Five-year Audit of Infectious Diseases at a Tertiary Care Hospital in Karachi, Pakistan

Background: Aim of the study was to assess trend in antibiotics consumption pattern from 2016 to 2019 using AWaRe classification, ATC and Defined daily dose methodology (DDD) in a tertiary care hospital. Antibiotics are crucial for treating infectious diseases and have significantly improved the prognosis of patients with infectious diseases, reducing morbidity and mortality. The aim of the study is to classify the antibiotic based on WHO AWaRe classification and compare their four-year consumption trends. The study was conducted at a tertiary care center, Pilakhuwa, Hapur. Antibiotic procurement data for a period of 4 years (2016-2019) was collected from the Central medical store.Methods: This is a retrospective time series analysis of systemic antibiotics with no intervention at patient level. Antibiotic procurement was taken as proxy for consumption assuming that same has been used. ATC for systemic use (ATC code J01) antibacterial was used and defined daily dose (DDD) per 100 bed days was calculated. Antibiotics were further classified as Access, Watch, and Reserve (WHO AWaRe classification). Antibiotics consumption was ranked based on their volume of DDD i.e., drug utilization (DU90%) was calculated. Non-parametric Pearson’s correlation coefficient was used for the comparison of consumption.Results: Mean antibiotic procurement increased 1.25 folds from 140.3 DDD in 2016 to 201 DDD in 2018. A significant fall was seen in total DDDs in year 2019 (p value <0.05). A total of 41 antibiotics agents (Access 12, Watch 21, Reserve 6 and Not recommended 2) were procured. Reserve category antibiotics were procured from 2017 onwards. Out of 41 antibiotics procured 11 antibiotics (Access 3 and watch 8) accounted for DU 90%.Conclusions: Antibiotics consumption of watch group was high and increasing antibiotic consumption trend was observed. Hospital antimicrobial stewardship program should be implemented to shift to use of Access group antibiotics and restrict use of Watch antibiotics.

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A secondary analysis of atypical presentations of older patients with infection in the emergency department of a tertiary care hospital in Thailand

Asian Biomedicine ◽

10.5372/1905-7415.1002.480 ◽

2016 ◽

Vol 10 (2) ◽

Author(s):

Panita Limpawattana ◽

Thapanawong Mitsungnern ◽

Pariwat Phungoen ◽

Natthida Tansangworn ◽

Wannisa Laosuangkoon

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Infectious Diseases ◽

Older Patients ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Secondary Analysis ◽

Care Hospital ◽

Associated Risk Factors ◽

Atypical Presentations

AbstractBackgroundClassic symptoms of illness are often absent in older adults, delaying diagnosis and management, and resulting in unfavorable outcomes.ObjectivesTo determine the prevalence of atypical presentations by older Thai adults with infections in the emergency department (ED) of a tertiary care hospital, and to identify factors associated with atypical presentations in such patients.MethodsWe performed a secondary analysis of a retrospective cohort observational study of atypical presentations of patients aged ≥65 years in the ED using a subset of data first reported in the Archives of Gerontology and Geriatrics in 2015; 62:97-102.ResultsThe prevalence of atypical presentations was 35% of those with infectious diseases (64 of 183 cases). Pneumonia was the most common (30%). We identified 4 associated risk factors: complicated urinary tract infection (UTI) (odds ratio (OR) 4.54; 95% confidence interval (CI) 1.75,11. 78; P = 0.002), cancer (OR 2.64; 95% CI 1.07, 6.53; P = 0.04), dementia (OR 6.66; 95% CI 1.47, 30.11; P = 0.01), and pulse rate >90 beats/min (OR 2.06; 95% CI 1.01, 4.22; P = 0.04). Infective diarrhea was protective (OR 0.27; 95% CI 0.09, 0.8; P = 0.02).ConclusionsAtypical presentations of infectious diseases by older Thai patients in the ED accounted for about one third of those with infectious disease. Associated risk factors were complicated UTI, cancer, dementia, and increased pulse rate. Older patients with these factors who have uncertain diagnoses should be considered for hospitalization because the absence of classic symptoms does not exclude life-threatening infections.

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Point-prevalence of hypersensitivity to antibiotics in a tertiary care hospital and the potential role of the intervention of a department of infectious diseases

10.26226/morressier.56d5ba2fd462b80296c95185 ◽

2016 ◽

Author(s):

Guillermo Maestro

Keyword(s):

Infectious Diseases ◽

Potential Role ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Point Prevalence ◽

Care Hospital

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PRESCRIBING PATTERNS OF CEPHALOSPORIN IN CHILDREN FOLLOWING IMPLEMENTATION OF ANTIBIOTIC STEWARDSHIP PROGRAM IN A TERTIARY CARE HOSPITAL AT WESTERN INDI

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2020.v13i9.38403 ◽

2020 ◽

pp. 110-114

Author(s):

ANURADHA JOSHI ◽

URVI KHUMBANI ◽

JAISHREE GANJIWALE ◽

BARNA GANGULY

Keyword(s):

Infectious Diseases ◽

Antibiotic Stewardship ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Prescribing Patterns ◽

Western India ◽

Antibiotic Prescribing ◽

Care Hospital ◽

Stewardship Program ◽

Case Files

Objective: The objective of the study was to study the prescribing patterns of cephalosporins in children following the implementation of Antibiotic Stewardship Program (ASP) in a tertiary care hospital at western India. Methods: This was an observational study of records using data of pre- and post-implementation of ASP. Data were collected from case files of children admitted to pediatric wards in the years 2012 and 2014, respectively. Data were analyzed to find the prescribing pattern of cephalosporin and its appropriateness in relation to ASP program guidelines. Results: Three hundred case files were collected and analyzed (n=150 each from the year 2012 and 2014). The mean age of patients in both years was 6.21 years±5.63 (the year 2012) and 5.88 years±5.88 in (the year 2014). Majority of children, that is, 47.3% were suffering from infectious diseases in the year 2012 while in the year 2014, 38.7% suffered from infectious diseases. Post-implementation of ASP, there was an improvement in the appropriateness of cephalosporin prescribing in terms of prophylactic and empirical treatments. Switch over of parenteral cephalosporins to oral was observed in 54.0% patients in 2012, while in 2014, it was seen in 51.3% of patients. There was a 4.6% rise in prescriptions containing 1st generation cephalosporins. Overall there was a significant impact of ASP in terms of appropriate cephalosporin prescribing (p=0.039). Conclusion: Implementation of ASP and its adherence by pediatricians can improve antibiotic prescribing in children.

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Trend of intestinal infectious diseases recorded at a tertiary care hospital in India: an ICD-10 analysis

BMJ Health & Care Informatics ◽

10.1136/bmjhci-2019-000021 ◽

2019 ◽

Vol 26 (1) ◽

pp. e000021

Author(s):

P N Roopalekha Jathanna ◽

Ramya Vijeta ◽

Vinod R Jathanna

Keyword(s):

Infectious Diseases ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

World Health ◽

Care Hospital ◽

Infectious Origin ◽

Index Study ◽

Icd 10 ◽

Health Organization ◽

Health Situation

The World Health Organization identifies the leading cause of morbidity and mortality in developing countries as infectious and communicable diseases. Health records coded uniformly using ICD-10 can form an accurate database and conclusions drawn from this are extremely important for understanding the public health situation.The aim of this study is to analyse the trend of intestinal infectious diseases recorded at a tertiary care hospital in India.A retrospective disease index study was conducted on data comprising 5317 cases from 2012 to 2016 for intestinal infectious diseases, analysed with ICD-10.Of these, 5.5% were from the age group 0-5 years; 57.66% were male; and 85% deaths in this cohort (62/73) were due to diarrhoea and gastroenteritis of presumed infectious origin.The findings of this study highlight an urgent need for health education among the population regarding infectious intestinal diseases and to redesign health promotion and preventive strategies for addressing these problems.

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