Patterns of infections and antimicrobial drugs' prescribing among pregnant women in Saudi Arabia: a cross sectional study.

BACKGROUND: Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. METHODS: This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). RESULTS: The results showed that urinary tract infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from classes B, C and D under the FDA risk classification system. CONCLUSION: The study revealed a high proportion of antimicrobials prescribed during pregnancy that might pose risks to mothers and their fetuses. Future multicenter studies are warranted to evaluate the rational prescription of antimicrobial medications during pregnancy.

Protective effect of Nigella sativa seeds against carbon tetrachloride-induced liver damage.

It has been reported that Nigella sativa oil possesses hepatoprotective effects in some models of liver toxicity. However, it is N. sativa seeds that are used in the treatment of liver ailments in folk medicine rather than its oil. Therefore, the aim of this study was to investigate the effect of the aqueous suspension of N. sativa on carbon tetrachloride (CCL4)-induced liver damage. Aqueous suspension of the seeds was given orally at two dose levels (250 mg/kg and 500 mg/kg) for five days. CCL4 (250 microl/kg intraperitoneally / day in olive oil) was given to the experimental group on days 4 and 5, while the control group was only treated with the vehicles. Animals treated with CCL4 showed remarkable centrilobular fatty changes and moderate inflammatory infiltrate in the form of neutrophil and mononuclear cells when compared to the controls. This effect was significantly decreased in animals pretreated with N. sativa. Histopathological or biochemical changes were not evident following administration of N. sativa alone. Serum levels of aspartic transaminase (AST), and L-alanine aminotransferase (ALT) were slightly decreased while lactate dehydrogenase (LDH) was significantly increased in animals treated with CCL4 when compared to the control group. LDH was restored to normal but ALT and AST levels were increased in animals pretreated with N. sativa. In conclusion, N. sativa seeds appeared to be safe and possibly protective against CCL4-induced hepatotoxicity. However, further studies may still be needed prior to supporting its use in folk medicine for hepatic diseases.

Use of antibiotics in the poultry industry in Saudi Arabia: implications for public health.

BACKGROUND: The use of antimicrobial agents in food-producing animals has become an important public health issue due to the spread of microbial resistance. This study was aimed at identifying the antimicrobial agents available for poultry use and highlighting their possible impact on public health. MATERIALS AND METHODS: Twenty-three randomly selected poultry farms and all veterinary pharmacies in the Eastern Province of Saudi Arabia were surveyed for the antibiotics used or dispensed. Further, a comprehensive literature survey was performed. RESULTS: Twenty-nine antimicrobial agents were identified as being available for poultry use, of which 22 (75.9%) were important for the treatment of human infections. Enrofloxacin, oxytetracycline, ampicillin, neomycin, sulphamethoxazole, colistin, doxycycline and erythromycin were the most frequently used drugs. Food-borne hypersensitivity reactions and the emergence of microbial resistance, as well as cross-resistance to the various groups of antibiotics in animals and its transfer to human pathogens, are well documented. CONCLUSION: The misuse of antibiotics in the local poultry industry poses a serious health risk to the public and may complicate the treatment of human infections. The veterinary use of antimicrobial agents, especially those with dual animal and human applications, should therefore be restricted. The establishment of a government department concerned with food and drug safety is also highly recommended.