The study aims to comparatively assess the nephrotoxicity of vancomycin when combined with piperacillin-tazobactam (V + PT) or meropenem (V + M) in adult patients hospitalized in general wards or intensive care units. We searched MEDLINE, Google Scholar, and Web of Science for observational studies evaluating incidences of AKI in adult patients receiving V + PT or V + M for at least 48 h in general wards or intensive care units. The primary outcome was AKI events, while the secondary outcomes were hospital length of stay, need for renal replacement therapy (RRT), and mortality events. The odds ratio (OR), or mean difference for the hospital length of stay, with a corresponding 95% confidence interval (CI) from the inverse variance weighting random-effects model were estimated for the risk of AKI, RRT, and mortality. Of the 112 studies identified, twelve observational studies were included in this meta-analysis with a total of 14,511 patients. The odds of having AKI were significantly higher in patients receiving V + PT compared with V + M (OR = 2.31; 95%CI 1.69–3.15). There were no differences between V + PT and V + M in the hospital length of stay, RRT, or mortality outcomes. Thus, clinicians should be vigilant while using V + PT, especially in patients who are at high risk of AKI.

Background Droperidol is a first-generation antipsychotic medication that has been used for various indications in the emergency department (ED); however, its use has been controversial due to reports of QT prolongation and the risk of torsades de pointes (TdP). The aim of the study is to evaluate the safety of droperidol administration in the ED. Methods This was a retrospective study, conducted at an academic level I trauma center. System-generated reports were used to identify all droperidol administrations in the ED from the time that droperidol was reintroduced to the institutional formulary on July 1, 2019 through January 31, 2023. The major safety endpoint was a composite of the incidence of QTc interval prolongation, incidence of TdP, ventricular arrhythmia, or hypotension. Results A total of 327 administrations of droperidol were identified in 245 patients in the ED. The composite safety endpoint occurred in 30 (9.1%) administrations. None of these events were classified as "probable" or "definite" on the Naranjo adverse drug reaction probability scale. No episodes of TdP or serious ventricular arrhythmia were reported. Higher cumulative droperidol dose and creatinine clearance < 60 mL/min were associated with an increased odds of developing QTc prolongation (OR 1.27 [CI 1.04-1.56]) and (OR 1.01 [CI 1.0-1.02]), respectively. Conclusions The study supports the use of low dose droperidol for various indications in the ED. There were no serious adverse events reported that could be directly attributed to droperidol use; however, it is crucial to consider the potential dose dependent impact on QTc prolongation.

Introduction: Hyperuricemia, characterized by elevated serum uric acid (UA) levels, is associated with cardiovascular–kidney–metabolic syndrome and remains challenging to manage due to medication side effects and adherence issues. SGLT2 inhibitors (SGLT2i), primarily prescribed for diabetes (DM), heart failure (HF), and chronic kidney disease (CKD), have demonstrated potential UA-lowering effects, though their precise impact is not well established.Methods: This multicenter retrospective cohort study used a pre-and-post analysis to evaluate the effect of SGLT2i on UA levels. Data were collected from four major healthcare centers in Saudi Arabia. The study included adult patients who initiated SGLT2i therapy between January 2022 and January 2024, excluding those with active gout flares, a history of cancer, or recent changes in UA-lowering therapy. The primary outcome was the percentage change in serum UA levels post- i initiation, with secondary outcomes including subgroup analyses, metabolic effects, univariate and multivariate modeling, and longitudinal trend evaluations.Results: Among 2,400 patients screened, 454 were included in the final analysis. SGLT2i significantly reduced UA levels by 4.5% (p=0.006), with the most pronounced reduction in patients with baseline elevated UA (10%, p=0.001) and those with HF (9%, p=0.001). Univariate analysis identified DM & HF, DM & CKD, and DM, HF & CKD as predictors of response, but multivariate analysis confirmed only DM & HF as an independent predictor (OR = 2.2, 95% CI: 1.2–4.04).Conclusion: These findings suggest that SGLT2i may serve as an adjunct therapy for hyperuricemia, especially in patients with DM & HF, highlighting the need for further research on long-term benefits.

There is a lack of Doctor of Pharmacy (PharmD) and Master of Public Health (MPH) dual degree programs in Saudi Arabia. This study aims to examine current pharmacy students’ perceptions regarding establishing such a program and the perceived limitations and advantages of pursuing such a degree. We conducted a cross-sectional web-based short survey to assess the feasibility of establishing a PharmD/MPH dual degree program in several randomly selected pharmacy schools in Saudi Arabia. Our cohort consisted of 657 students. Almost 56% were males, and nearly 58% were fourth-year pharmacy students. Close to 85% had a “very well” or “well” understanding regarding the pharmacist’s role in the public health area, and almost 70% stated that they see themselves playing a role in public health as a future pharmacist. Nearly 93% reported that they are either “very likely” or “likely” to enroll in such a program if given the opportunity. Almost 80% felt it would increase their job opportunities. On the other hand, close to 70% felt it would increase workload and stress. This study highlights pharmacy students’ positive perceptions regarding establishing a PharmD/MPH dual degree program in Saudi Arabia. The study results could be utilized as the starting point to propose and establish this program to health education policymakers in Saudi Arabia.