scholarly journals APPROPRIATE EMPIRICAL MANAGEMENT OF MICROBIAL INFECTIONS IN A TERTIARY CARE HOSPITAL: A COST- EFFECTIVENESS APPROACH.

2018 ◽  
Vol 11 (2) ◽  
pp. 124 ◽  
Author(s):  
Onchari Divinah N ◽  
Josin Mary Simon ◽  
Sneha Tomy ◽  
Arun Prasath R ◽  
Sivakumar V
Keyword(s):  
Cost Effectiveness ◽  
Tract Infection ◽  
Tertiary Care ◽  
Cost Effective ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Microbial Infection ◽  
Sensitivity Pattern ◽  
Microbial Infections ◽  
Effective Drugs

 Objective: Antibiotics are mostly prescribed empirically to decrease health-care costs. This has led to the misuse of antibiotics thereby making them inefficient in the treatment of infections. The aim of this study was to determine the appropriate, cost-effective drug for the empirical therapy in microbial infections.Methods: A prospective observational study was conducted for a period of 6 months. Cost-effectiveness ratio (CER) of these antibiotics prescribed was calculated to determine the cost-effective drugs for the common microorganisms and common infections.Results: In a population of 205 patients, 54.6% were treated based on antibiotic sensitivity pattern whereas 45.3% were treated empirically. In known microbial infections, the prevailing microorganism was extended-spectrum beta-lactamase (ESBL) producing Escherichia-coli (14.3%), Staphylococcus aureus (10.6%), Pseudomonas aeruginosa (9.8%), Klebsiella pneumonia (9.8%), and K. pneumoniae ESBL (6.81%). Based on the CER, the most cost-effective drugs for these organisms were found to be ciprofloxacin, clindamycin, ofloxacin, levofloxacin, and amikacin, respectively. In unknown microbial infection (empirical treatment), Diabetic Foot Infection (DFT) (25.8%), respiratory tract infection (RTI) (23.6%), and urinary tract infection (UTI) (16.1%) were the most common infections. The most cost-effective drugs for these infections were clindamycin, levofloxacin, and azithromycin, respectively. The predominant microorganism in DFT was found to be S. aureus (71%), in UTI was found to be E. coli ESBL (52%), and in RTI were found to be P. aeruginosa (42.4%) and K. pneumonia (32.3%).Conclusion: Appropriate empirical antibiotic treatment is associated with a lower medical cost and a better success rate in patients with microbial infections.

scholarly journals Antimicrobial Sensitivity Pattern of the Common Uropathogens among Patients Admitted in A Tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 21 (2) ◽  
pp. 93-97
Author(s):  
AKM Humayon Kabir ◽  
SK Jakaria Been Sayeed ◽  
Prodip Kumar Biswas ◽  
SM Hafiz ◽  
Md Uzzwal Mallik ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Care Hospital ◽  
College Hospital ◽  
Male Adult ◽  
Sensitivity Pattern

Urinary tract infection is one of the most common bacterial infections seen in clinical practice both in developed and developing countries. The causative agents of Urinary tract infection vary from place to place and they also vary in their susceptibility and resistance patterns. This descriptive study aimed to evaluate the antibiotic susceptibility patterns of pathogens isolated from routine laboratory specimens at Dhaka Medical College Hospital. A descriptive cross- sectional study was done from January 2018 to June 2018. A total of 100 mid-stream urine samples from the suspected UTI patients were tested microbiologically and antimicrobial susceptibility test were performed for the isolated pathogens using Kirby-Bauer disk diffusion method with positivity rate of UTI was 90% (90/100). Escherichia coli (39%) was the most UTI causing bacteria followed by Klebsiella 18(18%), Acinetobacter 12(12%), Staphylococci, 9 (9%), Pseudomonas 6 (6%), Enterococcus species 3 (3%) and Proteus 3 (3%). Female 83 (83%) were more affected in comparison with male. Adult female especially age range 18-30 years were found in high risk. Nitrofurantoin, Amikacin and Meropenem were recorded as most sensitive antibiogram for most of the bacteria’s whereas cephalosporin showed increased resistance. However, for uncomplicated community acquired UTI, Nitrofurantoin (oral) and Amikacin (Injectable) can be chosen as first line medication. J MEDICINE JUL 2020; 21 (2) : 93-97

scholarly journals Symptomatic first urinary tract infection in children and underlying kidney and urinary ttract abnormalities from a tertiary care hospital in India

2014 ◽  
Vol 9 (3) ◽  
pp. 45-53
Author(s):  
PK Dey ◽  
J Banerjee ◽  
RP Singh ◽  
A Pan ◽  
A Chatterjee
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Healthy Lifestyle ◽  
Tertiary Care ◽  
Posterior Urethral Valve ◽  
Voiding Cystourethrography ◽  
Care Hospital ◽  
Symptomatic Urinary Tract Infection ◽  
Sensitivity Pattern

Objective The aim of this study was to describe the characteristics and the clinical evolution of first documented symptomatic Urinary Tract Infection and to detect underlying abnormalities of the kidney and urinary tract if any. Methods Prospective observational study on 102 patients (6 months to 5 yrs) with first documented symptomatic Urinary Tract Infection diagnosed by positive urine culture in the department of Paediatrics, G.S.V.M Medical College, Kanpur, India between January 2008 and June 2009. Antibiotics were given according to the sensitivity pattern. All children were evaluated with renal bladder ultrasonogram and voiding cystourethrography. Results Out of 102 patients 62 (60.78%) girls and 40 (39.21%) boys, most of the patients (62.7%) within 6 months to 2 years old. The commonest presentation was fever (84.3%).The commonest organism was E.Coli (80.37%). Overall most common underlying abnormality was VUR, found in 31(30.31%) children. Other abnormalities were urolithiasis(4.9%), ureteropelvic junction obstruction (3.92%),Mild hydronephrosis (2.9%), ureteric duplex(0.98%), posterior urethral valve(0.98%), renal duplex (0.98%). Conclusion In our study 45.09% children had underlying abnormalities which may be a potential risk factor for urinary tract infection. Better recognition of risk factors, prompt diagnosis and early intervention are sufficient enough to maintain normal renal function and healthy lifestyle.   Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 45-53 DOI: http://dx.doi.org/10.3126/jcmsn.v9i3.10222  

scholarly journals Prevalence of urinary tract infection in malnourished children aged 6 months to 5 years attending tertiary care centre

2019 ◽  
Vol 6 (5) ◽  
pp. 1814
Author(s):  
Senthil Kumar A. ◽  
Thannoli Gowthami Gowrinathan
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Tertiary Care ◽  
Causative Organism ◽  
Klebsiella Pneumonia ◽  
Urinary Tract Abnormality ◽  
Malnourished Children ◽  
Sensitivity Pattern

Background: Infections are more common in malnourished children, as result of impaired immunity. Unexplained fever and failure to thrive are the common presenting features of urinary tract infection (UTI) in children. In malnourished children, UTI is mostly asymptomatic and is leading to pyelonephritis and renal scarring. The study was done with the aim to evaluate and find out the prevalence of urinary tract infection in malnourished children between 6 months to 5 year and to find out the causative organism and antibiotic sensitivity pattern.Methods: A total of 180 cases of malnourished children were enrolled and clean catch midstream urine sample was collected for urine culture, according to WHO criteria of malnutrition. Children with urinary tract abnormality were excluded from the study. Renal USG was done in all urine culture positive cases.Results: Total of 174 cases was present after exclusion. Of 174 children, 27 (15.5%) children were having UTI. In this study, 37% of children are asymptomatic. E. coli is the commonest organism causing UTI 16 (59%). Other organism are Klebsiella pneumonia 4 (14.9%), Proteus mirabilis 3 (11.1%), and Pseudomonas 3 (11.1%). The order of antimicrobial sensitivity pattern was amikacin (100%)> ciprofloxacin (81.4%)> cefotaxime (7%). Other common drugs have developed resistance to these organisms.Conclusions: Our observations conclude that malnourished children with fever of unknown origin are at risk of UTI. Hence, urine analysis and culture tests are to be done to all malnutrition cases for assisting to diagnose the bacterial infection and providing the appropriate treatment.

scholarly journals Prescribing Pattern of Antimicrobials in Urinary Tract Infection at Outpatient Department in a Tertiary Care Hospital in Dhaka

2020 ◽  
Vol 10 (1) ◽  
pp. 23-26
Author(s):  
Shima Akter Khatun ◽  
Shusmita Shaha
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
College Hospital ◽  
Sensitivity Pattern

Background: Urinary tract infection (UTI) is the most common illness affecting both males and females in almost all age groups. Hence, continuous analysis of prescribing pattern in UTI is vital. Objective: The study was designed to determine the prescribing pattern of antibiotics in UTI patients at a tertiary care hospital. Materials and Methods: A prospective observational study was carried out on 180 patients in Dhaka National Medical College Hospital from January to March 2012 by collecting data from outpatient department of Surgery, Medicine and Gynaecology & Obstetrics. Results: Analysis of prescribed drugs revealed that use of antibiotics such as nitrofurantoin (30.55%), cefuroxime (22.22%) and ciprofloxacin (16.66%) were significantly higher compared to other drugs. The most common isolated organisms were Escherichia coli (60%), Proteus (20%), Klebsiella (13.33%), and Pseudomonas (6.66%). Conclusion: Present findings are suggestive of the need for periodic monitoring of antibiotic sensitivity pattern to provide effective treatment. J Enam Med Col 2020; 10(1): 23-26

scholarly journals Microbiological Profile and Antibiotic Sensitivity Pattern of Bacteria in Diabetic Foot Ulcers in a Tertiary Care Hospital

2021 ◽  
Vol 08 (01) ◽  
pp. 1-8
Author(s):  
Gajender Singh Ranga ◽  
Keyword(s):  
Diabetic Foot ◽  
Tertiary Care ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
E Coli ◽  
Gram Positive Bacteria ◽  
Sensitivity Pattern

Introduction: Diabetic foot is any foot pathology due to diabetes or sequelae of diabetes mellitus. This study was conducted to identify the common microorganisms isolated from diabetic foot and to analyse the antibiotic susceptibility pattern of bacteria isolated from diabetic foot. Materials and Method: The study was a hospital based cross-sectional study where 146 foot ulcer samples (who had type 2 diabetes) were analysed. Swabs were collected from the edge and margins of ulcers, and organisms were identified by gram staining culture and biochemical reactions. Result:Out of 146 patients, 69 specimens showed growth of organisms. Total 84 aerobic organisms were isolated and out of them, 64 cases showed bacterial growth, in which 84 bacteria were isolated, which represented an average of 1.28 organisms per case. Among these organisms, 62 gram-negative and 22 gram-positive organisms were isolated. E. coli was the most common gram-negative isolate (23.81%), followed by Pseudomonas aeruginosa (21.4%), and Klebsiella pneumonia(8.33%), while among gram-positive bacteria, S. aureus was the most common isolate (22.6%). Conclusion: Incidence of growth was 47.2% in which E. coli (23.8%) was the most common isolate. Gram-negative bacteria were more common than gram-positive bacteria. Diabetic foot infections are polymicrobial in nature.

Sign in / Sign up

Export Citation Format

Share Document