scholarly journals A questionnaire base survey on the knowledge, attitude and practices about antimicrobial resistance and usage among the faculty and resident doctor of teaching tertiary care hospital, Chittoor, India

2019 ◽  
Vol 8 (7) ◽  
pp. 1673
Author(s):  
Vishnu Priya G. ◽  
Sankara Babu Gorle ◽  
Madhav P.
Keyword(s):  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Daily Practice ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Senior Faculty ◽  
Over The Counter ◽  
Antibiotic Resistant ◽  
Strongly Agree ◽  
Prescription Writing

Background: 10million could die every year due to antibiotic resistant infections by 2050 unless the threat is addressed. Irrational use of antibiotic use is a global phenomenon. So, 50% all anti bionics are prescribed, sold are dispensed inappropriately, while 50% of patients are not taking antibiotics correctly (WHO 2004).Methods: This was a cross section study it was a conducted in RVS institute, tertiary care teaching hospital. Chittoor. The questionnaire was distributed along the faculty resident doctors and senior faculty of this RVS institute Where their knowledge, attitude, practice regarding antibiotic prescription and resistance was assessed by a five point likert scale, whose response ranged from strongly agree to disagree. Some questionnaire were of useful or nor useful and yes or no.Results: Irrational prescription of antibiotics is worldwide problem and also in India was known to most of the physicians in our institute (n=95%) of participants. 80% subjects answered that prescription writing influenced by senior faculty and medical representatives. 50% subjects answered that antimicrobial resistance is a problem in daily practice.80 % subjects answered that most of the antibiotics available as over the counter drugs (OTC).Conclusions: This study concludes, prescription writing influences by senior faculty and medical representatives. It’s important to monitor and auditing prescription writing based on WHO Antibiotic guidelines to prevent resistance. Strict vigilance of OTC sales of antibiotics to prevent resistance.

scholarly journals Awareness of antibiotic usage and antimicrobial resistance among interns in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 2159
Author(s):  
Suchitra D. Akalu ◽  
Niveditha G. Belavadi
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Resistance Mechanisms ◽  
Antibiotic Usage ◽  
Care Hospital ◽  
Care Providers ◽  
Strongly Agree

Background: Antibiotic resistance is a global threat and new resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. Reducing the incidence of drug resistant infections is crucial and is a top priority at global and national levels. A study was conducted among interns to assess the awareness related to antibiotic usage and resistance.Methods: The questionnaire was administered to a batch of 75 medical interns whereby their awareness regarding antibiotic use and resistance was assessed by a five point Likert scale, whose responses ranged from “strongly agree” to “strongly disagree”, and always to never. Some questions were of true and false type. The data was analysed by using simple descriptive statistics.Results: Out of the 78 interns, 75 participated in the study and completed the questionnaires. All the 75 (100%) interns believed that indiscriminate antibiotic use leads to antimicrobial resistance and 78.6% (n=59) believed that if antimicrobials are taken too often, they are less likely to work in the future. Majority (90.6%) of the interns knew of the fact that common cold and influenza are due to viral aetiology and not bacterial. Regarding the antibiotic practices of the interns, questionnaire addressed questions related to their practices related to use of antimicrobials, 66.6% (n=50) of the interns disagreed on the question that antibiotics are safe drugs, hence can be commonly used while 62.6% (n=47) do not believe that skipping one or two doses of the drug does not lead to antibiotic resistance.Conclusions: The antibiotic resistance crisis has been attributed to the overuse and misuse of these medications. Judicious use of antibiotics is the only solution for which awareness is required at the level of both health care providers and patients. Our study provides an important insight regarding the regarding awareness of antibiotic usage and antibiotic resistance among interns.

scholarly journals Clinical Team Distribution and Antibiotic Use Patterns at a Tertiary-Care Academic Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s168-s169
Author(s):  
Rebecca Choudhury ◽  
Ronald Beaulieu ◽  
Thomas Talbot ◽  
George Nelson
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Hospital Units ◽  
Antibiotic Utilization ◽  
Academic Medical ◽  
Level Data ◽  
Utilization Data

Background: As more US hospitals report antibiotic utilization to the CDC, standardized antimicrobial administration ratios (SAARs) derived from patient care unit-based antibiotic utilization data will increasingly be used to guide local antibiotic stewardship interventions. Location-based antibiotic utilization surveillance data are often utilized given the relative ease of ascertainment. However, aggregating antibiotic use data on a unit basis may have variable effects depending on the number of clinical teams providing care. In this study, we examined antibiotic utilization from units at a tertiary-care hospital to illustrate the potential challenges of using unit-based antibiotic utilization to change individual prescribing. Methods: We used inpatient pharmacy antibiotic use administration records at an adult tertiary-care academic medical center over a 6-month period from January 2019 through June 2019 to describe the geographic footprints and AU of medical, surgical, and critical care teams. All teams accounting for at least 1 patient day present on each unit during the study period were included in the analysis, as were all teams prescribing at least 1 antibiotic day of therapy (DOT). Results: The study population consisted of 24 units: 6 ICUs (25%) and 18 non-ICUs (75%). Over the study period, the average numbers of teams caring for patients in ICU and non-ICU wards were 10.2 (range, 3.2–16.9) and 13.7 (range, 10.4–18.9), respectively. Units were divided into 3 categories by the number of teams, accounting for ≥70% of total patient days present (Fig. 1): “homogenous” (≤3), “pauciteam” (4–7 teams), and “heterogeneous” (>7 teams). In total, 12 (50%) units were “pauciteam”; 7 (29%) were “homogeneous”; and 5 (21%) were “heterogeneous.” Units could also be classified as “homogenous,” “pauciteam,” or “heterogeneous” based on team-level antibiotic utilization or DOT for specific antibiotics. Different patterns emerged based on antibiotic restriction status. Classifying units based on vancomycin DOT (unrestricted) exhibited fewer “heterogeneous” units, whereas using meropenem DOT (restricted) revealed no “heterogeneous” units. Furthermore, the average number of units where individual clinical teams prescribed an antibiotic varied widely (range, 1.4–12.3 units per team). Conclusions: Unit-based antibiotic utilization data may encounter limitations in affecting prescriber behavior, particularly on units where a large number of clinical teams contribute to antibiotic utilization. Additionally, some services prescribing antibiotics across many hospital units may be minimally influenced by unit-level data. Team-based antibiotic utilization may allow for a more targeted metric to drive individual team prescribing.Funding: NoneDisclosures: None

Clinical prediction of bacteremia and early antibiotics therapy in patients with solid tumors

2021 ◽  
pp. 1-7
Author(s):  
Jonathan M. Hyak ◽  
Mayar Al Mohajer ◽  
Daniel M. Musher ◽  
Benjamin L. Musher
Keyword(s):  
Solid Tumors ◽  
Solid Tumor ◽  
Cardiopulmonary Arrest ◽  
Tertiary Care ◽  
Organ Transplant ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Tumor Patients ◽  
Binomial Regression ◽  
Sirs Criteria

Abstract Objective: To investigate the relationship between the systemic inflammatory response syndrome (SIRS), early antibiotic use, and bacteremia in solid-tumor patients. Design, setting, and participants: We conducted a retrospective observational study of adults with solid tumors admitted to a tertiary-care hospital through the emergency department over a 2-year period. Patients with neutropenic fever, organ transplant, trauma, or cardiopulmonary arrest were excluded. Methods: Rates of SIRS, bacteremia, and early antibiotics (initiation within 8 hours of presentation) were compared using the χ2 and Student t tests. Binomial regression and receiver operator curves were analyzed to assess predictors of bacteremia and early antibiotics. Results: Early antibiotics were administered in 507 (37%) of 1,344 SIRS-positive cases and 492 (22%) of 2,236 SIRS-negative cases (P < .0001). Of SIRS-positive cases, 70% had blood cultures drawn within 48 hours and 19% were positive; among SIRS negative cases, 35% had cultures and 13% were positive (19% vs 13%; P = .003). Bacteremic cases were more often SIRS positive than nonbacteremic cases (60% vs 50%; P =.003), but they received early antibiotics at similar rates (50% vs 49%, P = .72). Three SIRS components predicted early antibiotics: temperature (OR, 1.7; 95% CI, 1.31–2.29; P = .0001), tachycardia (OR, 1.4; 95% CI, 1.10–1.69; P < .0001), and white blood-cell count (OR, 1.8; 95% CI, 1.56–2.14; P < .0001). Only temperature (OR, 1.6; 95% CI, 1.09–2.41; P = .01) and tachycardia (OR, 1.5; 95% CI, 1.09–2.06; P = .01) predicted bacteremia. SIRS criteria as a composite were poorly predictive of bacteremia (AUC, 0.57). Conclusions: SIRS criteria are frequently used to determine the need for early antibiotics, but they are poor predictors of bacteremia in solid-tumor patients. More reliable models are needed to guide judicious use of antibiotics in this population.

scholarly journals A 6-year surveillance of antimicrobial resistance patterns ofAcinetobacter baumanniibacteremia isolates from a tertiary care hospital in Saudi Arabia during 2005–2010

2014 ◽  
Vol 9 (1) ◽  
pp. 24039 ◽  
Author(s):  
Krishnappa Lakshmana Gowda ◽  
Mohammed A. M. Marie ◽  
Yazeed A Al-Sheikh ◽  
James John ◽  
Sangeetha Gopalkrishnan ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Resistance Patterns

scholarly journals Diagnostic Tests Can Stem the Threat of Antimicrobial Resistance: Infectious Disease Professionals Can Help

2020 ◽  
Author(s):  
Dana Trevas ◽  
Angela M Caliendo ◽  
Kimberly Hanson ◽  
Jaclyn Levy ◽  
Christine C Ginocchio
Keyword(s):  
Infectious Disease ◽  
Antimicrobial Resistance ◽  
Diagnostic Tests ◽  
Healthcare Providers ◽  
Federal Funding ◽  
Antibiotic Use ◽  
Advisory Council ◽  
Resistant Bacteria ◽  
Research Development ◽  
Antibiotic Resistant

Abstract Uptake of existing diagnostics to identify infections more accurately could minimize unnecessary antibiotic use and decrease the growing threat of antibiotic resistance. The Infectious Diseases Society of America (IDSA) and the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (PACCARB) agree that, to improve uptake of existing diagnostics, healthcare providers, health systems, and payors all need better clinical and economic outcomes data to support use of diagnostic tests over empiric use of antibiotics, providers need better tools and education about diagnostic tests, and diagnostics developers need federal funding in the absence of a viable diagnostics market. Recommendations from PACCARB and the IDSA are amplified. Incentives for—and challenges to—diagnostics research, development, and uptake are summarized. Advocacy opportunities are given for infectious disease professionals to join the fight against antimicrobial resistance.

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

scholarly journals MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

2017 ◽  
Vol 10 (6) ◽  
pp. 78
Author(s):  
Bhuvaneshwari Gunasekar
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Mar Index ◽  
Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of  surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

scholarly journals How Does Antimicrobial Resistance Increase Medical Costs in Community-Acquired Acute Pyelonephritis?

2021 ◽  
Vol 1 (S1) ◽  
pp. s23-s23
Author(s):  
Bongyoung Kim ◽  
Taul Cheong ◽  
Jungmo Ahn
Keyword(s):  
Antimicrobial Resistance ◽  
Linear Regression ◽  
Acute Pyelonephritis ◽  
Tertiary Care ◽  
Medical Costs ◽  
Hospitalized Patients ◽  
Care Hospital ◽  
Causative Pathogen ◽  
Significant Difference ◽  
Log Linear

Background: The proportion of antimicrobial-resistant Enterobacterales that are causative pathogens for community-acquired acute pyelonephritis (CA-APN) has been increasing. We examined the effect of antimicrobial resistance on medical costs in CA-APN. Methods: A single-center retrospective cohort study was conducted at a tertiary-care hospital in Korea between January 2018 to December 2019. All hospitalized patients aged ≥19 years who were diagnosed with CA-APN were recruited, and those with Enterobacterales as a causative pathogen were included. Comparisons between CA-APN caused by extended-spectrum β-lactamase (ESBL)–producing pathogens (ESBL+ group) and those by non–ESBL-producing organisms (ESBL– group) as well as CA-APN caused by ciprofloxacin-resistant pathogens (CIP-R group) and those by ciprofloxacin-sensitive pathogens (CIP-S group) were performed. Log-linear regression was performed to determine the risk factors for medical costs. Results: In total, 241 patients were included in this study. Of these, 75 (31.1%) had an ESBL-producing pathogen and 87 (36.1%) had a ciprofloxacin-resistant pathogen. The overall medical costs were significantly higher in the ESBL+ group compared with the ESBL− group (US$3,730.18 vs US$3,119.32) P <0.001) as well as in CIP-R group compared with CIP-S group (3,730.18 USD vs. 3,119.32 USD, P =0.005). In addition, length of stay was longer in ESBL+ group compared with ESBL-group (11 vs. 8 days, P <0.001) as well as in CIP-R group compared with CIP-S group (11 vs. 8 days, P <0.001). There were no significant difference in the proportion of clinical failure between ESBL+ and ESBL- groups; CIP-R and CIP-S groups. Based on the log-linear regression model, the costs associated with ESBL-producing Enterobacterales as the causative pathogen would be, on average, 27% higher or US$1,211 higher than its counterpart (P = .026). By the same token, a patient who is a year older would incur US$23 higher cost (P = .040). Having any structural problem in urinary tract would incur US$1,231 higher cost (P = .015). A unit increase in Pitt score would incur US$767 USD higher cost (P < 0.001) higher cost, all other things constant. Conclusions: Medical costs for hospitalized patients with CA-APN are increased by the existence of ESBL-producing Enterobacterales but not by the existence of ciprofloxacin-resistant Enterobacterales.Funding: NoDisclosures: None

scholarly journals EVALUATION OF RATIONAL USE OF ANTIBIOTIC DRUGS IN SURGERY DEPARTMENT AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 145-149
Author(s):  
SREEJA NYAYAKAR ◽  
MANDARA MS ◽  
HEMALATHA M ◽  
LALLAWMAWMI ◽  
MOHAMMED SALAHUDDIN ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Rational Use ◽  
Post Surgery ◽  
Antibiotic Drugs ◽  
Before And After ◽  
Hospital Patients ◽  
Surgery Department

Objective: Antibiotics are the only drug where use in one patient can impact the effectiveness in another, so antibiotic misuse adversely impacts the patients and society. Improving antibiotic use improves patient outcomes and saves money. Antibiotic resistance has been identified as a major threat by the WHO due to the lack of development of new antibiotics and the increasing infections caused by multidrug resistance pathogens became untreatable. Methods: A prospective observational study was conducted for a period of 6 months. Data were collected from prescriptions and inpatient record files at the surgery department of the tertiary care hospital. Patients above age of 18 years of either gender whose prescription containing the antibiotics and patients who are willing to participate in the study were included in the study. Microsoft Excel was used for recording and analyzing the data of recruited subjects. Results: During our study period, we have collected 100 cases as per inclusion criteria, in total collected 100 cases, 52% are male and 48% are female. The mean age and standard deviation of the study population were found to be 46.61±16.12. The most commonly prescribed classification before and after the surgery is cephalosporin’s that is 57%. Results show that in pre-surgery, almost 93% of prescriptions have chosen the drugs as per ASHP guidelines, whereas in post-surgery, 95% of drugs have selected the drug as per ASHP guidelines. Conclusion: Our study has observed that some of the prescriptions are irrationally prescribed so the pharmacist has to take the responsibility to improve the awareness regarding rational prescribing of antibiotics. The national wide monitoring of antibiotics use, national schemes to obtain rational use of antibiotics, reassessing the prescriptions, education to practitioners, and surveys on antibiotics should be implemented.

scholarly journals Outcome and complications of self-administration of over-the-counter abortion pills: an observational study in a tertiary care hospital of a medical college in New Delhi

2021 ◽  
Vol 10 (8) ◽  
pp. 3148
Author(s):  
Anjali Singh ◽  
Sruthi Bhaskaran ◽  
Anshuja Singla
Keyword(s):  
Observational Study ◽  
Health Care Providers ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Care Providers ◽  
Self Administration ◽  
Over The Counter ◽  
Gynecology And Obstetrics ◽  
Medical Termination

Background: Due to unrestricted free availability of abortion pills, despite of national policies, guidelines and medical termination of pregnancy (MTP) act, unsafe abortions by self-administration of these drugs for termination of unwanted pregnancies without prescription are becoming common in our country, leading to associated morbidity and mortality.Methods: A prospective Observational study was done at Guru Teg Bahadur hospital, university college of medical sciences, New Delhi, from November 2019 to April 2020, in the department of gynecology and obstetrics, on women visiting the outpatient department and casualty department with the history of self-administration of medical termination pills without prescription. This study was done to study the outcome and complications occurring due to self-administration of over-the-counter abortion pills that are freely available in the market. 95 women were included in study and data was collected regarding age, education level, parity, presenting complaints, complications and their management. Descriptive analysis of the collected data was done.Results: In this study 95 women were included 71.6% took pills before 8 weeks of gestation, 1% took in second trimester. 46.3% landed up in incomplete abortion and 33.68% needed surgical evacuation, 8.42% had ectopic out, 2.1% had scar site pregnancy and 7.36% needed laparotomy, 1.05% had rupture uterus followed by abortion pill intake while 1.05% suffered from acute kidney injury (AKI). There was no ICU admission nor any mortality.Conclusions: There is urgent need of strict legislation to curtail this bad practice and free availability of over-the-counter abortion pills which leads to unexpected morbidity and mortality, such drugs should be given only by health care providers under supervision, there is need of community level awareness so as to impart knowledge regarding this problem. 

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