In vitro activity of colistin in combination with various antimicrobials against Acinetobacter baumannii species, a report from South Iran.

INTRODUCTION: Acinetobacter baumannii is a gram-negative,opportunistic pathogen responsible for resistant nosocomial infections especially in the intensive care units (ICUS).One reason for the failure in the treatment of A. baumannii is its ability of develop resistance against several antimicrobials. combination of different antimicrobials can be used to overcome such a resistance. This study was done to evaluate the in vitro synergistic activity of colistin in combination with six different antimicrobials, including ciprofloxacin, levofloxacin, imipenem, meropenem, ampicillin-sulbactam, and rifampin against A. baumannii species isolated from blood culture of patients admitted to ICUs of Nemazee hospital, Shiraz, Iran. METHOD: After performing biochemical identification assays on 20 isolates of A. baumannii, minimum inhibitory concentrations were determined by E- test method and antibiotic interactions were assessed using broth microdilution checkerboard method. RESULTS: Combinations of colistin with all six studied antimicrobials had some synergistic effect. CONCLUSION: clinical studies are required to clarify the therapeutic potential of these antimicrobial combinations.

Correction to: Effect of sertraline on complications and survival after hematopoietic stem-cell transplantation, a double-blind, placebo-controlled clinical study.

The correct name of the corresponding author should be ''Maryam Mehrpooya'', and not ''Mehrpooya Maryam'' as given in the original publication of the article.

Effect of sertraline on complications and survival after hematopoietic stem-cell transplantation, a double-blind, placebo-controlled clinical study.

Previous studies have found a connection between psychiatric problems and post-hematopoietic stem-cell transplantation (HSCT) complications. We sought to evaluate the effect of sertraline on engraftment time, hospitalization period, mortality, and post-transplantation complications in HSCT recipients with depression and/or anxiety. We recruited adults aged 18-60, who were candidates for autologous or allogeneic HSCT with major depression and/or anxiety disorder. They were administered 50 mg of sertraline or placebo daily for the first week, and then 100 mg for the following seven weeks. We documented occurrence and severity of early post-HSCT complications, including infection, mucositis, nausea and vomiting, diarrhea, pain, renal toxicities and liver complications, acute graft-versus-host disease, and veno-occlusive disease, as well as time to engraftment, length of hospitalization and 6-month mortality. Overall, 56 patients participated in the study (sertraline group n = 30, placebo group n = 26). Of the complications, only mortality and readmission up to 6 months post-transplantation were significantly higher in the placebo group compared to sertraline group (P values = 0.040, 0.028, respectively). There were no significant differences for other complications between the groups. Mean engraftment time was significantly lower in the sertraline group (P value = 0.048). This study provides evidence that sertraline positively influences engraftment time, readmission, and mortality after HSCT.

A comparison of five common drug-drug interaction software programs regarding accuracy and comprehensiveness.

OBJECTIVE: Drug-drug interactions (DDIs) can cause failure in treatment and adverse events. DDIs screening software is an important tool to aid clinicians in the detection and management of DDIs. However, clinicians should be aware of the advantages and limitations of these programs. We compared the ability of five common DDI programs to detect clinically important DDIs. METHODS: Lexi-Interact, Micromedex Drug Interactions, iFacts, Medscape, and Epocrates were evaluated. The programs' sensitivity, specificity, and positive and negative predictive values were determined to assess their accuracy in detecting DDIs. The accuracy of each program was identified using 360 unknown pair interactions, taken randomly from prescriptions, and forty pairs of clinically important ones. The major reference was a clinical pharmacist alongside the Stockley's Drug Interaction and databases including PubMed, Scopus, and Google Scholar. Comprehensiveness of each program was determined by the number of components in the drug interaction monograph. The aggregate score for accuracy and comprehensiveness was calculated. FINDINGS: Scoring 250 out of possible 400 points, Lexi-Interact and Epocrates, provided the most accurate software programs. Micromedex, Medscape, and iFacts ranked third, fourth, and fifth, scoring 236, 202, and 191, respectively. In comprehensiveness test, iFacts showed the highest score, 134 out of possible 134 points, whereas Lexi-Interact rated second, with a score of 120. Scoring 370 and 330 out of possible 534 points, Lexi-Interact and Micromedex, respectively, provided the most competent, complete, and user-friendly applications. CONCLUSION: Lexi-Interact and Micromedex showed the best performances. An increase in sensitivity is possible by the combination of more than one programs and expert pharmacist intervention.

Health Care Workers' Knowledge, Attitude, and Practice About Chronic Pain Management, Shiraz, Iran.

BACKGROUND: Pain can adversely affect every aspect of a patient's daily activity, and consequently, it has a great influence on the quality of life. Studies have shown that health care professionals have little knowledge of and inadequate attitudes toward the assessment of pain and its treatment with analgesics. OBJECTIVES: This cross-sectional study was designed to evaluate the knowledge, attitudes, and practice of health care professionals regarding chronic pain management. It was carried out in six different educational hospitals affiliated with Shiraz University of Medical Sciences in Shiraz, Iran. PATIENTS AND METHODS: Participants were given a questionnaire containing 46 questions and demographic characteristics to fill out independently. In total, 213 health care professionals (114 nurses and 99 medical residents) volunteered to take part in this study. In order to ease further analysis, the questions were grouped into three categories: narcotic drugs, non-narcotic drugs, and non-drug-related questions. RESULTS: The mean correct response rate was 43.13% ± 11.10. Medical residents scored 51.23% ± 9.02% and nurses 36.10% ± 7.31% (P < 0.001). There was no statistically significant relation between field of specialty and the mean scores of medical residents. Narcotic drug questions received the lowest (39.02%) and non-narcotic drug questions received the highest (57.32%) percentages of correct responses. Only 9.3% of participants believed that they had received adequate education about pain and its management. CONCLUSIONS: The findings of this study support concern about inadequate knowledge, attitudes, and practice regarding chronic pain management. We believe that further education and practical training will be needed for adequate pain management.