A Prospective Observational Study on Anti-infective Agents in Adults in A Hospital

The main aim of the pharmacist is to provide the right drug in the right quality at the right time to patient. The monitoring studies of such prescription pattern can nourish the relevant use and exploit or misuse of the drug which is monitored. The main goal of the present study is to ease the rational use of drugs and make awareness of the irrational use of the drug which is more prevalent to the drug resistance, economic burden to the patient and failure of the treatment. The present prospective observational study was going on the usage of anti-infective agents in the adults based on the prescription of the physician to the patients. Prescriptions were obtained from various clinical departments was done over the period of 6 months from October 2020 to March 2021 to assess the appropriate use of anti-infective agents in adults. Total 1610 prescriptions data of anti-infective agents were analysed of average range of medication includes antibacterial, antiviral, antifungal, anthelmintic, antiparasitic, antimicrobials. A total of 1610 prescriptions from out patient and in patient department of the hospital were analysed in this study and out of those patients, male patients were 714 (44.34%) and female patients were 896 (55.65%). The most common age group which was prescribed more antiinfective agents was 51-60 years. Among them the antibacterial were about 65.03%, antiviral 1.59%, antifungal 7.04%, anthelmintic 7.09%, antiparasitic 0.89%, antimicrobial 0.51%, antimalarial 0.93%, antitubercular 0.51%, Antibacterial+Antiprotozoal 16.45%. Now a days usage of anti-infective agents was high to improve the rational use of drugs and to avoid the irrational usage of antibiotics in increasing the side effects and resistance towards the drug and total cost of treatment as well.

Recent Advances in the Synthesis and Development of Curcumin, its Combinations, Formulations and Curcumin-like Compounds as Antiinfective Agents

: Infectious diseases are caused by pathogenic microorganisms, such as bacteria, fungi, parasites and viruses. Such diseases mostly develop in tropical and sub-tropical climates and represent major health challenges. The pathogens of these diseases are able to multiply in human hosts, warranting their continual survival. Treatment is becoming extremely difficult, due to the absence of effective vaccines and the emergence of resistance by their causative pathogens to existing drugs. Several currently available drugs employ oxidative stress, resulting from the generation of reactive oxygen nitrogen species (RONS), as mechanism for exerting their pharmacological actions. RONS inhibit endogenous antioxidant enzymes, which ultimately eradicate the microbiota. Curcumin, a redox-active natural product, has for centuries been used in Asian traditional medicine for the treatment of various diseases. It is known for possessing multiple biological and pharmacological activities. Curcumin has been investigated extensively over the years for its anti-inflammatory, anticancer, antiparasitic, antiviral and antibacterial activities, and no toxicity is associated with the compound. Despite its potency and safety profile, curcumin is still in clinical trials for the treatment of diseases, such as tuberculosis, acquired immunodeficiency syndrome (AIDS), Chron’s disease, colorectal cancer and multiple myeloma, among many others, as it is yet to be qualified as a therapeutic agent. This review summarizes events over the last decade, especially, regarding the discovery of curcumin, an update of its synthesis, its pathogen specific mechanisms of action, and the pharmacological effects of its derivatives as potential antibacterial, antifungal, antiparasitic and antiviral agents for the treatment of various infectious diseases.

Management of Drug Interactions between Anti-infectives and Common Anesthetics

Interactions between various medications can lead to changes in the expected response of one or more of those medications. Drug interactions can be pharmacokinetic (altered absorption, distribution, metabolism or excretion of the medication) or pharmacodynamic (alterations based on similarities or differences in the mechanisms of medications with respect to their effect on the body). Although drug interactions exist in many specialties in medicine, this chapter focuses on those that affect the responses of common anesthetic agents or drugs given with those agents. While anesthesiologists monitor objective measures and titrate many medications to the desired effect, understanding and anticipating drug interactions can help reduce unexpected effects of medications. This review contains 2 figures, 4 tables and 36 references Key words: anesthetic agents, antiinfective agents, drug interactions, mechanism, pharmacodynamics, pharmacokinetics

Nebulization of Antiinfective Agents in Invasively Mechanically Ventilated Adults

Background Nebulization of antiinfective agents is a common but unstandardized practice in critically ill patients. Methods A systematic review of 1,435 studies was performed in adults receiving invasive mechanical ventilation. Two different administration strategies (adjunctive and substitute) were considered clinically relevant. Inclusion was restricted to studies using jet, ultrasonic, and vibrating-mesh nebulizers. Studies involving children, colonized-but-not-infected adults, and cystic fibrosis patients were excluded. Results Five of the 11 studies included had a small sample size (fewer than 50 patients), and only 6 were randomized. Diversity of case-mix, dosage, and devices are sources of bias. Only a few patients had severe hypoxemia. Aminoglycosides and colistin were the most common antibiotics, being safe regarding nephrotoxicity and neurotoxicity, but increased respiratory complications in 9% (95% CI, 0.01 to 0.18; I2 = 52%), particularly when administered to hypoxemic patients. For tracheobronchitis, a significant decrease in emergence of resistance was evidenced (risk ratio, 0.18; 95% CI, 0.05 to 0.64; I2 = 0%). Similar findings were observed in pneumonia by susceptible pathogens, without improvement in mortality or ventilation duration. In pneumonia caused by resistant pathogens, higher clinical resolution (odds ratio, 1.96; 95% CI, 1.30 to 2.96; I2 = 0%) was evidenced. These findings were not consistently evidenced in the assessment of efficacy against pneumonia caused by susceptible pathogens. Conclusions Performance of randomized trials evaluating the impact of nebulized antibiotics with more homogeneous populations, standardized drug delivery, predetermined clinical efficacy, and safety outcomes is urgently required. Infections by resistant pathogens might potentially have higher benefit from nebulized antiinfective agents. Nebulization, without concomitant systemic administration of the drug, may reduce nephrotoxicity but may also be associated with higher risk of respiratory complications.

Prodrugs of Antiinfective Agents: A Review

Prodrugs are the pharmacologically inactive derivatives of active drugs typically intended to optimize the exposure of active drug at target site, through manipulation of its physicochemical, biopharmaceutical or pharmacokinetic properties. This approach has a number of advantages over conventional drug administration. Antiinfective agents are associated with number of limitations, responsible for their reduced bioavailability. Various antiinfective prodrugs have been synthesized with reduced side effects and improved pharmacological properties. The present paper illustrates different vistas of prodrug approach of antiinfective agents describing brief classification, synthetic approaches, pharmacological aspects and recent patents. It is a very productive area of research and its prologue in human therapy has given triumphant outcomes in improving the clinical and therapeutic effectiveness of drugs.This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.