Journal of Research in Pharmacy Practice

A randomized clinical trial evaluating the efficacy of colistin loading dose in critically ill children

Shiva Fatehi; Hamid Eshaghi; Meisam Sharifzadeh; Bahador Mirrahimi; Mostafa Qorbani; Parin Tanzifi; Kheirollah Gholami; Toktam Faghihi

Volume 8, Issue 4 , October 2019, , Pages 196-201

Abstract

Pharmacokinetic and clinical studies recommend applying loading dose of colistin for the treatment of severe infections in the critically ill adults. Pharmacokinetic studies of ... Read More

Impact of protocol implementation on rationalization of albumin use in a tertiary care teaching hospital in Tehran, Iran

Sholeh Ebrahimpour; Marzieh Nosrati; Mehdi Mohammadi; Haniyeh Kamyab; Amir Sarayani; Habibollah Mahmoodzadeh; Zahra Jahangard-Rafsanjani; Kheirollah Gholami

Volume 7, Issue 4 , October 2018, , Pages 182-187

Abstract

With respect to the high cost and limited availability of albumin, its use must be restricted to indications strongly supported by solid scientific evidence. It was anticipated that ... Read More

Ciprofloxacin use in hospitalized children: Approved or off-label?

Toktam Faghihi; Leila Yavari Tekmehdash; Mania Radfar; Kheirollah Gholami

Volume 6, Issue 4 , October 2017, , Pages 193-198

Abstract

Fluoroquinolones are not routinely used as the first-line antimicrobial therapy in pediatrics. The American Academy of Pediatrics (AAP) and the United States Food and Drug Administration ... Read More Fluoroquinolones are not routinely used as the first-line antimicrobial therapy in pediatrics. The American Academy of Pediatrics (AAP) and the United States Food and Drug Administration (FDA) approved fluoroquinolones on certain indications in children. The aim of this study was to evaluate to what extent and how ciprofloxacin is used on approved indication or as off-label. Besides, dose adequacy and treatment duration were assessed. Methods: In a 10-month observational study, all children receiving systemic ciprofloxacin were assessed. We classified ciprofloxacin prescription to an AAP/FDA or off-label indication. The off-label prescriptions were further categorized to justified and unjustified therapy subgroups. The AAP/FDA category and the justified subgroup constituted the appropriate prescriptions. Findings: During the study period, 32 patients were prescribed ciprofloxacin. In general, 37% (12) of prescriptions determined to be appropriate. Of the appropriate prescriptions, 7 were AAP/FDA-approved indications. Children with Crohn's disease with abdominal abscess and children with infectious bloody diarrhea constituted the off-label; justified therapy subgroup. Unjustified prescriptions mainly occurred in the presence of a suitable alternative antibiotic for ciprofloxacin. Mean ± SD of ciprofloxacin dose (mg/kg/day) and duration (days) were 21.25 ± 6.35 and 13.56 ± 8.48, respectively. Of the appropriate prescriptions, 41% were underdosed. Underdosing was more encountered in patients with cystic fibrosis. Duration of treatment of the appropriate prescriptions was determined to be appropriate. Conclusion: The majority of children were receiving ciprofloxacin off-label and in an inappropriate manner. This issue emphasizes that antimicrobial stewardship program on ciprofloxacin use in pediatric hospitals should be implemented. Further studies evaluating clinical and microbiological outcomes of these programs in children are needed.

Journal of Research in Pharmacy Practice

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Author = Kheirollah Gholami

A randomized clinical trial evaluating the efficacy of colistin loading dose in critically ill children

Abstract

Impact of protocol implementation on rationalization of albumin use in a tertiary care teaching hospital in Tehran, Iran

Abstract

Ciprofloxacin use in hospitalized children: Approved or off-label?

Abstract