Pediatric Lower Respiratory Tract Emergencies: Bronchiolitis, Pneumonia, and Asthma

Respiratory illnesses account for a significant proportion of pediatric morbidity and mortality. Respiratory complaints are a common cause of emergency department visits and hospital admissions. They range from mild and self-limited to severe and rapidly progressive. This review discusses the pathophysiology, assessment, stabilization, and management of asthma, community-acquired pneumonia, and bronchiolitis. Given the prevalence of these conditions and the morbidity and mortality attributed to them, it is important for clinicians to be familiar with their presentations and up to date on evidence-based management recommendations. This review contains 7 figures, 25 tables and 80 references Keywords: antibiotics, asthma, bronchiolitis, community-acquired pneumonia, pediatric respiratory, pneumonia, respiratory emergency, respiratory illness, respiratory syncytial virus

A Review on Crisis of Antibiotic Resistance

The current challenges and crisis related to antibiotic use and its resistance are unique and differ from the past challenges, as there is a lot of novel pathogens involved in the emergence of antibiotics resistance. Antibiotic resistance has become a major concern and challenge, hindering the usage of antibiotics. Crisis of antibiotic resistance is the increasing global incidence of infectious diseases affecting human population making it untreatable with any known antibiotic or antimicrobial agent. Newer resistance mechanisms are emerging and spreading globally thereby, imposing a major threat to the treatment of common infectious diseases. This has consequently led to an increase in the morbidity and mortality rates and thereby the rise in cost of the treatment as well. The process of antibiotic resistance has become an evolutionary response due to factors like widespread, extensive, and unnecessary use of antibiotics and unavailability of newer drugs attributable to exigent regulatory requirements. The situation in developing countries is expected to worsen unless governments become more stable, major advances occur in standards of living, preventive measures and in providing adequate medical care. Comprehensive and coordinated efforts are required to minimize the pace of resistance by implement new policies, researches and pursue steps to manage crisis. Keywords: antibiotics, resistance, crisis micro-organisms.

Antibiotics Prescription Patterns among Dentists in Lahore, Pakistan

Background: Odontogenic infections are one of the main causes of patients visit to a dental office. Antibiotics are magical drugs that have revolutionized the 20th Century in their ability to treat infectious diseases, increasing the life expectancy of individuals. Antibiotics prescription is a common practice among dental professionals and according to an estimate by Centre for Disease Control (CDC) and American Dental Association (ADA), over prescription of antibiotics is seen in 30-50% of the cases. Aim: To assess and compare (no comparison) the antibiotic prescription pattern among general dentists and specialty dentists in Lahore, Pakistan. Methodology: A cross sectional survey was conducted amongst dentists working in the teaching institutions and in the private clinics of Lahore. A pre-piloted questionnaire survey adopted from Jagan et al with slight modifications was used. In this descriptive study 300 practicing dentists were selected using consecutive sampling with a 5% level of significance and margin of error Results: Total 300 filled questionnaires were collected. Almost 84% of the dentists were less than 30 years old while 13% were between 31-40 years old. Of the participants 65.3% were females and 34.7 percent were males. Dental infections associated with gross swelling or associated with closure of the eye were the most common reasons for prescription of antibiotics. Almost 62% of the dentists would give antibiotic if any delay in treatment is anticipated. Almost 50% of the dentists would prescribe antibiotics for periapical abscess and cellulitis. Conclusion: There is a trend towards over prescription of antibiotics by dentists without following the standard guidelines. Emphasis on the correct prescription strategies of antibiotics at the undergraduate level and more awareness should be created as continuing dental education programs for practicing dentists. Keywords: Antibiotics, Dentists, Prescription Pattern.

Statistical Study of Self Medication with OTC and Antibiotics in three major cities of Pakistan

Aim: To discover the frequency of self-medicine with antibiotics/OTC amongst population of 3 metro cities of Pakistan (Lahore, Multan, and Islamabad). Methods: As we realize that antibiotic resistance has the ability to have an effect on humans at any level of life, in addition to the healthcare, veterinary, and agriculture industries, making it one of the global’s most pressing public health issues. There are a couple of motives for resistance and the maximum not unusual are self-medication and pharma industries antibiotic wastage without remedy. The survey used was primarily based on a cross-Sectional examine that's used to collect data on a populace at a single factor in time. Results: The material required for this survey covered Performa containing a list of questions concerning self-medicinal drug with OTC drugs and antibiotics. One hundred patients from every metropolis have been interviewed in line with the Performa/ questionnaire. Conclusion: This survey indicated want for energetic involvement of health care experts, specially physicians and pharmacists, in educating and counseling the populace approximately the safe utilization of medication, even though it is hard to eliminate self-remedy practice legal rules can be made approximately the sale of OTC pills and antibiotics so as to maximize the exercise of rational use of medication. Keywords: Antibiotics, Prescription, Health Care, Rational, Wastage

Antimicrobial Susceptibility of Pseudomonas aeruginosa Isolated from Hospital Environment

Pseudomonas aeruginosa is a leading cause of disease and death particularly in cystic fibrosis patients and also considered resistance to chemotherapeutic agents. Therefore, it is very difficult to remove the Pseudomonas aeruginosa from the hospital environment by using simple techniques. In the contemporary study, biofilm mediated mechanism of various antimicrobial responses were analyzed. For this purpose, different Pseudomonas aeruginosa clinical isolates were collected from Pakistan medical institute Islamabad (PIMS) hospital and were investigated for pellicle formation. Pseudomonas aeruginosa isolates were studied for different groups of antibiotics including imipenem, meropenem, ceftazidime, amikacin, tobramycin, gentamicin, piperacillin, cefoperazone, and cefotaxime. The goal was to check antimicrobial susceptibility of pseudomonas aeruginosa which shows resistant to tobramycin, imipenem, meropenem, amikacin, gentamicin, cefotaxime, piperacillin, ceftazidime, cefoperazone. Additionally, in this study, Pseudomonas aeruginosa strains were also investigated for pellicle formation. In conclusion, this research work wills highlights the useful mechanism of antibiotics resistance to Pseudomonas aeruginosa infections in clinical practice. Keywords: Antibiotics, Pseudomonas aeruginosa, antibiotics, Biofilm, Peliclle.

Societal Usage Of Antibiotics In The Syrian Coastal Region During 2021

This study is based on an electronic questionnaire about the use of antibiotics. It investigates the knowledge about antibiotics and their resistance among the Syrian coastal people. 639 individuals responded to the questionnaire. The results show that there is fairly good information about those drugs. Yet, there is much to be done to spread the awareness in the whole community, especially with regards to enact laws that prohibit antibiotics purchase without a prescription. Doctors on the other hand, should give antibiotics only on necessity. People also have to be well educated about antibiotics resistance, which is an inevitable consequence to the misuse of those drugs. Keywords: Antibiotics, Misuse, Resistance, Awareness, Infection. Keyword : Antibiotics, Misuse, Resistance, Awareness, Infection.

Wagner’s Classification for Management and Evaluation of Diabetic Foot: A Prospective Study

Background: In our community diabetes is one of the most common co-morbid illnesses. Out of its several complications in long course diabetic foot is one of them. Morbidity and mortality due to this complication is a major health issue. Objective: This study is undertaken for management and evaluation of foot ulceration to avoid amputation of lower extremities due to diabetic foot disease. Methods: This prospective observational study conducted between July 2019 and September 2020, 40 patients with diabetic foot admitted to Department of General Surgery, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar (TS) were subjected to surgical treatment depending upon the Wagner’s classification. Data was collected and analyzed by statistical software SPSS V 25. Results: Majority of the patients presented with higher grade and with poor glycemic control at the time of presentation. Conservative management with antibiotics was useful in a small subset of the patients. Majority of the patients needed surgical treatment in the form of debridement to amputations. Conclusion: Patient education and strict glycemic control can reduce the burden of diabetic foot. Early diagnosis and hospitalization, appropriate treatment including medical and surgical treatment according to the grade can reduce the morbidity mortality and improve the outcome of the disease. Keywords: Antibiotics; Amputation; Wagner classification; Complications; Glycemic control.

Nasopharyngeal Carriage of Staphylococcus aureus among Horses and Horse Handlers in Kano Metropolis, Nigeria

Staphylococcal species are important opportunistic bacterial pathogens that can asymptomatically colonize both human and animals bodies. The presence of nasopharyngeal carriage Staphylococci has been an increased risk factor of acquiring an infection with this pathogen. The present study aimed at determining the nasopharyngeal carriage of Staphylococcal aureus in horses and horse handlers in Kano metropolis, Nigeria. One hundred and sixty (160) non-duplicated nasopharyngeal samples were collected using sterile swab stick from each horse and 100 from consented horse handlers. All the samples were analyzed using a standard bacteriological procedure. Antibiotics susceptibility testing to eight (8) most commonly used antibiotics was carried out using a modified Kirby Bauer method. One hundred and forty-two (88.8%) staphylococcal isolates were recovered from horses and 84 (84.0%) from horse handlers. Among all the isolated staphylococci high sensitivity was observed in response to Gentamycin and Ciprofloxacin antibiotics, while Tetracycline was found to have the least activity. The report of this study showed a high prevalence of Staphylococci among horses and horse handlers. Moreover, it confirmed the tendency of Staphylococcal isolates cross-transmission between horses and handlers in the study site. This study indicated the importance of increase in handler's awareness of possible risk factors of staphylococcal colonization that can lead to invasive infection. Keywords: Antibiotics, Horses, Horse Handlers, Nasopharyngeal, Staphylococci

Analysis of the prevalence of antibiotic-resistant opportunistic microflora isolated in patients with bronchitis

In Press The study of Staphylococcus and Streptococcus antibiotics sensitivity revealed absolute sensitivity of S. aureus to cefepime and imipenem, S. pyogenes – to amoxiclav, ofloxacin and clindamycin. Staphylococcus showed the greatest resistance to penicillins (50–75%), amoxiclav (35–43%), norfloxacin (40–50%), azithromycin (S. aureus – 14%, S. epidermidis – 84%). Amoxiclav was the most active against Streptococcus (81–100% of sensitive strains). S. pyogenes strains had the greatest resistance to azithromycin (75%), penicillins (50–60%), carbapenems (50–60%). Other Streptococcus were resistant to azithromycin (34–50% cases). Keywords: antibiotics resistance, opportunistic microorganisms, bronchitis.

Patterns of Prescribing Co-Amoxiclav to Children in Ibri Polyclinic, Oman

Objectives: This study aimed to describe patterns of prescribing co-amoxiclav to children aged ≤5 years at a polyclinic in Oman and to assess level of adherence to the antibiotic prescription guidelines outlined by the Omani Ministry of Health (MOH). Methods: This cross-sectional retrospective study was conducted between June and December 2017 at Ibri Polyclinic (IPC) in Ibri, Oman. A random sample of 399 children aged ≤5 years who were prescribed a suspension of co-amoxiclav over the four winter months of 2016 were included in the study. The children’s electronic medical records were reviewed to determine whether the prescription complied with MOH guidelines. Results: The majority of the children were 2–3 years old (52.4%). Overall, 73.9% of prescriptions were written by general practitioners, while 26.1% were written by specialists. Co-amoxiclav therapy was the first line of management in 90.5% of cases, regardless of category of prescriber. Culture tests were ordered in only 43 cases (10.8%), of which five (11.6%) were found to be sensitive to the prescribed co-amoxiclav. Conclusion: Unnecessary antibiotics were prescribed to many paediatric patients attending IPC. Strict enforcement of the MOH antibiotic guidelines is needed to reduce irrational or discretionary prescription of this type of antibiotic. Healthcare providers should receive additional training in evidence-based methods of prescribing antibiotics. KEYWORDS Antibiotics; Children; Co-Amoxiclav; Inappropriate Prescribing; Antibiotic Resistance; Oman.