Objective: The purpose of the study was to assess the knowledge, attitudes, beliefs, and factors associated with the uptake of the influenza (flu) vaccination in women within Saudi Arabia during their pregnancy period. Methods: A cross-sectional prospective survey was conducted on 1085 pregnant women at the antenatal clinic over a period of 6 weeks with the provision of influenza vaccination. The questionnaire collected demographic and other data; it included 12 questions on their general knowledge and assessed their attitude toward influenza vaccination, and their awareness of vaccine risk and the potential benefits during pregnancy. The knowledge score obtained was then calculated and compared. Results: A total of 998 patients took part in the questionnaire with a response rate of 92%. There was poor awareness that the flu vaccine is safe to administer during pregnancy (130, 13.1%) and that all pregnant women should receive the flu vaccine (190, 19.1%). Pregnant women with flu vaccine knowledge score of ⩽5 (range 0-12) were significantly less likely to take the vaccine (OR 3.78, 95% CI 2.68-5.26, p < 0.001). There was a low uptake of the vaccine (178, 18.1%) and only 29 (3.0%) had previously been offered the flu vaccine by any doctor during their pregnancy. In addition, 255 (25.8%) were against taking the flu vaccine during pregnancy. Conclusion: The knowledge and uptake of the influenza vaccine among Saudi pregnant women are low. One quarter was against the vaccine during pregnancy. Very few believed the flu vaccine to be safe during pregnancy. Rarely, physicians advise their clients to take flu vaccine.

Antimicrobial resistance (AMR) is presently considered an emergent major global public health concern and excessive and/or inappropriate use of broad-spectrum antimicrobials contribute to the development of AMR. To evaluate the appropriateness of carbapenems and piperacillin-tazobactam use in a tertiary care hospital. A retrospective, observational, cross-sectional, drug-utilization study was conducted. The study included all adult hospitalized patients who had received at least one dose of the antimicrobials during their admission for the period between 1 January 2016 and 31 December 2017. The appropriateness of antimicrobial therapy was evaluated according to the Infectious Diseases Society of America (IDSA) guidelines with the consideration of the institutional antibiogram. Overall, 2731 patients received 5005 courses with one of the antimicrobials, for a total of 5045.9 defined daily doses (DDD) of imipenem-cilastatin, 6492.3 of meropenem and 15,595 of piperacillin-tazobactam (4.93, 6.34 and 15.24 DDD/100 bed days, respectively). The mean age of the patients who received either antimicrobial was 55.5 ± 20.3 years, with a 14-day average length of hospital stay. About half (52%) of the prescriptions were written for patients treated in the medical ward. Pneumonia (26.6%) and sepsis (24.9%) were the most common indication for the initiation of antimicrobial therapy. Of the assessed prescriptions, only 2787 (56.5%) were prescribed appropriately, with 2142 (43.5%) deemed inappropriate. The three most common reasons for inappropriate prescription were: the spectrum of activity was too broad (44.6%), followed by antimicrobial use without culture request (32.4%), and failure of suitable antimicrobial de-escalation (19.9%). The study indicates that the overall rate of inappropriateness was high, emphasizing the need to develop initiatives to effectively improve broad-spectrum antimicrobial prescribing.

Antimicrobial resistance (AMR) is a global public health threat associated with increased mortality, morbidity and costs. Inappropriate antimicrobial prescribing, particularly of broad-spectrums antimicrobials (BSAs), is considered a major factor behind growing AMR. The aim of this study was to explore physician perception and views about BSAs and factors that impact upon their BSAs prescribing decisions. Qualitative semistructured telephone interviews over an eleven-week period were conducted with physicians in a single tertiary care hospital in Riyadh, Saudi Arabia. Purposeful and snowball sampling techniques were adopted as sampling strategy. All interviews were audio recorded, transcribed verbatim, uploaded to NVivo^® software and analysed following thematic analysis approach. Four major themes emerged: views on BSAs, factors influencing BSA prescribing and antimicrobial stewardship: practices and barriers and recommendations to improve appropriate BSA prescribing. Recommendations for the future include improving clinical knowledge, feedback on prescribing, multidisciplinary team decision-making and local guideline implementation. Identification of views and determinants of BSA prescribing can guide the design of a multifaceted intervention to support physicians and policymakers to improve antimicrobial prescribing practices.

Background/Objectives: The objective of this study is to investigate the patterns and characteristics of medication errors (MEs) associated with antipsychotic medication use in hospitals affiliated with the Ministry of Health (MOH) in Saudi Arabia and to identify areas for improvement. Methods: A retrospective descriptive analysis of MEs associated with antipsychotic use was conducted using data collected from MOH-affiliated hospitals between April 2020 and September 2022. The data were analyzed descriptively to identify the factors underpinning unsafe antipsychotic use. Results: The sample period produced 35,077 reported MEs. Reports from the Western region contributed the highest error percentage, and MEs were reported more frequently in male (76.1%, n = 26,705) and adult (97.7%, n = 34,275) patients. Pharmacists reported MEs more often than other healthcare professionals (66.5%, n = 23,312). Most MEs (89.9%, n = 31,524) originated in the prescribing stage, with missing prescription information being the most frequently reported ME type (40.5%, n = 14,206). Atypical antipsychotics accounted for the greatest proportion of reports (79.3%, n = 27,811) compared to typical antipsychotics (20.7%, n = 7262). Most ME outcomes fell into Category B: The error occurred but did not reach the patient (56.4%, n = 19,794). Factors related to staffing or workflow accounted for 21.3% (n = 7467) of the reported errors, followed by a lack of policies in relation to antipsychotics prescribing and monitoring (20.5%; n = 7195). Conclusions: MEs in hospitals in Saudi Arabia frequently involve antipsychotic medications. This study identified important targets that may help reduce such risks in the future.

The World Health Organization reports that depression affects more than 280 million people globally. Women are approximately 50% more likely to experience depression compared to men. Depression during pregnancy leads to deterioration of the mother’s and the fetus’s health. We aim to explore women’s perceptions and attitudes toward using antidepressants and to identify the factors that influence decision-making regarding antidepressant use. A cross-sectional survey, employing a convenience sampling method, was conducted on a university campus in Riyadh, Saudi Arabia. The survey was developed by the investigators and validated by health practitioners. Answers were reported using a 5-point Likert scale. The responses were summed up to give a total score for each respondent. Respondents who scored above or equal 75% of the total score was considered positive perception or favorable attitude. Binary logistic regression analysis was used to identify factors influencing participants’ perception and attitude toward taking antidepressants. A total of 991 subjects were surveyed. The majority of women had negative perceptions and favorable attitudes towards using antidepressants during pregnancy reaching 64%. While women with positive perceptions and favorable attitudes represented about 20% of the study subjects. Participants reported that social stigma, religious beliefs, and fear of addiction significantly influenced their attitudes toward antidepressant use. This study explores women’s perceptions of depression and antidepressant use, revealing that a significant proportion of Saudi women have a negative perception. The research emphasizes the need for tailored awareness programs to promote informed decision-making regarding antidepressant usage among Saudi women.

Background: Ulcerative colitis (UC) is a long-term condition marked by recurrent episodes of inflammation affecting the colonic mucosa. Despite mesalamine’s or 5-amino salicylic acid’s (5-ASA) established role in inducing and maintaining remission, some patients experience persistent symptoms and inflammatory activity. Atorvastatin has pleiotropic anti-inflammatory effects, and provide therapeutic benefits in UC. Several preclinical studies assessed the beneficial role of atorvastatin in colitis, but clinical data remain scarce. Aim: To evaluate the efficacy and safety of 5-ASA plus atorvastatin (versus 5-ASA plus placebo) in patients with mild to moderate UC. Methods: In this randomized, double-blind Pilot trial, 54 patients with mild-to-moderate UC were randomized to receive 5-ASA plus atorvastatin (Atorvastatin group, n = 27) or 5-ASA plus placebo (Control group, n = 27) for 6 months. Clinical activity was assessed using the Simple Clinical Colitis Activity Index (SCCAI), quality of life using the Inflammatory Bowel Disease Questionnaire (IBDQ-32), and inflammatory status using serum interleukin-18 (IL-18), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Statistical analysis was conducted using intention to treat. Results: After treatment, both groups showed significant changes in all measured parameters when compared to baseline except for bowel frequency at night in control group (p = 0.148). When compared to the control group, the atorvastatin group demonstrated significantly greater post-treatment improvements in IBDQ systemic (p = 0.001), digestive (p = 0.013), emotional domains (p = 0.015), and total score (p = 0.003). Reductions in IL-18, CRP, and ESR were observed in both groups, but were significantly greater with atorvastatin (IL-18: p = 0.026; CRP: p = 0.027; ESR: p = 0.03, SCCAI: p = 0.0005). Clinical response was achieved in 66.6% of atorvastatin-treated patients versus 44% of controls (p = 0.02). Spearman’s analysis showed IBDQ-32 scores were negatively correlated with SCCAI (r = −0.498), ESR (r = −0.549), CRP (r = −0.356), and IL-18 (r = −0.548). No significant reported side effects. Conclusion: Adjunctive atorvastatin with 5-ASA significantly improved clinical disease activity, quality of life, and inflammatory biomarkers compared to 5-ASA alone in mild-to-moderate patients with UC. Clinical Trial Registration: clinicaltrials.gov , Identifier NCT05567068.