Hospital Pharmacy最新文献

{"title":"Mitigating Risks in Hospital Stock Management: A Structured Method for Validating Excel Files.","authors":"Yasmina Gaoual, Zineb Aliat, Ali Cherif Chefchaouni, Adam Mahyaoui, Oussama Merhom, Younes Rahali","doi":"10.1177/00185787251337614","DOIUrl":"10.1177/00185787251337614","url":null,"abstract":"<p><p><b>Introduction:</b> Validation ensures data integrity, accuracy, and usability, addressing risks such as unauthorized modifications, computational errors, and security vulnerabilities. The validation process includes steps like verifying access controls, formulas, conditional formatting, and cell characteristics to align with predefined specifications. <b>Methods:</b> This study, conducted in the Pharmacy of the Hospital of Specialties in Rabat, focused on validating Excel files (Excel 2013) used for data management to ensure compliance with good practices. The methodology involved collaborative development of a validation protocol, including steps like file identification, access level verification, formula testing, and review of hidden elements, cell characteristics, conditional formatting, and headers/footers. This systematic approach ensured data reliability, transparency, and adherence to regulatory standards. <b>Results and discussion:</b> Results demonstrate that the Excel system meets all validation criteria, with secured data protection, accurate calculations, and user-friendly visual cues for identifying critical stock issues. Conditional formatting enhances usability by prioritizing at-risk items, facilitating prompt action. The validated system supports reliable decision-making and operational efficiency, ensuring consistent and transparent medication management. While this approach provides numerous benefits, including enhanced reliability and compliance, challenges such as resource requirements, dependency on user expertise, and frequent updates pose limitations. Nonetheless, integrating validation principles into hospital pharmacy operations offers a pathway to optimizing digital tools for improved healthcare outcomes.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337614"},"PeriodicalIF":0.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Associated Tendinopathies and Ligament Disorders: Results from a Retrospective Pharmacovigilance Study Using Disproportionality Analysis.","authors":"Kannan Sridharan","doi":"10.1177/00185787251337621","DOIUrl":"10.1177/00185787251337621","url":null,"abstract":"<p><p><b>Background:</b> Tendinopathies and ligament disorders are significant musculoskeletal adverse events associated with various drugs, leading to restricted mobility and reduced quality of life. Although certain drug classes such as fluoroquinolones and corticosteroids have established links to these conditions, there is limited research on other potential drug associations. This study aimed to comprehensively evaluate drugs associated with tendinopathies and ligament disorders using data from the USFDA Adverse Event Reporting System (AERS). <b>Methods:</b> A retrospective pharmacovigilance study utilizing spontaneous reports from the USFDA AERS database between March 2004 and June 2024 was conducted. The Standardized Medical Dictionary for Regulatory Activities (MedDRA) query \"Tendinopathies and ligament disorders\" and relevant Preferred Terms were used to identify cases. Disproportionality analysis was performed using both frequentist and Bayesian methods. Subgroup analyses were conducted by age, gender, and clinical outcomes. <b>Results:</b> Out of 29 153 222 reports, 40 485 unique reports were included, with 6641 related to tendon rupture and 2121 to ligament rupture. Fluoroquinolones, corticosteroids, lipid-modifying agents, immunosuppressants, and bisphosphonates were confirmed to have strong associations with tendon and ligament disorders. Emergent signals were identified for anti-inflammatory drugs, and various other drugs, including vaccines. Hospitalization rates were significantly higher in cases of tendon rupture compared to ligament rupture (<i>P</i> < .0001). <b>Conclusion:</b> This study confirms established drug associations and identifies new signals for tendinopathies and ligament disorders. Continued pharmacovigilance is necessary to validate these findings and enhance our understanding of drug-induced musculoskeletal disorders.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337621"},"PeriodicalIF":0.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Utilization and Potentially Inappropriate Prescriptions Assessment Among Discharged Pediatric Patients in a Tertiary Care Hospital.","authors":"Meeradevi Maratha Muthu, Shamala Balan, Sofea Syahira Salim, Ellya Maisarah Mohamad Idris, Anis Suzanna Nor Azmi","doi":"10.1177/00185787251337624","DOIUrl":"10.1177/00185787251337624","url":null,"abstract":"<p><p><b>Background and Aims:</b> Drug utilization and appropriateness assessment among pediatrics is crucial and relies on relevant evidence generation. The study aimed to analyze drug utilization and prevalence of potentially inappropriate prescriptions (PIP) and determine the risk factors for PIP among discharged pediatric patients in a tertiary care hospital. <b>Methods:</b> The cross-sectional study included discharged pediatric (aged < 18 years) prescriptions received between March and May 2023. Drug utilization was assessed using World Health Organization (WHO) Prescribing Indicators. Appropriateness was evaluated using the prescription intervention categories (implicit tool) and 67-item Key Potentially Inappropriate Drugs in Pediatrics List (KIDs List; explicit tool). Categorical and continuous data were analyzed descriptively. Risk factors of PIP were determined by logistic regression analysis. <b>Results:</b> Overall, 1952 prescriptions (mean age 4.61 ± 4.72 years) containing 3304 drugs and 149 drug types were analyzed. The average number of drugs per prescription was 1.69. The use of generic names and drugs from the Malaysian National Essential Medicines List were 2061 (62.38%) and 2985 (90.35%), respectively. The number of antibiotics and injectables per prescription were 1338 (68.55%) and 1(0.05%), respectively. The prevalence of PIP was 8.15% (n = 159). Sixty-one (3.13%) prescriptions were intervened for inappropriate regimen, mainly involving inappropriate dose (n = 47, 2.41%), and inappropriate frequency (n = 15, 0.77%). Ten drugs (14.93%) from KIDs List were prescribed in 80 prescriptions (4.09%), primarily involving tramadol (n = 40, 2.05%). Number of drugs prescribed (adjusted odds ratio (aOR) = 1.63, 95% CI (1.40, 1.89), <i>P</i> < .001), and ages 28 days to 23 months (aOR = 0.15, 95% CI (0.05, 0.49), <i>P</i> = .001), and 2 to 11 years (aOR = 0.22, 95% CI (0.07, 0.71), <i>P</i> = .011) were identified as PIP risk factors. <b>Conclusion:</b> The study found inconsistencies with WHO recommendations for essential drugs, antibiotics, and generic names. Although PIP prevalence was low, the number of drugs prescribed and age categories were key risk factors, emphasizing the need for structured drug reconciliation and a country-specific safe prescribing tool to minimize PIP in pediatric patients.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337624"},"PeriodicalIF":0.8,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist's Educational Intervention on Disease Knowledge, Medication Adherence, and Health-Related Quality of Life Among Rheumatoid Arthritis Patients: A Single Centre, Open-Label, Randomised Controlled Study.","authors":"Sujita Khadka, Sabina Sankhi, Nirmal Raj Marasine","doi":"10.1177/00185787251337594","DOIUrl":"10.1177/00185787251337594","url":null,"abstract":"<p><p><b>Objective:</b> Pharmacists with their unique roles and responsibilities, play a vital role in improving patients knowledge and medication adherence, ultimately contributing to improved health-related quality of life (HRQoL). This study aims to evaluate the impact of pharmacist-led educational intervention on disease knowledge, medication adherence, and HRQoL among patients with rheumatoid arthritis (RA). <b>Methods:</b> A randomized, single-blind, parallel, controlled study was conducted among 118 patients with RA visiting the outpatient department of the National Center for Rheumatic Diseases, Kathmandu, Nepal. Data on disease knowledge, medication adherence, and HRQoL were collected at baseline and follow-up at 12 weeks. Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), General Medication Adherence Scale (GMAS), and European Quality of Life Scale (EuroQol) 5-Dimension 5-Level (EQ-5D-5L) were used to measure knowledge level, adherence level, and HRQoL, respectively. <b>Results:</b> At follow-up, disease knowledge significantly improved in the intervention group (IG) (excellent knowledge: 42;71.2% vs 9;15.3% at baseline), while the change was minimal in control group (CG) (12;20.3% vs 22.0% at baseline). Similarly, the IG showed a marked increase in medication adherence (high: 57;96.6% vs 20;33.9% at baseline), with only slight improvement in CG (37;62.7% vs 29;49.2% at baseline). The Proportion of patients with the best HRQoL significantly increased in the IG (48;81.4% vs 17;28.8% at baseline), while it remained unchanged in CG. Statistically significant improvements were observed in disease knowledge, medication adherence and HRQoL scores (<i>P</i> < .01) in the IG. <b>Conclusion:</b> The intervention group demonstrated significantly improved disease knowledge, medication adherence, and HRQoL scores, while control group showed minimal changes, highlighting the effectiveness of pharmacist-led educational intervention in disease management.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337594"},"PeriodicalIF":0.8,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IVIG Administration: Lessons from Cross-Institutional Protocol Review.","authors":"Michelle L Payne, Keaton S Smetana, Casey C May","doi":"10.1177/00185787251340651","DOIUrl":"10.1177/00185787251340651","url":null,"abstract":"<p><p><b>Background:</b> Intravenous immunoglobulin (IVIG) is used in the acute care, including neurocritical care, setting for a variety of autoimmune and inflammatory conditions. Incidence and severity of infusion-related reactions have been found to be affected by several key factors, including osmolarity, sodium and IgA content, and infusion rate. The purpose of this study was to survey and synthesize IVIG-related practices across various hospitals into a practical guide for clinicians and provide a reference for reviewing or developing IVIG infusion protocols. <b>Methods:</b> Pharmacists from the Neurocritical Care Society Connect online forum were invited to participate in a survey regarding their institutional protocols related to IVIG infusions in the inpatient setting. <b>Results:</b> Data were collected from 12 participating medical centers, all of which have dedicated neurocritical care units. The most common formulation of IVIG used was Privigen^®, followed by Gammagard^®. Gamunex^®-C was only used at two centers. Starting rates for IVIG infusions ranged from 0.3 to 0.6 mL/kg/hr with increases every 15 to 30 minutes. Maximum infusion rates were heterogenous ranging from 2 to 8 mL/kg/hr and often reduced in high-risk populations, such as renal impairment or older age. Significant variation in medication selection and standardization was identified in pre-medication practices and management of adverse reactions. <b>Conclusion:</b> This study highlights the variability in IVIG administration protocols and underscores the need for standardized practices to enhance patient safety and treatment efficacy.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251340651"},"PeriodicalIF":0.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women and Hyponatremia: An Analysis of Sex Differences in Adverse Drug Reactions.","authors":"Eleonora Castellana, Patricia Madalina Budau, Maria Rachele Chiappetta","doi":"10.1177/00185787251337618","DOIUrl":"https://doi.org/10.1177/00185787251337618","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337618"},"PeriodicalIF":0.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relation Between Polypharmacy, Potentially Inappropriate Medications, Organ Function, and Quality of Life in Elderly Patients with Type 2 Diabetes.","authors":"Hozan Jaza Hama Salh, Tavga Ahmed Aziz, Taha Othman Mahwi, Narmin Hamaamin Hussen, Dlivan Fattah Aziz","doi":"10.1177/00185787251337592","DOIUrl":"https://doi.org/10.1177/00185787251337592","url":null,"abstract":"<p><p><b>Objective:</b> To determine the prevalence of polypharmacy, potentially inappropriate medications (PIMs) and potentially serious clinically relevant DDIs and to determine the association of polypharmacy with PIMs, potentially serious clinically relevant DDI, kidney function, liver function, serum electrolytes, and quality of life (QoL) in old patients with type 2 diabetes mellitus (T2DM). <b>Methods:</b> A cross-sectional study was performed among 136 patients (aged ≥ 65) with T2DM in the Center of Diabetes and Endocrine Diseases in Sulaimani, Iraq. A clinical pharmacist used an interview-based questionnaire to collect data. Blood samples were obtained to measure HbA1c, fasting blood glucose, creatinine, urea, AST, ALT, and potassium. STOPP criteria version 3 was used to identify PIMs, while, DDIs were checked using the Medscape interaction database. <b>Results:</b> In this study, the prevalence of polypharmacy was 55.88%. Patients on polypharmacy exhibited higher BMI 29.60 ± 4.220 (<i>P</i>-value = 0.037), longer diabetes duration 14.24 ± 6.464 (<i>P</i>-value = 0.0001), more comorbidities 100% (<i>P</i>-value = 0.0001), more diabetes complications 93.4% (<i>P</i>-value = 0.006), and greater use of chronic medications 100% (<i>P</i>-value = 0.0001) compared to those without polypharmacy. Among the participants, 64.7% had PIMs, with 64% linked to the endocrine system. Additionally, 14% experienced potentially serious clinically relevant DDIs, mostly due to interaction between aspirin and ACE inhibitors 47.8%. The prevalence of PIMs 73.7% (<i>P</i>-value = 0.019) and potentially serious clinically relevant DDIs 25% (<i>P</i>-value = 0.0001) respectively were higher in patients with polypharmacy compared to those without polypharmacy. Furthermore, polypharmacy was correlated with lower QoL index scores 0.221 ± 0.411 (<i>P</i>-value = 0.002), lower mean VAS scores 59.54 ± 7.83 (<i>P</i>-value = 0.028), and high serum K⁺ 4.81 ± 0.545 (<i>P</i>-value = 0.022). However, no significant differences in kidney function tests (GFR and urea) and liver function tests (AST and ALT), were seen between the two groups. <b>Conclusion:</b> The findings highlight a high prevalence of PIMs and potentially serious DDIs in patients on polypharmacy. Furthermore, polypharmacy is associated with poorer QoL outcomes in older patients with T2DM, emphasizing the need for careful medication review and management in this population.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337592"},"PeriodicalIF":0.8,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unpacking Oral Challenge Protocols: A Descriptive Epidemiologic Study of Reactions, Predictors, and Practices for Delabeling Low-Risk Penicillin Allergies Leveraging Data from a Systematic Review and Meta-Analysis.","authors":"Mira Maximos, Ryan Pelletier, Sameer Elsayed, Colleen J Maxwell, Sherilyn K D Houle, Brie McConnell, John-Michael Gamble","doi":"10.1177/00185787251337626","DOIUrl":"https://doi.org/10.1177/00185787251337626","url":null,"abstract":"<p><p><b>Background:</b> Oral challenges with amoxicillin or other penicillins are safe and effective for delabeling low-risk penicillin allergy histories. While approximately 90% of reported penicillin allergies can be safely delabeled, detailed data on reaction frequency, types, and timing during and after delabeling interventions remain limited. Such data are crucial to optimizing protocols and integrating oral challenges into routine practice. This study aims to characterize the interventions commonly used for oral challenge, classify reported reactions, and identify reported predictors of hypersensitivity reactions in randomized controlled trials and quasi-experimental studies involving an oral challenge for patients with low-risk penicillin allergies. <b>Methods:</b> This study leverages data from a systematic review and meta-analysis assessing the effectiveness of oral challenge interventions in patients with low-risk penicillin allergies. This descriptive analysis summarizes the adverse reactions experienced among patients in published studies who received oral challenge. Participant demographics, intervention protocols, frequency, type, and timing of post-challenge adverse reactions are reported. Reactions are categorized as immediate, delayed, or other, with frequencies summarized using descriptive statistics. A random effects meta-analysis quantifies a pooled adverse reaction rate. Predictors of hypersensitivity reactions were synthesized narratively. <b>Results:</b> Across 26 studies (2 randomized trials, 24 quasi-experimental studies) evaluating an oral challenge for patients with a low-risk penicillin allergy, the average participant age was 56 years, with a predominance of females (61%) and limited ethnic diversity with 88% reported or identifying as White. Amoxicillin was the most frequenty used oral challenge agent, typically administered as a single 250 mg oral dose. The incidence of reaction or non-delabeling was 4% (95% Confidence Interval 3%, 6%), <i>I</i> ² = 43%, <i>P</i> = .0001. Cutaneous manifestations, such as rashes, were the most frequent reactions. Delayed reactions, primarily mild maculopapular rashes, were uncommon and managed with antihistamines or topical steroids. Risk factors for oral challenge reactions included higher baseline allergy burden and shorter intervals to oral challenge since the index reaction. <b>Conclusion:</b> Oral challenge strategies to delabel low-risk penicillin allergies can involve single doses of amoxicillin or other penicillins with monitoring protocols that can be managed in ambulatory settings. However, although these delabeling strategies are becoming more prevalent, continued study of standardized protocols and follow-up are essential for effective and replicable delabeling strategies. Future research should prioritize diverse populations and equity-driven frameworks to improve generalizability to all individuals and to resource limited settings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337626"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agnostic Drugs: A New Paradigm in Pharmacological Therapy.","authors":"Eleonora Castellana, Maria Rachele Chiappetta","doi":"10.1177/00185787251340598","DOIUrl":"https://doi.org/10.1177/00185787251340598","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251340598"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Safety, and Cost-Effectiveness of N-Acetylcysteine in Preventing Amphotericin B Nephrotoxicity in Egyptian Patients with Hematological Malignancies: A Randomized Controlled Trial.","authors":"Abdel-Hameed Ibrahim Mohamed Ebid, Haydi Sayed Mohamed, Yasmin Medhat Monir Mohammed, Sara Mohamed Mohamed Abdel Motaleb","doi":"10.1177/00185787251337615","DOIUrl":"https://doi.org/10.1177/00185787251337615","url":null,"abstract":"<p><p><b>Introduction:</b> Amphotericin B (AmB-d) is one of the most common agents for treating fatal systemic fungal infections in patients with hematologic malignancies. However, its severe adverse effects, especially nephrotoxicity, limited its use. This study evaluated the efficacy, safety, and cost-effectiveness of oral N-acetylcysteine (NAC) in preventing AmB-d nephrotoxicity and promoting renal recovery in Egyptian hematological malignancy patients. <b>Methods:</b> A prospective open-label randomized controlled trial was conducted. Patients were randomized to receive AmB-d plus 600 mg NAC twice daily (intervention group) or AmB-d alone (control group). The primary outcome was the incidence of acute kidney injury (AKI), with secondary outcomes including electrolyte imbalances (hypokalemia, hypomagnesemia) and renal recovery from AKI. A cost-effectiveness analysis was performed, supported by one-way and probabilistic sensitivity analyses (PSA). <b>Results:</b> NAC co-treatment significantly reduced AmB-d-induced AKI (odds ratio = 0.415, 95% CI: 0.174-0.992, <i>P</i> = .041). Renal recovery rates were higher in the NAC group (73.33% vs 53.85%), though not statistically significant (<i>P</i> = .322); the number needed to treat (NNT) was 6, indicating clinical relevance. No significant differences were observed in hypokalemia (<i>P</i> = .547) or hypomagnesemia (<i>P</i> = .768). NAC was cost-effective, with an effectiveness gain of 0.22 and cost savings of 2742.678 EGP per patient. Sensitivity analyses confirmed robustness, with NAC being dominant in 942 out of 1000 PSA scenarios. NAC was well-tolerated, with only mild gastrointestinal side effects reported. <b>Conclusion:</b> NAC co-administration with AmB-d effectively prevents nephrotoxicity, reduces costs, and may promote renal recovery in Egyptian hematological malignancy patients. The favorable NNT for renal recovery suggests clinical relevance, warranting further investigation in larger studies. <b>Trial registration:</b> ClinicalTrials.gov identifier, NCT06122311.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337615"},"PeriodicalIF":0.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}