Technology has increasingly influenced the provision of healthcare services by enhancing patient safety, optimising workflows, and improving efficiency. Large healthcare facilities have adopted automated dispensing cabinets (ADCs) as an advanced technological solution. A key gap exists in understanding the ADC implementation experience in different contexts. Therefore, this study seeks to fill this literature gap by exploring key stakeholders’ perspectives on the benefits, barriers, and improvement opportunities related to ADCs, offering valuable insights to support their effective integration across various healthcare settings. This qualitative study was conducted in Saudi Arabia. The implementation of ADCs generally has positive outcomes for all staff. The system has brought about enhanced medication tracking, greater time efficiency, along with reduced workload and medication errors. However, there are barriers to their implementation, including changes in workflow and workload distribution, cabinet design, technical medication management challenges, and the need for staff training. To maximise the effectiveness of ADCs, healthcare organisations should focus on improving operational workflows, providing ongoing staff training, and maintaining robust system monitoring. Additionally, manufacturers should focus on advancing technology to further enhance the efficiency and functionality of ADCs.

Introduction: The preferred PK/PD goal for vancomycin is now AUC_0–24/MIC-guided dosing, which requires two blood samples, additional time, increased cost, and possibly specialized staff, potentially limiting its use. Our study compared vancomycin target attainment using trough versus single-sample Bayesian AUC_0–24/MIC in critically ill patients, using a validated online calculator. Methods: This retrospective cohort study included adults aged ≥18 years with stable renal function who were receiving vancomycin. Exclusions were age under 18, unstable renal function, hemodialysis, missing data, or non-steady-state vancomycin. Steady-state troughs were obtained, and AUC_0–24/MIC was calculated using ClinCalc. The primary endpoint was discordance in target attainment between trough (15–20 mg/L) and AUC_0–24/MIC (400–600 mg·h/L). The secondary endpoint was AKI within 48 h of initiating vancomycin. Results: The mean trough was 14.8 ± 8.0 mg/L, and the mean AUC_0–24/MIC was 499.7 ± 201.3 mg·h/L. Trough levels were within target in 20%, and AUC_0–24/MIC in 67%. The 3 × 3 cross-tabulation showed a significant association (χ² = 27.33, p < 0.001), but only fair agreement (Cohen’s κ = 0.215) and a biased disagreement pattern (p < 0.001). Thirty-eight patients (38%) had “false alarming” results: trough < 15 mg/L despite AUC_0–24/MIC ≥ 400 mg·h/L. Three patients (3.0%) showed “falsely reassuring” results: trough 15–20 mg/L with AUC_0–24/MIC > 600 mg·h/L. The odds of supratherapeutic AUC_0–24/MIC > 600 mg·h/L were tenfold higher in patients with trough 15–20 mg/L than in those below 15 mg/L (OR 10.24, p = 0.048). Conclusions: In critically ill ICU patients, calculator-derived AUC_0–24/MIC showed significant discordance with single-trough vancomycin monitoring, primarily indicating apparent under-exposure by trough criteria in patients with adequate AUC_0–24/MIC levels, which may lead to unnecessary dose escalation.

HIV (Human Immunodeficiency Virus) is a virus that causes the immune system to be damaged, which results in reducing the body’s ability to defend aga