ABSTRACT
Background: Respiratory tract infections have been one of the commonest types of infections affecting the Indian population. With antibiotic resistance being a global threat and challenge to healthcare, concerns over skilful and judicious use of existing antibiotics have been on rise. Update on region specific bacterial susceptibility pattern is thus a need. The present study was planned to identify the common pathogens responsible for the respiratory tract infection and their antibiotic susceptibility patterns.Methods: A prospective study was carried out, where subjects with lower respiratory tract (LRT) infection admitted in the Intensive Care Unit in the tertiary care centre in Eastern India during the one-year period were enrolled in the study. Samples such as sputum, suction tip, endotracheal aspirate, bronchial aspirate and pleural fluid were obtained under aseptic precautions and were processed. The bacterial isolates were subjected to susceptibility testing by standard Kirby Bauer disc diffusion methods. The susceptibility patterns of the bacterial pathogens were determined.Results: Out of 234 processed samples, klebsiella (33.44%) was found to be commonest pathogen isolated from all the sites followed by Pseudomonas, staphylococcus and others. Amongst the penicillin group of antibiotics, ampicillin showed highest activity against pseudomonas and E. coli respectively. Antibiotics like penicillin G, ampicillin/sulbactam and amoxicillin/clavulanic acid combination showed lower susceptibility towards most pathogens. Amongst broad spectrum antibiotics, amikacin showed high susceptibility towards pseudomonas species followed by chloramphenicol and tetracycline.Conclusions: With changing trends in microbiological patterns of responsible organisms, knowledge regarding antibiotic susceptibility pattern needs to be regularly revised, thus ensuring prompt initiation of adequate and appropriate antibiotic treatment with better patient outcomes.
ABSTRACT
Background: Primary open angle glaucoma remains a high magnitude healthcare problem due to its prevalence and chronicity. The real world scenario of anti glaucoma medical therapy needs periodical auditing as far as drug prescriptions are concerned for formulation of treatment guidelines. Few studies from India have taken a longitudinal approach in this respect. This study was undertaken to identify such lacunae.Methods: This was an open label, prospective, observational study. Each treatment naive patient was followed up for a period of 6 months, where their prescriptions were scanned for the type of the anti glaucoma medications, total number of medications, route of administration, their duration of use and their frequency of dosage and change in medications if any, in each visits.Results: A gradual shift from monotherapy towards combination therapy was observed. Overall averages for prescriptions were topped by monotherapy at 44.25 followed by fixed dose combinations at 38.25, and then combination-polytherapy at 36 and the least number of prescriptions were for concurrent polytherapy at 17.5. Amongst all monotherapy agents, beta blockers were the most frequently prescribed drugs at baseline but their share of prescriptions was almost halved at the end of our study. The prostaglandin analogs on the other hand saw an upsurge in prescriptions from their baseline to the end of this study. Prostaglandin analogs andbeta blockers as fixed dose combination was a popular prescription over the entire study duration.Conclusions: Prescribing trends were remarkable for the shift from primary monotherapy towards fixed dose combinations as the study concluded. The decline in the number of beta blocker prescriptions and a rise in prostaglandin analog prescriptions is a testament to their better effectiveness and tolerability. The future of open angle glaucoma pharmacotherapy lies in prescribing more efficacious drugs either in monotherapy or in fixed combinations.