title: Clinicians' knowledge of 2007 Food and Drug Administration recommendation to discontinue nelfinavir use during pregnancy.
abstract: In 2007, the US Food and Drug Administration (FDA) and Pfizer Inc recommended immediate discontinuation of nelfinavir (NFV) during pregnancy due to contamination with a potential teratogen. A few weeks after the announcement, we surveyed antenatal HIV care providers to determine how widely the warning was disseminated. Overall, 69 of 121 (57.0%) providers knew to discontinue NFV. Callers with more than 50 HIV-infected patients were 2.54 times as likely to be aware as callers with 1-3 HIV-infected patients (P < .01). Only 12 (33.3%) obstetricians were aware, compared to 21 (80.8%) infectious diseases specialists (P < .001). The FDA/Pfizer Inc recommendation to avoid nelfinavir mesylate (NFV) in pregnancy appears to have successfully reached HIV experts. However, not all pregnant women have access to experts and may receive most of their care from providers without extensive HIV experience. More effective dissemination of critical HIV-related information to all antenatal care providers, including general obstetricians, family physicians, and midwives, may be needed.
authors.affiliation: Department of Family and Community Medicine, San Francisco General Hospital, University of California, San Francisco, CA 94143, USA. jfogler@nccc.ucsf.edu
authors.forename: Jessica
authors.initials: J
authors.lastname: Fogler
authors.forename: Shannon
authors.initials: S
authors.lastname: Weber
authors.forename: Megan R
authors.initials: MR
authors.lastname: Mahoney
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Goldschmidt
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology / Q000517:prevention & control*; D002983:Clinical Competence; D000075202:Contraindications; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D017320:HIV Protease Inhibitors; D006801:Humans; D008511:Medicine; D019888:Nelfinavir; D009726:Nurses; D010595:Pharmacists; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D013038:Specialization; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D017320:HIV Protease Inhibitors; D019888:Nelfinavir