per 1000 catheter days, and most common causative organisms were Staphylococcus species. We believe that a well-established training program for caregivers can reduce the rate of infectious complications associated with long-term PN support.