scholarly journals Appropriateness of the Empirical Antibiotics Prescribed and Their Concordance with National Guidelines for Three Selected Infections among Cancer Patients in a Tertiary Care Centre in Sri Lanka

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Gayashan Chathuranga ◽  
Thushari Dissanayake ◽  
Neluka Fernando ◽  
Chandanie Wanigatunge
Keyword(s):  
Sri Lanka ◽  
Cancer Patients ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Bacterial Isolates ◽  
National Guidelines ◽  
Tertiary Care Centre ◽  
Microbiological Methods ◽  
Empirical Antibiotics ◽  
Tract Infections

Background. Prophylactic and empirical antibiotic use is essential in cancer patients due to the underlying immune deficiencies. We examined the spectrum of causative bacteria and the appropriateness of empirical antibiotic prescription for three selected infections in cancer patients. Methodology. A descriptive cross-sectional study was conducted at the National Institute of Cancer (NIC), Sri Lanka, from June 2018 to February 2019. Bacterial isolates obtained from adult cancer patients with a diagnosis of lower respiratory tract infections (LRTI), skin and soft tissue infections (SSTI), or urinary tract infections (UTI) were included. Causative bacteria were identified and the antibiotic susceptibility was determined by standard microbiological methods. Empirical therapy was defined as appropriate if the isolated pathogen was susceptible in vitro to the given antibiotic. Results. A total of 155 bacterial isolates were included in the analysis. LRTI were the most prevalent infections (37.2%, 55/148) encountered during the study period. Majority (90.9%) of the isolated bacteria were ESKAPE pathogens. Klebsiella pneumoniae was the most frequent pathogen causing LRTI (42.4%, 25/59), whereas Escherichia coli (32%, 16/50) and Staphylococcus aureus (26.1%, 12/46) predominated in UTI and SSTI, respectively. Meropenem was the most prescribed empirical antibiotic for LRTI (29.1%, 16/55) and SSTI (26.6%, 11/43) while it was ceftazidime for UTI (36%, 18/50). Only 20.6% (32/155) of the isolated bacteria were susceptible to the empirical antibiotic prescribed while 48.4% (75/155) were resistant to them. The prescribed empirical antibiotic did not have the spectrum of activity for the isolated bacteria in 29% (45/155) of cases. Conclusion. High resistance rates were observed against the prescribed empirical antibiotics. National empirical antibiotic guidelines should be revised with updated data on causative organisms and their susceptibility patterns to ensure appropriate empirical antibiotic prescription.

scholarly journals Study of antibiotic prescription pattern in PICU of a tertiary care hospital

2018 ◽  
Vol 7 (12) ◽  
pp. 2319
Author(s):  
Vivek Virbhan Bamel ◽  
Savita Ramesh Shahani
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Care Hospital ◽  
National Guidelines ◽  
Mortality And Morbidity ◽  
Institutional Ethics ◽  
Causes Of Mortality ◽  
Tract Infections ◽  
Written Informed Consent

Background: Infectious disease is one of the importance causes of mortality and morbidity in India, therefore pattern of use of antibiotics requires separate study as they differ from adult, Therefore the aim of our study is to observe the antibiotic prescription in the tertiary care hospital.Methods: A prospective observational study was carried out in the children admitted in PICU. The study was started after obtaining the approval from Institutional Ethics Committee. Written informed consent was obtained from a parent or legal guardian of participants.Results: There were 50 patients were enrolled. The maximum antibiotics were prescribed from cephalosporin class (42; 40.38%) which included ceftriaxone, cefixime, cefotaxim, cefpodoxime. The majority of cephalosporins were prescribed in miscellaneous cases followed by respiratory tract infections, gastrointestinal tract, Central nervous tract infections and nil in CVS cases, secondly higher number of antibiotics prescribed was metronidazole and from Aminopenicillin class which includes amoxiclav and ampicillin and another beta lactamase which includes ureidopenicilin and carbepenem. The majority of aminopenicillin were prescribed in miscellaneous group infections followed by respiratory tract infections.Conclusions: From this study, it can conclude that commonly antibiotic were from 3rd generation cephalosporins followed by metronidazole and other β lactamase inhibitor and all of the antibiotics were prescribed as per the national guidelines.

scholarly journals Emergence of multi-drug resistant strains among bacterial isolates in burn wound swabs in a tertiary care centre, Nanded, Maharashtra, India

2017 ◽  
Vol 5 (3) ◽  
pp. 973
Author(s):  
Vimal S. Rathod ◽  
. Kasturi ◽  
Sharmila S. Raut
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Empirical Therapy ◽  
Coagulase Negative Staphylococcus ◽  
Burn Patients ◽  
Bacterial Isolates ◽  
Burn Wound ◽  
Tertiary Care Centre ◽  
Microbiological Methods ◽  
Sensitivity Pattern

Background: Infection is a major cause of morbidity and mortality among burn patients. The worldwide emergence of antimicrobial resistance among a wide variety of burn wound pathogens, particularly nosocomial isolates, limits the available therapeutic options for effective treatment of burn wound infections. The study was conducted in the department of Microbiology, Dr. S.C.G.M.C, Nanded, Maharashtra, India to determine aerobic bacterial isolates from burn wound swabs and describe their antibiogram.Methods: Two wound swabs were taken from 570 patients, cultured aerobically. The isolates were identified by standard microbiological methods and antibiotic sensitivity pattern was determined.Results: Among 570 patients, 434 (76.14%) were female and 136 (23.85%) were male. Out of the total swabs collected, 548 (96.14%) were culture positive and 36 (6.56%) were having 2 isolates. Pseudomonas aeruginosa (34.93%) was the commonest isolate followed by Staphylococcus aureus (22.77%), Klebsiella pneumoniae (13.87%), Escherichia coli (13.01%) and Coagulase negative staphylococcus (11.31%). Incidence of MRSA was 59.39% and ESBL producers were 61.46 %. Gram positive isolates were 100% sensitive to Vancomycin, Linezolid and Gram negative organisms to Imipenem.Conclusions: Routine periodic sampling of burn wounds would facilitate the selection of appropriate empirical therapy and reduce the incidence of multidrug resistant infections among burn patients.

scholarly journals Maternal and foetal outcome in elective versus emergency caesarean sections

2017 ◽  
Vol 6 (4) ◽  
pp. 1222
Author(s):  
Amit A. Gurunule ◽  
Himangi S. Warke
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Emergency Caesarean Section ◽  
Tertiary Care Centre ◽  
Emergency Caesarean ◽  
Significant Difference ◽  
Foetal Outcome ◽  
Tract Infections

Background: Caesarean delivery is defined as the birth of the foetus through an incision in the abdominal wall (i.e. laparotomy) and the uterine wall (hysterotomy). The purpose was to analyze the maternal and foetal outcome in elective versus emergency caesarean sections retrospectively in a tertiary care centre and to analyze the indications of elective versus emergency caesarean sections.Methods: A retrospective observational study of the cases undergoing caesarean sections in KEM hospital, Mumbai, India was carried out during the period of September 2013 to September 2015. Maternal and foetal outcome was studied. The data was collected and analyzed from the maternal medical records. The neonatology records were also examined.Results: Out of the 600 selected patients, 300 patients in each group of elective and emergency caesarean section were studied. The usual indications of emergency caesarean sections were foetal distress, followed by meconium stained amniotic fluid (MSAF) and cephalopelvic disproportion (CPD). The most frequent indicator for elective lower segment caesarean section (LSCS) was patient with previous LSCS not willing for vaginal birth, followed by breech presentation and previous multiple LSCS. There was a significant difference seen in the occurrence of fever, urinary tract infections and wound infections in the two groups. These were more common in the emergency caesarean section group. Significant difference was also seen in the incidence of postpartum haemorrhage in the two groups, which was more in the elective caesarean section group.Conclusions: The maternal morbidity, intra operative and postoperative complications were more in the emergency LSCS group as compared to patients who underwent elective LSCS.

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