Journal of Research in Pharmacy Practice最新文献

{"title":"Medication Adherence and Clinical Outcomes among Patients with Chronic Kidney Disease: A 6-month Prospective Evaluation using Individual Adherence Assessment.","authors":"Seow Yee Ng, Farida Islahudin, Adyani Md Redzuan, Francis R Capule","doi":"10.4103/jrpp.jrpp_96_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_96_25","url":null,"abstract":"<p><p>Medication adherence is a critical issue in managing chronic kidney disease (CKD) patients for slowing CKD progression.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the relationship between individual medication adherence and secondary clinical outcomes (pill burden, medication knowledge, and CKD stages) over a 6-month period. This prospective observational study with repeated measures was performed among patients with CKD in a tertiary hospital in Malaysia.</p><p><strong>Methods: </strong>A prospective observational study was conducted among CKD patients, with assessments at baseline, month 3, and month 6. Individual adherence, pill burden, medication knowledge, and CKD stages were assessed at each visit. Groups were compared using Mann-Whitney <i>U</i> test, Chi-squared, <i>T</i>-test, McNemar test, or ANOVA as necessary.</p><p><strong>Findings: </strong>A total of 200 patients were included, with 140 completing the 6-month follow-up. Medication adherence remained stable over time, with 58.0% (<i>n</i> = 116/200) adherent at baseline, 59.7% (<i>n</i> = 86/144) at month 3, and 59.3% (<i>n</i> = 83/140) at month 6 (all <i>P</i> > 0.05). For the secondary outcomes, adherent patients had a significantly lower pill burden at baseline (mean 9.9 vs. 11.5 pills; <i>P</i> = 0.033), although this was not observed at month 3 or month 6. Medication knowledge scores were consistently higher among adherent patients at baseline (<i>P</i> < 0.001), month 3 (<i>P</i> = 0.002), and month 6 (<i>P</i> < 0.001). CKD stages differed significantly between adherent and nonadherent patients at all time points (baseline, <i>P</i> = 0.005; month 3, <i>P</i> = 0.006; month 6, <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>These findings highlight the clinical value of pharmacist-led, medication-level adherence assessment, enabling targeted interventions to optimize therapy, reduce complications, and improve patient outcomes.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"18"},"PeriodicalIF":0.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774780","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":"Variability in Drug-Drug Interaction Identification Across Commonly Used Drug Information Resources: An Analysis of Real world Tertiary Care Prescriptions (Retrospective Cross sectional Study).","authors":"Swastik Verma, Shubham Atal, Bhavya Bhavya, Balakrishnan Sadasivam","doi":"10.4103/jrpp.jrpp_119_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_119_25","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate and compare three popular drug interaction checkers - Lexidrug, Medscape, and Drugs.com - in detecting major drug-drug interactions (DDIs) from real-world prescriptions in a tertiary care hospital.</p><p><strong>Methods: </strong>We analyzed 500 randomly selected prescriptions from a hospital database, identifying 1133 unique drug pairs. Each pair was checked for potential interactions using all three platforms. We compared how often DDIs were detected, their severity ratings, and agreement between tools using Cohen's kappa for concordance.</p><p><strong>Finding: </strong>Polypharmacy, defined as five or more drugs, was present in 23.8% of prescriptions, with an average of 6.3 drugs per patient. Polypharmacy was strongly linked to severe DDIs, showing nearly a threefold increased risk. Drugs.com identified the highest number of DDIs (21%), followed by Lexidrug (19.6%) and Medscape (16.2%). Severity ratings varied, and agreement between the tools was moderate (κ = 0.47-0.50).</p><p><strong>Conclusion: </strong>There is notable variation in detecting and classifying major DDIs among these common tools. Standardizing databases and interaction definitions is important. Meanwhile, clinicians should use multiple checkers alongside their clinical judgment to ensure safer prescribing when managing patients on many drugs.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"19"},"PeriodicalIF":0.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774808","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":"Acute Post-cataract Surgery Endophthalmitis and Corneal Ulcer with <i>Acinetobacter</i> Managed with Colistin: A Case Report.","authors":"Mohsen Pourazizi, Alireza Peyman, Alireza Dehghani, Asieh Aslani, Mahsa Pourmahdi-Boroujeni, Paria Sanei","doi":"10.4103/jrpp.jrpp_72_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_72_25","url":null,"abstract":"<p><p>Postoperative endophthalmitis is a rare but severe complication of phacoemulsification cataract surgery (PCS). <i>Acinetobacter baumannii</i> is an uncommon pathogen, often associated with multidrug resistance and poor outcomes. In this report, a 73-year-old male who developed endophthalmitis following PCS is introduced, who, despite intensive empirical therapy, experienced no clinical improvement. Following a vitreous sample analysis with polymerase chain reaction, <i>A. baumannii</i> infection was diagnosed. The patient was treated with fortified topical colistin, amikacin, and subconjunctival and intravitreal colistin, which responded with the resolution of intraocular inflammation. This case emphasizes the therapeutic challenges of <i>A. baumannii</i> endophthalmitis. It highlights colistin as an effective treatment option in cases resistant to conventional regimens.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"15"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674387","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":"Evaluation of Adverse Drug Reactions at Hospital Besut: A 5-year Retrospective Study.","authors":"Nur Aizahakiki Shafie, Nurul Ain Tahir, Muhammad Luqman Alhakim Fami, Nur Rashida Hani Juraimi, Nur Aqilah Mohd Azmi, Rabihah Abdul Rashid","doi":"10.4103/jrpp.jrpp_55_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_55_25","url":null,"abstract":"<p><strong>Objectives: </strong>An adverse drug reaction (ADR) is an unintended and harmful response to a medicinal product and is a significant cause of morbidity and mortality. Despite its importance, no prior systematic ADR evaluation has been conducted at Hospital Besut. This study aimed to analyze ADR patterns reported within 5 years (2019 to 2023) in Hospital Besut, focusing on affected organ systems and types of drugs involved, causality, severity, outcomes, and identifying associations between demographics, severity, and reaction onset.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using all ADR reports recorded in the Pharmacy Information System (PhIS) and submitted to the National Pharmaceutical Regulatory Agency. Data from January 2019 to December 2023 were collected and analyzed from June to November 2024. The descriptive and statistical analyses, including the Chi-square test, were used to present the findings, with significance set at <i>P</i> < 0.05 using SPSS software version 27.</p><p><strong>Findings: </strong>A total of 289 ADR forms with 413 reactions were analyzed. The occurrence of ADRs was common among females (<i>n</i> = 151, 52.2%), followed by males (<i>n</i> = 138, 47.8%). The average mean age of patients was 36 ± 21.9 years. Most ADRs involved the skin (<i>n</i> = 280, 67.8%) and respiratory system (<i>n</i> = 44, 11.6%). The drug-reaction relationships were mostly classified as probable and possible, which were 114 (39.4%), respectively. In addition, most of the onset of ADR occurred within minutes (<i>n</i> = 117, 40.5%), and the reactions were mild (<i>n</i> = 171, 59.2%), with 181 (62.6%) of patients recovering from the ADR. Antibiotics (<i>n</i> = 94, 32.5%) and analgesics (<i>n</i> = 55, 19.03%) were responsible for most ADRs. Only age was significantly associated with the reaction severity (<i>P</i> = 0.037).</p><p><strong>Conclusion: </strong>This study emphasizes the importance of pharmacovigilance in identifying common ADR patterns and promoting safer medication practices in Hospital Besut.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"16"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674451","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":"Prospective Evaluation of Cephalosporin Prescribing and Guideline Adherence in Adult Inpatients at a Tertiary Care Hospital in South India.","authors":"K Pavithra, R S Shajan, A Mohamed Parvis, S Anto Melvin Raj, B Priya, Sankaralingam Ramalakshmi","doi":"10.4103/jrpp.jrpp_92_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_92_25","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess cephalosporin prescribing patterns, clinical appropriateness, susceptibility and resistance profiles, potential drug-drug interactions, and de-escalation practices in the management of infectious diseases.</p><p><strong>Methods: </strong>This prospective observational study was conducted over 6 months (May-October 2024) at a tertiary care hospital in South India. A total of 288 adult patients (>18 years) who received at least one cephalosporin prescription were included. Relevant demographic, clinical, and prescription data were collected from the patient case records. The appropriateness of antimicrobial therapy was evaluated according to the Indian Council of Medical Research antimicrobial stewardship guidelines. Data were entered into Microsoft Excel and analyzed using IBM SPSS Statistics version 20.0.</p><p><strong>Findings: </strong>Among the 288 patients, 383 cephalosporin prescriptions were documented. Culture testing was performed in 63% (<i>n</i> = 181) of cases; however, only 13.9% (<i>n</i> = 40) showed positive microbial growth. <i>Escherichia coli</i> was the most frequently isolated organism, accounting for 30% (<i>n</i> = 12) of culture-positive cases. Guideline-based evaluation revealed that 32.4% of cephalosporin prescriptions were inappropriate, indicating a significant deviation from evidence-based practice.</p><p><strong>Conclusion: </strong>Third-generation cephalosporins were predominantly prescribed in the study population. Although cephalosporins remain important and accessible therapeutic agents, inappropriate and empirical prescribing practices contribute to the rising antimicrobial resistance. Rational use guided by culture sensitivity results and antimicrobial stewardship principles is essential to preserve their clinical efficacy and limit further resistance.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"12"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674513","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":"Bridging the Gap: Promoting Adverse Drug Reaction Reporting through Innovative Strategies in Zero-reporting Zones at Karaikal - An Educational Intervention Study at Adverse Drug Reaction Monitoring Center.","authors":"Priyadharsini Raman Palanisamy, S Kiruthika, Dhivya Ravichandran","doi":"10.4103/jrpp.jrpp_65_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_65_25","url":null,"abstract":"<p><strong>Objective: </strong>Adverse drug reactions (ADRs) contribute to morbidity, mortality, compromised quality of life, and increased healthcare costs. Despite various efforts by the regulatory authorities, there remains a problem of underreporting. Our ADR monitoring center was established in JIPMER, Karaikal, and there were nil reports from the nearest hospitals in this geographical area before 2 years. The reasons are lack of knowledge, time constraints, etc., and to overcome the challenge of underreporting, we planned a study to identify the effect of an educational intervention program on ADR reporting by healthcare professionals.</p><p><strong>Methods: </strong>A total number of 200 participants were involved in the program, which included various components such as game activities, video, poster, meme contest, hands-on training, and lectures, followed by practice-based learning. The participants filled out a pretest questionnaire before attending the program. A posttest questionnaire was filled out after 1 month.</p><p><strong>Findings: </strong>There was a significant improvement in the knowledge before and after the intervention (<i>P</i> < 0.0001). More than 50% believed that there would be legal consequences of ADR reporting, and very few people (12%) had reported ADR to their seniors through telephone. The study also increased the spontaneous ADR reporting in a period of 1 year.</p><p><strong>Conclusion: </strong>The findings of the study suggest that the active educational intervention has a major impact on ADR reporting, yet it requires multiple reminders, through telephone, messages help in a consistent ADR reporting culture among the healthcare professionals.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"8"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674392","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":"Evaluation of the Efficacy and Safety of the Addition of Lacosamide to Duloxetine in the Treatment of Taxane-induced Peripheral Neuropathy: A Randomized Double-Blind Placebo-Controlled Trial.","authors":"Minoo Moghimi, Ehsan Zaboli, Leila Mirzakhani, Mohammad Eslamijouybari, Zahra Nekoukar, Hamidreza Namvar, Mahmood Moosazadeh, Ebrahim Salehifar","doi":"10.4103/jrpp.jrpp_39_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_39_25","url":null,"abstract":"<p><strong>Objective: </strong>Taxane-induced peripheral neuropathy (TIPN) is a frequent and potentially dose-limiting condition. Despite extensive research, there are still no clear guidelines for treating or preventing TIPN, though recent findings indicate that lacosamide may help relieve acute oxaliplatin-induced neuropathy. Based on this, the present study was conducted to assess the efficacy and safety of combining lacosamide with duloxetine in the treatment of TIPN.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled clinical trial enrolled patients undergoing chemotherapy regimens including paclitaxel or docetaxel who developed neuropathy and met predefined inclusion criteria. All participants received duloxetine therapy, initiated at 30 mg per day for the 1^st week and increased to 60 mg daily for the following 11 weeks. In addition, subjects were randomized to receive either lacosamide 200 mg twice daily or a matched placebo. The main outcomes included neuropathy severity assessed at baseline, week 6, and week 12. Data analysis was performed using SPSS version 20, with statistical significance defined as a <i>P</i> < 0.05.</p><p><strong>Findings: </strong>Both groups showed improvements over time, with reductions in numerical pain rating scale, National Cancer Institute Common Terminology Criteria for Adverse Event, Functional Assessment of Cancer Therapy-Taxane, and Neuropathy Pain Scale scores, and increased scores on the GHS/QoL scale. However, comparisons between the two groups revealed no statistically significant differences at any time point. Similarly, the EORTC QLQ-C30 symptom subscales did not demonstrate significant between-group differences.</p><p><strong>Conclusion: </strong>This study found that duloxetine alone and its combination with lacosamide both alleviated neuropathic symptoms and improved functional outcomes in patients with TIPN. Nonetheless, the addition of lacosamide did not confer a statistically significant advantage over duloxetine monotherapy.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"5"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674413","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":"Comparison of the Effect of Co-Trimoxazole versus Co-Trimoxazole and Fluoroquinolones in Urinary Tract Infection Prophylaxis in Kidney Transplant Recipients: A Systematic Review and Meta-analysis.","authors":"Atousa Hakamifard, Mahnaz Momenzadeh","doi":"10.4103/jrpp.jrpp_91_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_91_25","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are one of the most important infectious complications in kidney transplant recipients; hence, antibiotic prophylaxis is warranted. Due to limited information for selection of an appropriate antibiotic for prophylaxis, as well as the varying reports concerning increasing resistance of <i>Escherichia coli</i> as the common related pathogen, this systematic review and meta-analysis assess the effect of a combined regimen including fluoroquinolone + co-trimoxazole as prophylaxis in high-risk group patients. PubMed, Cochrane Library, Embase, and Web of Science were used as electronic databases to perform a systematic literature between 2010 and December 2024. A commercially available software program (EndNote X9) was used for electronic title management. Searches were performed with keywords, (\"Urinary Tract Infections\" OR \"urinary tract infection\" OR \"UTI\") AND (\"Kidney Transplantation\" OR \"renal transplant*\" OR \"kidney transplant*\") AND (\"Co-Trimoxazole\" OR \"co-trimoxazole\" OR \"trimethoprim sulfamethoxazole\" OR \"TMP-SMX\") AND (\"Fluoroquinolones\" OR \"fluoroquinolone*\" OR \"ciprofloxacin\" OR \"levofloxacin\"). A total of 454 potentially relevant titles and abstracts were found during the electronic and manual search, finally two studies were included. Heterogeneity showed a higher percentage of patients in Group I suffered from urinary infection, compared to Group II. Addition of ciprofloxacin to the standard regimen, co-trimoxazole, was related to a reduced risk of UTI in kidney transplant recipients.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"14"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674431","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":"Melatonin Supplementation Improves Pain, Sleep Quality, and Total Plasma Antioxidant Capacity in Women with Fibrocystic Breast Disease: A Randomized, Double-blind, Placebo-controlled Trial.","authors":"Esmaeel Abdolrahim-Kashi, Hosein Sadeghi, Shima Shafagh, Nushin Moussavi Biuki, Alireza Abed, Gholam Abbass Moosavi","doi":"10.4103/jrpp.jrpp_63_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_63_25","url":null,"abstract":"<p><strong>Objective: </strong>Fibrocystic breast disease (FBD) is a prevalent benign breast disorder primarily affecting women of reproductive age. Characterized by breast pain (mastalgia), cystic and solid breast lesions, and associated hormonal imbalances. Melatonin, a hormone produced by the pineal gland, exhibits potent antioxidant, anti-inflammatory, and has been shown to improve sleep quality and mental health in various clinical populations. These properties suggest that melatonin may be a promising therapeutic option for symptom management in women with FBD.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled trial enrolled 66 women aged 18-40 years with FBD, diagnosed according to American Cancer Society guidelines, at Beheshti Clinic, Kashan University of Medical Sciences. Participants were randomized to receive either melatonin (6 mg/day; <i>n</i> = 33) or placebo (<i>n</i> = 33) for 12 weeks. Primary outcomes included breast pain severity and high-sensitivity C-reactive protein (hs-CRP), while secondary outcomes assessed sleep quality, depression, anxiety, and biomarkers of oxidative stress and inflammation, including total antioxidant capacity (TAC), malondialdehyde (MDA).</p><p><strong>Findings: </strong>After 12 weeks, melatonin supplementation resulted in a significant reduction in breast pain scores (<i>P</i> = 0.006) and improvement in sleep quality (<i>P</i> = 0.02) compared to placebo. Additionally, TAC was significantly increased in the melatonin group (<i>P</i> = 0.01). No significant differences were observed for depression, anxiety, serum hs-CRP, or MDA levels.</p><p><strong>Conclusion: </strong>Twelve weeks of melatonin supplementation (6 mg/day) significantly alleviates breast pain, enhances sleep quality, and improves antioxidant status in women with FBD. These findings support the use of melatonin as a safe and effective adjunctive treatment for FBD symptom management.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"6"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674364","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":"Evaluation of the Effect of Mechanical Ventilation on the Pharmacokinetic Parameters of Vancomycin in Intensive Care Patients: A Prospective Cohort Study.","authors":"Farnia Ghanbarveisi, Shahram Ala, Fatemeh Heydari, Afshin Gholipour Baradari, Reza Alizadeh-Navaei, Alireza Nikzadjamnani","doi":"10.4103/jrpp.jrpp_73_25","DOIUrl":"https://doi.org/10.4103/jrpp.jrpp_73_25","url":null,"abstract":"<p><strong>Objective: </strong>Intensive care unit (ICU) patients on mechanical ventilation, in particular, may experience changes in pharmacokinetics due to alterations in cardiac output and organ blood flow. This study aims to evaluate the effects of mechanical ventilation on the steady-state pharmacokinetic changes of vancomycin.</p><p><strong>Methods: </strong>In this prospective cohort study, eligible patients were enrolled into either the ventilated or non-ventilated group. Demographic and clinical data were gathered, and peak and trough blood samples were collected to measure their levels. Additional pharmacokinetic parameters were calculated using appropriate formulas.</p><p><strong>Findings: </strong>A total of 39 ICU patients were enrolled in the final analysis. Of these, 32 matched patients were divided into two equal groups: ventilated and nonventilated. None of the pharmacokinetic parameters, including peak plasma concentration (<i>P</i> = 0.878), trough plasma concentration (<i>P</i> = 0.437), volume of distribution (<i>P</i> = 0.468), <i>K</i> (<i>P</i> = 0.234), <i>t</i> _½ (<i>P</i> = 0.266), clearance (<i>P</i> = 0.709), and daily area under the curve (<i>P</i> = 0.418), were significantly different between the two groups. Bivariate correlation analysis showed a significant correlation between estimated glomerular filtration rate, acute physiology and chronic health evaluation II score, and C-reactive protein (CRP) level with vancomycin pharmacokinetic parameters. Furthermore, significant effects of augmented renal clearance (ARC) on vancomycin pharmacokinetics were determined.</p><p><strong>Conclusion: </strong>The key finding of this study was that ARC significantly impacted vancomycin serum levels, resulting in subtherapeutic concentrations in 23.1% of patients. High CRP levels also significantly correlated with increased vancomycin distribution volume, emphasizing the role of inflammation. These findings underscore the importance of personalized vancomycin dosing, taking into account factors such as ARC and inflammation, to improve patient outcomes. However, due to the small sample size, further studies with larger cohorts are necessary.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"15 1","pages":"7"},"PeriodicalIF":0.7,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674390","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}