ObjectivesTo evaluate the effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations (HRAs) by healthcare professionals.DesignQuasi-experimental study consisting of a single group before-and-after study design.SettingA public emergency hospital in Mecca, Saudi Arabia.Participants660 (preintervention) and then 498 (postintervention) handwritten physician orders, medication administration records (MRAs) and pharmacy dispensing sheets of 482 and 388 patients, respectively, from emergency wards, inpatient settings and the pharmacy department were reviewed.InterventionThe intervention consisted of a series of interactive lectures delivered by an experienced clinical pharmacist to all hospital staff members and dissemination of educational tools (flash cards, printed list of HRAs, awareness posters) designed in line with the recommendations of the Institute for Safe Medical Practices and the US Food and Drug Administration. The duration of intervention was from April to May 2011.Main outcomeReduction in the incidence of HRAs use from the preintervention to postintervention study period.FindingsThe five most common abbreviations recorded prior to the interventions were ‘IJ for injection’ (28.6%), ‘SC for subcutaneous’ (17.4%), drug name and dose running together (9.7%), ‘OD for once daily’ (5.8%) and ‘D/C for discharge’ (4.3%). The incidence of the use of HRAs was highest in discharge prescriptions and dispensing records (72.7%) followed by prescriptions from in-patient wards (47.3%). After the intervention, the overall incidence of HRA was significantly reduced by 52% (ie, 53.6% vs 25.5%; p=0.001). In addition, there was a statistically significant reduction in the incidence of HRAs across all three settings: the pharmacy department (72.7% vs 39.3%), inpatient settings (47.3% vs 23.3%) and emergency wards (40.9% vs 10.7%).ConclusionsPharmacist-led educational interventions can significantly reduce the use of HRAs by healthcare providers. Future research should investigate the long-term effectiveness of such educational interventions through a randomised controlled trial.

Therapeutic vancomycin levels are difficult to maintain in critically ill patients who are receiving IV vancomycin therapy whilst on CRRT. Aggressive dosing schedules and frequent monitoring are required to ensure adequate vancomycin therapy in this setting.

Methemoglobinemia is a rare but fatal disorder of the oxygen-carrying capacity of hemoglobin. Here is a case representing high-dose Sulfamethoxazole/ Trimethoprim ( SMX/TMP ) induced Methemoglobinemia in a boy treated for Ventilator-associated pneumonia (VAP), which was resolved successfully after administration of methylene blue and discontinuation of SMX/TMP

In this report, a case of high dose of sulfamethoxazole/trimethoprim‐induced methemoglobinemia and is reported in a young boy with ventilator‐associated pneumonia and was treated successfully with methylene blue and cessation of the offending agent.

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