A word of caution regarding Ceftriaxone

2021 ◽  
Vol 71 (11) ◽  
pp. 2692-2692
Author(s):  
Naveen Azhar ◽  
Arooma Shaukat Arooma shaukat ◽  
Navaira Shoaib Navaira Shoaib
Keyword(s):  
Bacterial Infections ◽  
Adverse Reactions ◽  
Standard Treatment ◽  
Care Hospital ◽  
Biliary Lithiasis ◽  
The Third ◽  
Bilirubin Encephalopathy ◽  
Life Threatening ◽  
A Prospective Study ◽  
Intravenous Calcium

Ceftriaxone is a well-known antibiotic belonging to the third generation of cephalosporins. This broad-spectrum drug is highly effective against gram negative and gram-positive bacterial infections and is frequently used to treat severe bacterial infections in pediatrics, including disseminated gonococcal infections, sepsis and meningitis. However, concerns have been raised regarding the drug’s safety as it is prone to various side effects like bilirubin encephalopathy, cholestasis, pseudolithiasis and rarely hepatitis and pancreatitis.1 A prospective study in 154 children published in Human and Experimental Toxicology in 2016 further validate this point.2 According to this study, out of 84, 20.9% children treated with ceftriaxone had abnormal biliary sonographic findings and 15.1% had biliary lithiasis whereas cefotaxime was found to be comparatively safer. Worrying facts related to Ceftriaxone should definitely be taken into consideration as ceftriaxone is a standard treatment for several bacterial infections in children and is being prescribed at a regular basis in many countries. In fact, a clinical study performed in a secondary care hospital of Karachi, Pakistan, declared it the most frequently prescribed antibiotic.3 Physicians should prescribe ceftriaxone with caution. Ceftriaxone should be avoided in neonates especially those with hyperbilirubinemia. Caution must be advised for the use of intravenous ceftriaxone with intravenous calcium containing solutions as their concomitant use can lead to life threatening adverse reactions.4 Patient should seek medical help if they experience diarrhea, jaundice, confusion, headache, heart palpitations etc. Similar drugs with a safer adverse effect profile should be considered as a future alternative. Continuous..

scholarly journals Investigations on the Aetiology and Antibiotic Management of Neonatal Septicemia

2019 ◽  
Vol 28 (5-6) ◽  
pp. 105-15
Author(s):  
Hans Eldih Monintja
Keyword(s):  
Prospective Study ◽  
Neonatal Sepsis ◽  
Standard Treatment ◽  
Case Fatality ◽  
Third Generation ◽  
Neonatal Septicemia ◽  
E Coli ◽  
The Third ◽  
Antibiotic Management ◽  
A Prospective Study

This is a prospective study aimed in identifying the latest aetiological factors of neonatal sepsis in Dr. Cipto General Hospital, Jakarta, and investigating the efficacy of antibiotics treatment especially with ceftriaxone. This study revealed that the present main causative microorganisms are as follows: Pseudomonas, Klebsiella and E. coli. The case fatality rates being: (1) Standard treatment with ampicillin and gentamycin: 80.9%, (2) S(andard treatment with consomittant ceftriaxone: 20%, (3) Ceftriaxone: 9,52%. It seems that in facing neonatal septicemia, the initial antibiotic should be the third generation cephalosporine. The second choice is chloramphenicol. However, the causative agent and the sensitivity test should be monitored regularly.

Adverse Reactions to Indoprofen: A Survey Based on a Total of 6764 Patients

1982 ◽  
Vol 10 (5) ◽  
pp. 306-324 ◽  
Author(s):  
G Bruni ◽  
M Lavezzari ◽  
A Perbellini ◽  
A Battaglia ◽  
A Emanueli
Keyword(s):  
Adverse Reactions ◽  
Phase 1 ◽  
Safety Data ◽  
Intestinal Bleeding ◽  
Clear Cut ◽  
Parenteral Route ◽  
The Third ◽  
Life Threatening ◽  
Laboratory Changes ◽  
Reaction Profile

Safety data on indoprofen are presented, deriving from three sources: the first was a phase 4 multicentre clinical study based on 4042 patients suffering from osteoarthritis and treated with 400–800 mg daily by mouth for about 4 weeks; the second was a survey based on a heterogeneous series of 2722 subjects belonging to phase 1, 2 and 3 investigations, and treated with 200 to 1200 mg daily by the oral and/or parenteral route for from 1 to more than 180 days; the third was a safety laboratory study conducted in 472 patients, most of whom had participated in the first study, while the remainder were included in the second. Adverse events of any type occurred in 22% of patients in the first study and in 13% in the second, but treatment had to be withdrawn for drug-related reasons in less than 5% in both. Potentially life-threatening events were rare, overall including 16 instances of clinically overt gastro-intestinal bleeding and 2 anaphylactic reactions. Unfavourable laboratory changes, i.e. shifting from normal to abnormal values, were recorded in about 10% of the series studied. The adverse reaction profile of indoprofen was similar to that of most NSAIDs, with gastro-intestinal troubles prevailing over the other events, a distribution which, however, was clear-cut only with oral indoprofen. Tolerability problems appeared to be dose-related up to some point between 400 and 600 mg daily plateauing thereafter, and were less frequent following parenteral than following oral administration.

scholarly journals Prescription pattern of antiepileptic drugs in indoor patients at tertiary care hospital in Haryana, India

2018 ◽  
Vol 7 (3) ◽  
pp. 537 ◽  
Author(s):  
Arvind Narwat ◽  
Vivek Sharma
Keyword(s):  
Sodium Valproate ◽  
Tertiary Care ◽  
Medical Problem ◽  
Prolonged Treatment ◽  
Prescription Data ◽  
Care Hospital ◽  
Prescription Pattern ◽  
Life Threatening ◽  
Generalized Epilepsy ◽  
A Prospective Study

Background: Epilepsy is a challenging medical problem in India with an annual incidence of 27.27 per 100,000 population and prevalence of 572.8 per 100,000. People with epilepsy require prolonged treatment and monitoring. The main goal in the treatment of epilepsy should be adequate control of seizures, without causing any life-threatening reactions due to the medications. This study was done to get an insight into the prescription pattern of anti-epileptic drugs (AEDs) in different types of epilepsy.Methods: A prospective study was carried out for six months (Feb to June 2016) in admitted patients in super speciality ward (Lala Shyam Lal) in neurology department of PGIMS, Rohtak, Haryana. The prescription data of 100 patients of seizures was analysed.Results: Idiopathic generalised epilepsy was commonest type of epilepsy (42%) and sodium valproate was the commonest drug prescribed for its treatment (66.66%) followed by phenytoin (23.33%) Symptomatic epilepsy was second commonest seizure (30%) and phenytoin (60%) was the commonest drug prescribed for it followed by sodium valproate (30%). Common adverse effects associated with anti-epileptic drugs (AEDs) were nausea, drowsiness, weight gain, diplopia and ataxia.Conclusions: Idiopathic generalized epilepsy was the commonest type of epilepsy recorded and sodium valproate was the commonest prescribed drug.

scholarly journals A study on presentation and management of ectopic pregnancy at tertiary care hospital

2021 ◽  
Vol 10 (5) ◽  
pp. 1997
Author(s):  
Tarini Singh ◽  
Sanil Mohan ◽  
Shikha Aggarwal ◽  
Debkalyan Maji
Keyword(s):  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Severe Form ◽  
Successful Outcome ◽  
Care Hospital ◽  
Northern India ◽  
Pain Abdomen ◽  
Life Threatening ◽  
A Prospective Study

Background: Ectopic pregnancy and its consequences are the most severe form of obstetric emergency during first trimester of pregnancy. It is a kind of life threatening emergency leading to significant maternal morbidity and even mortality.Methods: A prospective study was conducted at a tertiary care teaching hospital of Northern India from 01 Jan 2020 to 31 Mar 2020. All cases of ectopic pregnancy which were admitted and managed during this study period were included in the study. All collected data were analysed with Epitable 6.04 version and SPSS version 20 software.Results: During the study period total 32 cases of ectopic pregnancy were studied. Classical symptoms of amenorrhoea, pain abdomen and bleeding per vaginum were observed in 62.50% cases whereas 93.75% cases were associated with pain abdomen only and 71.88% cases had the symptoms of bleeding per vaginum only. All cases were managed surgically. The incidence of ectopic pregnancy was one in 200 delivered pregnancy. Most case were multiparas and common in 27 -32 yr age group (53.13%). Tubal ectopic pregnancy was common in right side (63%).   Approximately 81% cases presented with haemoperitoneum and 63% cases required blood transfusion.Conclusions: Ectopic pregnancy mostly presents as an obstetrics emergency in our hospital especially with rupture ectopic pregnancy with haemoperitoneum. Early diagnosis and intervention suited best for the situation is mainstay for favourable and successful outcome.

scholarly journals Study of maternal and fetal outcome in various types of placenta previa

2018 ◽  
Vol 7 (11) ◽  
pp. 4652
Author(s):  
Sonal Bhuyar ◽  
Neha Dharmale
Keyword(s):  
Neonatal Outcome ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Intrauterine Death ◽  
Care Hospital ◽  
Institutional Deliveries ◽  
Life Threatening ◽  
A Prospective Study

Background: Placenta previa is one of the life-threatening complications in obstetrics which affects maternal and neonatal outcome. Now-a-days its incidence is increasing due to previous operative procedures. The objective of the present study was to study out maternal and fetal outcome in various types of placenta previa.Methods: A prospective study was conducted in our tertiary care hospital on 78 patients in order to know the cause and outcome of placenta previa.Results: Early termination was carried out in major PP group due to APH. 13 out of 17 patients presenting with APH had major degree of PP. Abnormal lie and presentation are commonly seen in cases of PP however cephalic constituted 83.3% cases of fetal presentations in present study followed by breech 10.2%, oblique 3.9%, face 1.3% and transverse 1.3%. In this study, 92.2% neonates were born alive while neonatal death and intrauterine death (IUD) was observed in 5.2% and 2.6% neonates respectively.Conclusions: Combined efforts for prevention of risk factors for PP, timely diagnosis and planned institutional deliveries can only reduce the morbidity and mortality associated with PP.

scholarly journals A prospective study of epidemiology and clinical presentation of non-traumatic acute abdomen cases in a tertiary care hospital of central India

2016 ◽  
Vol 4 (1) ◽  
pp. 242
Author(s):  
Rajiv Jain ◽  
Vikas Gupta
Keyword(s):  
Prospective Study ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
Central India ◽  
Care Hospital ◽  
Medical College ◽  
Sri Aurobindo ◽  
Life Threatening ◽  
Abdominal Emergencies ◽  
A Prospective Study

Background:Acute Abdomen is a term used to encompass a spectrum of surgical, medical and gynecological conditions ranging from trivial to life threatening conditions, which require hospital admission, investigations and treatment. The purpose of this study was to identify the epidemiological pattern and to determine the spectrum of disease causing “non-traumatic acute abdomen in central India”.Methods: This is a prospective study of 98 patients of non-traumatic acute abdominal cases conducted in the Department of Surgery, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India. In this study, preoperative detailed history and thorough physical examination was done for all acute abdominal emergencies, to arrive at pre-operative diagnosis.Results:Amongst the study of 98 patients, males have higher incidence of acute abdomen with the young age group (21-30 years) most commonly affected. Perforation peritonitis constituted the most common cause of acute abdomen (39.7%), followed by acute appendicitis (37.7%), followed by intestinal obstruction (14.2%).Conclusions: This study was conducted to evaluate the epidemiology, etiology and differential diagnosis of non-traumatic acute abdomen. At the end of the study, we had a better insight of the spectrum of the condition and we concluded that there is more scope for further work in the same field for better understanding of this topic.

Epidemias y Religión

2020 ◽  
pp. 49-81
Author(s):  
Bruno Van der Maat
Keyword(s):  
Pastoral Care ◽  
Key Words ◽  
Adverse Reactions ◽  
Religious Groups ◽  
Government Regulations ◽  
The Third ◽  
The Bible ◽  
The World ◽  
Ethical Reflections

The current pandemic has seen some adverse reactions from the most diverse religious groups all over the world to government regulations. After having described some of their manifestations, this contribution analyzes what the Bible and some post biblical (patristic and Talmudic) traditions say about illness and pandemics. As it is ascertained that these sources contain very limited material on these subjects, the third part of this article proposes some ethical reflections regarding the official response to the pandemic as well as some pastoral implications. Key Words: Pandemic, Religion, Bible, Talmud, Pastoral Care.

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