Racecadotril for the treatment of acute gastroenteritis in children received outpatient care in Qatar

Introduction: Acute gastroenteritis is a clinical syndrome often defined by increased stool frequency (eg, ≥3 loose or watery stools in 24 hours, also it is one of the most common causes of morbidity and mortality in children under 5 years in the developing world. Racecadotril is an antisecretory agent that can prevent fluid/electrolyte depletion from the bowel as a result of acute diarrhea without affecting intestinal motility. Research question or hypothesis: To investigate whether prescribing Racecadotril plus oral rehydrating solution in outpatient care helps to decrease the hospital revisit rate within 72 hours due to acute gastroenteritis in comparison with oral rehydrating solution alone. Study design: Retrospective cohort study. Methods: Pediatric patients aged 3 months to 14 years visited Al Wakra Pediatric emergency department due to acute gastroenteritis for outpatient care in the period between 1/1/2022 till 30/06/2022 were included. Case group was defined as patients who prescribed oral rehydrating solution plus Racecadotril upon their initial visit. Control group was defined as patients who prescribed only oral rehydrating solution upon their initial visit. Results: 2505 pediatric patients were included, 520 patients were enrolled in the control group, and 1985 patients were included in the case group. Most patients in both groups were 1 to 5 years old (67% in control group, and 59% in case group). The hospital revisit rate within 72 hours due to gastroenteritis was slightly less in case group 7.1% in comparison with 7.5% in control group (Relative risk 0.95, 95% CI 0.68 to 1.34). Most patients (88%) who revisited the hospital due to gastroenteritis within 72 hours showed no or mild signs of clinical dehydration in their initial visit (77% in control group, and 93% in case group) Conclusion: Racecadotril was found to have insignificant impact on hospital revisit rate in acute pediatric gastroenteritis managed at outpatient setting. (AU)

Burnout among pharmacy professionals in Qatar: A cross-sectional study.

BACKGROUND: Pharmacists' roles and responsibilities have expanded in the modern pharmacy profession, and the expectations from pharmacists have increased. This has been associated with new psychological challenges and emotional stress that can induce burnout. OBJECTIVE: To determine the prevalence of burnout syndrome and factors associated with burnout among pharmacy professionals in the healthcare system in Qatar. METHODS: This institutional-based cross-sectional study was conducted on 850 pharmacy professionals within Hamad Medical Corporation (HMC) in Qatar. Convenience sampling was followed. The survey utilized the Maslach Burnout Inventory (MBI) Toolkit™ for Medical Personnel and a modified version of the Astudillo and Mendinueta questionnaire. Statistical analyses were performed using Stata version 16 for Windows and SAS Studio 3.8 (Enterprise Edition). P-value of less than 0.05 was considered significant. RESULTS: One hundred ninety-four pharmacy professionals (23%) responded to the survey. The prevalence of burnout was 19.7% [95% Confidence interval (CI); 13.8% - 26.8%] among 142 respondents who completed MBI questionnaire and 17.3% [95% CI; 11.7%-24.2%] among 139 respondents who completed Astudillo Mendinueta questionnaire. The most commonly reported factors that may lead to burnout were: tension and lack of organization in teamwork (59.6%), lack of recognition of or indifference to effort from patients, superiors, and colleagues (58.2%), and demanding and challenging patients and family members (56.7%). Multiple regression analysis showed that overtime working hours per month is independently associated with a higher risk of burnout [odds ratio (OR), 1.57; 95% CI, 1.15-2.14 for each 10-hours increase in monthly overtime, P = 0.005], while non-Arab ethnicity is associated with lower risk of burnout [OR, 0.27; 95% CI, 0.1-0.75; P = 0.012]. CONCLUSIONS: There is a relatively low prevalence of burnout syndrome among health-system pharmacy professionals in Qatar. Overtime working hours and Arab ethnicity are independently associated with burnout.

Thrombocytopenia Associated With Teicoplanin Use: A Retrospective Observational Study.

BACKGROUND: Contradictory studies reporting vast heterogeneity in the teicoplanin-induced thrombocytopenia (TIT) incidence exist. OBJECTIVE: To identify the incidence of TIT associated with teicoplanin dosing range (6-12 mg/kg/dose) and the risk factors of TIT. METHODS: This retrospective observational study included adult patients who received teicoplanin for ≥3 consecutive days over a period of 3.5 years. Thrombocytopenia was defined as a platelet count of <100 × 103/µL coupled with at least a 25% drop from the baseline count. The TIT incidence was assessed using the adverse drug reaction probability scale (Naranjo scale). RESULTS: Data from 482 patients who received teicoplanin and met the predefined inclusion criteria were included in the analyses. The cohort presented a mean age of 53.5 ± 19 years, where 72.4% were male, and 49.2% exhibited normal baseline renal function. Teicoplanin was most commonly used for bacteremia (n = 134), and the most common isolated pathogen being Staphylococcus aureus (n = 221). The TIT incidence was 4.6% (the possible and probable category using the Naranjo scale; 22/482). The median time to first platelet count dropped to <100 × 103/µL after teicoplanin initiation was 5 (interquartile range [IQR], 3-10) days and 8 (IQR, 5-14) days till the maximum platelet count dropped. None of the tested patient variables were found to be independently associated with an increased risk of thrombocytopenia. CONCLUSION AND RELEVANCE: The overall TIT incidence was low across our study cohort, including critically ill patients. Our study results may aid in the optimal monitoring of such serious teicoplanin-induced adverse effects.