No abstract

This report adds to the evidence-base of AIAM and emphasizes the importance of taking a thorough medication history in individuals with suspected meningitis. Considering the wide utilization of amoxicillin, it is important that healthcare providers are aware of AIAM.
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2 AbstractPurpose: Drug safety classifications give a very basic estimation of risk and should only be used as general guideline when assessing risk of pregnancy-related drug exposure or planning treatment. We conducted a study to assess the strength of association between both the clinical pharmacologists' risk assessment and the FDA risk categorization, and adverse pregnancy outcomes. Methods: We retrospectively reviewed records of 1076 patients consecutively referred to the clinical pharmacology outpatient clinic for pregnancyrelated drug exposures (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008). Clinical pharmacologists' risk assessments were reviewed in relation to FDA drug categorization and available pregnancy outcomes. Results:Overall, clinical pharmacologists' risk estimation was in agreement with the FDA risk categorization system in only 28% of consulted women, and in only 9% of women with high risk exposure (FDA DX). Clinical pharmacologists' risk assessment confirming high risk drug exposure had a better positive predictive value for adverse pregnancy outcomes than the FDA DX categorization (25% vs. 14%, respectively), while the negative predictive values were similar (92% vs. 94%, respectively). Clinical pharmacologists' risk assessment was a better predictor of adverse pregnancy outcomes when compared to FDA risk categorization [OR 2.11 (95%CI 1.5-3.1; p<0.001) vs. OR 1.52 (95%CI 1.1-2.1; p=0.014), respectively].Conclusions: Additional evaluation beyond the FDA drug classification is essential for safer and more rational drug use in pregnancy. Clinical pharmacologists who have undergone rigorous medical training are ideally placed to consult on administration of medicines in pregnant women, thus making the prescribing of treatments in that patient category substantially safer and more rational.

Exclusive use of amikacin significantly reduced the resistance of GNB isolates to gentamicin and netilmicin, the number of GNB nosocomial bacteremias, and the cost of total antibiotic usage in ICUs.

CYP2C9 and VKORC1 genotype-guided dosing of warfarin may be beneficial in patients diagnosed with AF. There is no evidence for such conclusion in patients with DVT and PE.