ABSTRACT
HIV is a global problem with increased mortality and morbidity. The highly active antiretroviral therapy is effective in reducing the HIV RNA and improving the immune response. The drugs in the current regimen have certain disadvantages such as adverse effects, drug intolerance, and drug resistance. Since there is a demand for identifying the drugs with new mechanism of action, the compounds which target the viral gp120 receptor were screened and the most suitable drug among them was identified. In a Phase II and Phase III trial, the drug BMS-663068 fostemsavir was found to be efficacious in reducing the viral RNA levels. The drug is a prodrug that gets converted into metabolite temsavir BMS-626529. The preferred dose is 600 mg orally 12 hourly in patients who had undergone many treatment schedules with multidrug-resistant infection and those who cannot tolerate the drug regimen due to resistance and safety issues. The drug is metabolized by CYP3A4 and has drug interactions with CYP3A4 inducers and inhibitors. This review mainly comprises the mechanism of action, clinical trials, pharmacological properties, and adverse effects of the drug fostemsavir.
ABSTRACT
Background: Skin diseases of microbial etiology are caused by bacteria, fungi, viruses and ectoparasites of which bacterial infections are most common than others. Although many bacteria reside on skin, they are unable to establish infection because of the natural defense mechanisms. Most of the bacterial infections are caused by Staphylococcus and Streptococcus. Antibiotic resistance among the micro-organisms is developing due to indiscriminate use of antibiotics and irrational prescription of drugs. Periodic study on drug utilization research and analysis of prescription pattern of antibiotics followed in recent past will guide physicians to prescribe the antibiotics judicially and with a rational approach. Methods: A prospective analysis of 291 in-patients admitted in the Department of Dermatology, Karaikal, over a period of 1-year (January 2013-December 2013) was carried out to analyze the usage of antibiotics through various routes to treat infections associated with dermatological disorders. Results: Among the study population, 60.48% were male and 39.51% were female. We found that out of 29 diseases observed, most common skin disease diagnosed was psoriasis (24.82%), followed by eczema (24.82%). The average number of drugs per prescription was 6.37±2.06. Oral antibiotics were mostly prescribed than parenteral and topical formulations among the study population. Among the oral antibiotics, amoxicillin with clavulanic acid (29.6%) was widely prescribed. In the context of parenteral formulations, cefotaxime (38.92%) was majorly prescribed. Among the topical antibiotics, mupirocin (60.71%) was mostly used. Conclusion: Our study provided an idea about the prevalence of dermatological disorders in a coastal area of Karaikal, Puducherry, the drug utilization strategy of antibiotics, the rationality behind usage and has given useful suggestions to achieve treatment success through judicious use of antibiotics.