Prescribing pattern of antimicrobials and adverse drug reactions in children suffering from lower respiratory tract infection in tertiary care hospital

Background: Acute respiratory tract infections are leading cause of mortality in children in India. Further, indiscriminate use of antimicrobials has led to increased drug resistance and large number of adverse drug reactions (ADR). Therefore, aim of study was to study antimicrobial prescribing pattern and record incidence and causality assessment of ADRs in pediatric in-patients having lower respiratory tract infection (LRTI).Methods: In this prospective and observational study total of 300 children aged 2 months to 12 years suffering from LRTI and hospitalized for minimum 48 hrs duration were included. A descriptive analysis was carried out to determine frequency and combinations of antibiotics prescribed and causality and number of ADRs.Results: Out of 300 subjects, 70.3% of patients were males and 54.6% of cases with LRTI belonged to 2-6 months age group. The most frequently prescribed antibiotic was ceftriaxone alone in 67 (22.3%) patients while ceftriaxone and amikacin was the most common 2 drug combination in 60 (20%) patients. Ceftriaxone, ampicillin and gentamicin was most common 3 drug combination in 7 (2.3%) patients. There were 49 cases (16.3%) of ADRs and maximum were in 2-6 months age group and ceftriaxone with amikacin was associated with maximum number 10 (20.4%) of cases. Diarrhoea was most frequent adverse effect associated with antibiotics in 36 (76.6%) cases.Conclusions: The use of cephalosporins (single or combination) are most commonly used drug and associated with maximum number of ADRs in 2-6 months male children with LRTI so clinicians should use them judiciously and rationally.

A study of effect of Nigella sativa oil in paracetamol induced hepatotoxicity in albino rats.

Background: Acetaminophen (paracetamol) toxicity is a common cause of drug induced hepatotoxicity in children and adults. Specific treatment of paracetamol induced hepatitis is available in the form of N acetylcysteine only. Nigella sativa (NS) is used for the treatment of various ailments. Many studies have shown that NS plant has hepatoprotective potential. Hence, this study study was carried out to explore the prophylactic and therapeutic effect of NS oil against hepatotoxicity induced by paracetamol. Methods: Hepatotoxicity was induced in rats by paracetamol and it was assessed using biochemical parameters such as serum (Sr.) alanine aminotransferase (ALT), Sr. aspartate aminotransferase (AST), Sr. bilurubin, Sr. alkaline phosphatase, and Sr. total protein. In addition, histopathological score was also assessed. The therapeutic and prophylactic effect of NS oil administration on paracetamol induced hepatotoxicity was investigated by using above mentioned biochemical and histopathological parameters. Results: Paracetamol administration leads to rise in serum liver enzymes ad fall in Sr. total protein levels. NS oil has heptoprotective effect. NS oil significantly reversed changes in serum levels of AST, ALT, alkaline phophatase, bilurubin, and total protein produced by paracetamol. Furthermore, histopathological changes produced by paracetamol were reversed. Conclusion: This study demonstrated that NS oil has hepatoprotective effect. NS oil administration can prevent or reverse the hepatotoxicity induced by paracetamol.

A multicentre pharmacoepidemiological study of dermatological disorders in Wardha district.

Background: Skin diseases are common among the general population and account for a high percentage of all diseases. For considering the increase in the prevalence of specific skin diseases, prevalence data are needed. Appropriate treatment of common diseases and provision of essential drugs are two essential components of the primary health care. The aim in dermatological therapy is to use the safest and least number of drugs in order to obtain the best possible effect in the shortest period at reasonable cost. For that important step is taken to monitor, evaluate and therapeutically analyze the prescribing pattern of dermatological drugs. Methods: 12210 cases were screened for dermatological disorders in the Primary Health Care Centers and Rural Hospital of Wardha district during the time frame 1st January 2006 to 30th September 2010, out of which 1000 patients experienced different variety of dermatological disorders were analyzed. In prescription analysis 800 prescriptions with 1946 drugs were analyzed. Results: The prevalence of dermatological disorders in our study was found 8.19%. Out of 1000 patients, there were 567 females (56.7%) and 433 male (43.3%).1000 cases were divided into five age groups viz. 1-20 yrs, 21-40 yrs, 41-60 yrs, 61-80 yrs and more than 80 yrs. Percentage distribution for the various age ranges were 21%, 48%, 20%, 8% and 3% respectively. In spectrum of dermatological disorders, Acne vulgaris (14.8%) was the most common disorder followed by Tinea infection (13.6%) , Eczema (13.2%), scabies (12.4%) and pyoderma (11.6%), Acute urticaria (6.6%), Melasma (5.8%), Psoriasis (3.8%), Polymorphous light eruption (3.6%), Phytophotodermatitis (2.6%), Leprosy (2%) and other disorders (10%). The total number of drugs prescribed in 800 prescriptions was 1946 i.e. on average 2.43 drugs were prescribed per patient. Out of 1946 drugs, 1054 were topical and 892 were oral preparations. Antifungal was most common topically prescribed drug. Conclusions: The prevalence of dermatological disorders is 8.19 %. Younger age group (21-40 yrs) and Females is most affected by dermatological disorders. The commonest dermatological disorder is Acne and in prescription analysis, antifungals are most commonly prescribed.

Aspirin induced fixed drug eruptions: a case report.

Fixed drug eruptions are common cutaneous adverse drug reactions, commonly caused by anticonvulsants, antibiotics and analgesics. Here, we report a case of a 27-year-old male of fixed drug eruptions due to Aspirin which was used in treatment of headache.

Effect of honey on hepatotoxicity induced by antitubercular drugs in albino rats.

Background: Drug-induced hepatotoxicity is a potentially serious adverse effect of antituberculosis treatment (ATT) regimens containing isoniazid, rifampicin and pyrazinamide. Many in vitro and in vivo studies revealed that honey possess antioxidant property and hepotoprotective property but there is no systematic work available to test the effect of honey on antitubercular drugs induced hepatotoxicity in rats. Hence present study was carried out to explore the prophylactic and therapeutic effect of honey with its antioxidant activity against hepatotoxicity induced by antitubercular drugs (Isoniazid, Rifampicin and Pyrazinamide) in albino rats. Methods: Hepatotoxicity in rats treated with antitubercular drugs (Isoniazid, Rifampicin and Pyrazinamide) was studied by assessing parameters such as Serum alanine aminotransferase (ALT), Serum aspartate aminotransferase (AST), Serum total protein, Serum Malondialdehyde (MDA) and Serum Superoxide dismutase activity (SOD). The effect of Honey as co-administration and administration after establishment of hepatotoxicity on above parameter was investigated. These biochemical observations were supplemented by Histopathological examination of liver. Results: Honey significantly reversed changes in serum levels of AST, ALT, MDA, SOD, total protein and also histopathological changes produced by Antitubercular drugs. It was found that honey significantly prevented as well as reversed Antitubercular drugs induced hepatotoxicity and antioxidant activity. Conclusions: The results of present study show that honey has significant prophylactic and therapeutic value against antitubercular drugs induced hepatotoxicity.