Background: Medication consumption and DRUG abUSE are considered important socio-economic and medicolegal issues all around the world. The significance of the problem is highlighted during pregnancy. Objectives: We aimed to evaluate the prevalence of medication and DRUG consumption during pregnancy in Tehran. Methods: In this descriptive study, we selected several maternity hospitals as the sources of our study population. All women of postpartum period willing to participate in the study were included. We prepared self-designed questionnaires to be filled out by trained personnel while interviewing women face to face. All the data were collected and analyzed by SPSS16 software. Results: In this study, we evaluated 3279 mothers who delivered in 10 different hospitals in Tehran. The result showed that the most common medications USEd during pregnancy were iron (85. 2%), folic acid (81. 7%), and calcium (48. 2%). In this population, insulin, levothyroxine, and antihypertensive medications were USEd in 7. 1%, 5. 9%, and 1. 8% of the mothers, respectively. Overall, 14. 5% of our population USEd medications for medical conditions during pregnancy. Cigarette smoking, alcohol, and substance abUSE before or during pregnancy had a very low prevalence in comparison with other developed countries. Conclusions: The USE of medication during pregnancy increases the risk of several complications. Careful pharmaceutical monitoring during pregnancyandnational surveys arerecommendedfor obtaining up-to-date informationandmakinga better decision by policymakers.

Background and Objective: Fixed DRUG eruption (FDE) is one kind of DRUG rashes that is characterized by re-appearance of the lesions on the same sites after re-exposure to the causative DRUG. This study was performed to evaluate the epidemiologic characteristics of FDE. Materials and Methods: This descriptive study was done on a series of 100FDE cases, whom were admitted at the outpatient dermatology clinic of Hazrat-e-Rasoul Hospital over a six-year period. The primary diagnosis of FDE was suggested according to clinical findings including a remaining hyperpigmentation at the site of healed skin lesion(s). Oral challenge test with a single low dose administration of the suspected DRUG was USEd to confinn the diagnosis. Recurrence of the lesion(s) at the same body area(s) was considered as positive result. Results: Most commonly causative agents were co-trimoxazole and codein, which were found in 88% and 3% FDE cases; respectively. The most common site of involvement was penile glans in 57.7% of male patients and trunk in 48.3% of females. In one patient, reaction to multiple DRUGs including co-trimoxazole, codein and tetracycline was observed and after re-challenge with each DRUG, re-appearance of the skin lesion at the same site was evident. Several patients reported concomitant acetaminophen intake, but there was no reaction to that DRUG. Conclusion: Co-trimoxazole is the most common caUSE of FDE.      

Introduction: Colistin is an old antibacterial agent, which is using for multiple DRUG resistant (MDR) infections. Due to increased rate of MDR infections, the USE of this agent is rising worldwide. The aim of this study was to identify colistin utilization patterns in a teaching hospital.  Materials and Methods: This prospective study performed on 43 patients admitted to Imam Reza Hospital at Mashhad from March 2018 until February 2019 who received more than three doses of Colistin. At the beginning oof the study, demographic characteristics, Colistin doses, laboratory findings, culture results and the response to treatment bwere recorded. Finally, Data were analyzed by SPSS v. 16 software and the frequency of errors in Colistin indication, dose, dose intervals, and dose adjustments were evaluated, also for DRUG interactions.  Results: Out of 43 patients who received colistin, burning (39. 53%) was the main indication for Colistin prescription. Colistin was prescribed based on microbiological findings for 20. 93% of cases, only. Colistin was administered prior to culture response for 39. 53% of cases, and for 39. 53% of cases no specimen for culture was sent. In 81. 25% of cases the received dose was correct and in 18. 75% the dose was more than standard. Dose adjustment based on creatinine monitoring was not performed properly in 71. 43% of cases. A total of 541 Colistin vials were administered without indication and a cost of 90. 347. 000 Rials was imposed on the Health system.  Conclusion: The results of this study indicate that there is a pressing need for physicians' training programs and appropriate strategies for prescribing Colistin in the treatment protocols.

Background: Rational DRUG USE is an important issue in all healthcare settings. Core DRUG USE indicators have been developed by World Health Organization/ International Network for Rational USE of DRUGs (WHO/INRUD). The prescribing indicators measure healthcare providers’ performance in five key areas of DRUG usage. The aim of this study was to evaluate WHO/INRUD indicators of prescribing in emergency ward of a teaching hospital.  Methods: This descriptive cross-sectional study was carried out in Emergency Ward of teaching hospital from March 2022 – March 2023. A standard prescribing indicators form was utilized to collect the required data using WHO DRUG prescribing indicators. Besides the rate of intravenous fluids and narcotic analgesics administration was evaluated. Index of rational DRUG prescribing (IRDP) was also calculated for each month and the mean of 12 IRDPs represent the emergency ward IRDP. Descriptive statistics were USEd for analysis.  Results: Antibiotics were prescribed in 34% of studied prescriptions and ceftriaxone was the most widely USEd antibiotic (33.8%). Index of rational DRUG prescribing (IRDP) was 0.73 for polypharmacy, 0.93 for generic name prescribing, 0.88 for antibiotic prescribing, 0.1 for injectable DRUG USE and 1 for formulary-based DRUG prescription. Total IRDP for the emergency ward was 3.64 (from optimal value of 5). IV fluids and narcotics were prescribed in 61.1% and 8.3% of studied prescription respectively.  Conclusion: We concluded that although our overall IRDP value is below the WHO standard but it is about other neighbor countries. Our condition regarding IV DRUG administration showed a huge difference with WHO standards. It shows we need more input and regulations in this regard.

The common caUSE of healthcare-associated infections is surgical site infections (SSIs). The appropriate USE of antibiotic prophylaxis plays an important role in the prevention and reduction of surgical site infection. So, this study was evaluated the antibiotics prophylaxis administration in surgical patients. A prospective cross-sectional study was conducted on surgical patients from July 2015 to December 2016. Data were collected for all patients who undergoing surgery and met inclusion criteria. CDC Guideline for wound classification and antibiotic prophylaxis administration were USEd. SPSS software version 21 was USEd for data analysis of descriptive statistics. A total of 134 patients who undergoing surgery and met the study criteria were evaluated. Of these, 81 (60. 4%) were males. The mean+SD age of the participants was 40. 74+18. 3. Most commonly USEd agent was vancomycin plus ceftazidime (71. 6%). Duration of antibiotic administration and appropriate antibiotics were not compatible with guidelines. Educational interventions are necessary to improve administration of antibiotic prophylaxis prior to surgery and reduce surgical site infection.

In order to investigate the effect of pharmacist intervention on vancomycin USE, this study was performed on all patients receiving vancomycin in the intensive care unit (ICU) and hematology-oncology ward of Taleghani Educational Hospital in Tehran, Iran. Vancomycin USE was assessed during a pre- and post-intervention period in accordance with the Center of Disease Control and prevention (CDC) and Infectious Diseases Society of America (IDSA) guidelines. Following the intervention, there was a significant change in appropriate initiation of vancomycin (P = 0.009) and no significant improvement was observed in adequate dosage and the duration of therapy (P = 0.15 and P = 0.54 respectively); however, informing the physician resulted in discontinuation of the DRUG in 50% of inappropriate cases and vancomycin dosage was adjustedin 31% of cases. Temperature charts, culture results and pre-treatment CBC tests changed significantly (P = 0.02, P = 0.009 and P = 0.04 respectively). The rate of infusion related adverse DRUG reactions did not decrease significantly (P = 0.06); yet in 100% of patients, these reactions were resolved after notifying the nursing team. After pharmacist intervention, vancomycin USE improved in some aspects. A significant improvement in appropriate initiation of therapy was observed; however, treatments continued despite negative cultures. It is necessary to optimize the USE of vancomycin by performing more educational interventions.

DRUG utilization EVALUATION (DUE) is an effective program to identify variability in DRUG USE and to support interventions that will improve patient outcomes. The appropriate USE of enoxaparin, a low molecular weight heparin (LMWH), which is widely USEd as curative or preventive treatment of thromboembolic disorders was assessed in the study.A prospective DUE was carried out at Masih Daneshvari teaching hospital. Criteria for the appropriate USE of enoxaparin were USEd to evaluate prescription and administration patterns in this hospital.Enoxaparin utilization of 147 inpatients was reviewed. A total of 944 variables (70.92%) in the regimen, among all subjects, were rated as appropriate and 382 (28.70%) were rated as inappropriate for the conditions diagnosed.The results of this study showed that inappropriate dosing, administration and prescribing of enoxaparin is rather common in masih hospital. Educational programs and implementation of protocols may be needed in the teaching hospitals to control prescribing patterns.