Irrational antibiotic prescribing practice among children in critical care of tertiary hospitals

This study assessed the prescribing pattern of irrational use of antibiotic among children under age of 12 years in public and private sector hospitals in Pakistan. The prospective clinical evaluation of drug utilization pattern of antimicrobials from Patient Bedside File [PBF] of in-patients and Culture Sensitivity Test [CST] reports were evaluated to determine the antibiotic resistance. Two indicators recorded to assess antibiotic prescribing were; dose of prescribed antibiotic [low-dose, rational and high -dose] and Indication [valid or invalid]. Antibiotics resistance for 25 selected antibiotics was determined by culture sensitivity test. This study showed that in Private Sector Hospital 77.7% neonates, 13.3% infants and 9% children admitted in ICU were receiving antibiotics, among them only 57.3% neonates, 62% infants and 59.9% children were found valid that is prescribed antibiotics for right indication. 27% neonates, 19% infants and 22.1% children were prescribed under dose of antibiotics, which may lead to antimicrobial resistance and increased cost of hospital stay. Only 29.1% neonates, 30% infants and 36.8% children were receiving rational dosing. In Public Sector Hospital, 65.6% neonates, 19.4% infants and 15% children were receiving antibiotics. Among them valid indication was found in 35.3% neonates, 35.6% infants and 39.8% in children. 33.3% neonates, 26.6% infants and 28.2% children were receiving under dose that may lead to resistance not only among those who were prescribed under dose but also such bacteria become resistant and spread to other population to increase antimicrobial resistance. The irrational prescribing of antibiotics was found very high [above 50%] in Public sector hospital [Hospital-B] for every age group whereas in Private sector hospital [Hospital-A] this practice was found near to 50%. In this study the prescribing frequency of Amikacin, Cefixime, Cefotaxime, Meropenem, Amoxicillin, Vancomycin, Azithromycin, Levofloxacin and Clarithromycin was found above 80% in both hospitals [A and B]. Among these, Amoxicillin, Penicillin, Erythromycin and Cephalexin showed higher resistance i.e. 49.2%

Sensitivity pattern of ceftriaxone against different clinical isolates

Emerging resistance against broad-spectrum antibiotics for standard empiric therapy is a global concern. Ceftriaxone [broad spectrum, third generation cephalosporin] is widely used in tertiary care settings to treat severe bacterial infections usually non-responsive to other antibiotics. The aim of the study is to evaluate the current sensitivity pattern of ceftriaxone [30micro g/disk] among different clinical isolates. For this purpose, three hundred clinical isolates including Escherichia coli [25%], Staphylococcus aureus [30%], Salmonella typhi [17%] and Klebsiella pneumoniae [20%] were collected from different pathological laboratories of Karachi, Pakistan. The in-vitro sensitivity of different Gram positive and Gram-negative bacteria was determined by disk-diffusion technique using 0.5 McFarland standard. Results showed that ceftriaxone was highly sensitive against Escherichia coli [90%] and least sensitive against Klebsiella pneumoniae [65%]. It is concluded that the sensitivity of ceftriaxone is progressively decreasing in comparison with past studies creating an alarming situation. Therefore, continuous surveillance is required to determine the current resistance status of clinical pathogens and for effective anti-microbial therapy

Mini Review: herbal medicinal products regulation in Pakistan

Pakistan is gifted with a rich prosperity of curative plants from All Mighty Allah. Herbs have always been most important form of medicine in Pakistani population and currently plants have got popularity throughout the globe. Standardization, quality control and import and export of raw materials and herbal formulations materialize the key dispute for herbal drug manufacturers which is due to the non availability of sufficient regulatory strategy, principally for good manufacturing practice [GMP], no execution of good agricultural and collection practices [GACP], and weak implementation of the Herbal product drug act from the ministry of health of Pakistan. Now there are several opportunities for the development of quality of herbal products on the basis of data based studies which is essential for the establishment of the herbal products quality, safety and efficacy in the domestic and export market. Finally, strong Regulatory implementation becomes now necessary to moderate the hindrance for the commercialization of the herbal medicinal drug in Pakistan with the help of scientific research at Institutions, Universities and hi-tech advancement in the field of herbal medicine and their related products

Synthesis and cytotoxic activity of some derivatives of alkyl piperidine

Synthesis of novel phenacyl derivatives of alkyl piperidine as cytotoxic agents via simple and single step reaction procedure is going to be reported here. Twelve new compounds were successfully synthesized in moderate yield and in solid form. Their synthesis was confirmed by TLC, melting point, CHN analysis and through different spectral studies such as UV, IR, Mass and proton NMR. The advantages of this synthetic route are simple operation, mild reaction conditions and good yields. These newly synthesized derivatives were extensively explored for their cytotoxicity by brine shrimp lethality assay

Phytomedicine New and old approach

The relationship between man and plants is as old as the history of mankind itself. Since antiquity man has studied plants and animals, particularly as a source of food and to ward off ailments [Said, 1982]. Therefore with the passage of time man was able to distinguish between harmful or poisonous and useful plants. Some plants were found useful as food while other showed beneficial effect against various types of diseases. This is how the knowledge of drugs from plants developed. Based on son authentic, published sources, the authors aim at presenting a survey of biologically active compounds isolated from plant sources, and establishing link between ethnopharmacology and contemporary use of medicinal plants, as well as research trends in phytomedicine