ABSTRACT
Background: Sepsis with septic shock has remained a dreadful disease inspite of early intervention mostly due to lack of sensitivity to first line antibiotics. This observational study was conducted to evaluate the utilization of antimicrobials and sensitivity-resistance pattern in paediatric patients suffering from sepsis due to various causes.Methods: A prospective, non-interventional, pharmaco-vigilant study. 38 patients suffering from sepsis admitted in paediatric ward and PICU from September 2012 to February 2014 were evaluated. The research protocol was approved by Institutional Ethical Committee, KIMS. Data were collected from case sheets of patients from the ward as well as Medical Record and Data section. Average of Data on a continuous scale was expressed as a mean along with standard deviation, Categorical data was expressed as percentage. Comparative statistical analysis was done by using student's t-test in respect of data measured on a continuous scale. All differences with P value below 0.05 were labelled as statistically significant.Results: Total 38 patients were admitted with provisional diagnosis of sepsis. 52.5% patients were suffering from ?2 diseases while pneumonia (64%) and meningitis (22%) were observed to cause sepsis. 10(27%) patients presented with septic shock while 39.3% patients having single organ failure and 10.4% patients having multiple organ failure. inj Dopamine (33%) and inj Dobutamine 11% were used and ventilator was used in 1 patient. Most of the patients received multiple antibiotics in I.V. route, 30 (79%) patients received ?3 antibiotics. Linezolid+ piperacillin+ tazo + aminoglycoside + 4th drug combination was observed to be used in 34% patients while Linezolid+ 3rd gen. cephalosporin+ aminoglycoside+ 4th drug combination was used in 21% patients. Cephalosporin was most frequently withdrawn antibiotic (47 % of use). High resistance was observed for both gram +ve and gram -ve bacteria against cephalosporin.Conclusions: Anti-MRSA agents (Linezolid) and anti-MDR GNB agent (Meropenem) significantly used to control the severe sepsis in conjunction to Piperacilin/ ceftriaxone + amikacin.
ABSTRACT
The principal aim of drug utilisation studies (DUS) is to facilitate the rational use of drug in a population.DUS is an essential part of pharmacoepidemiology and pharmacoeconomic as it describes the extent,nature and determinants of drug exposure. Diabetes at present appears as a common non communicable disease. It leads to high morbidity and mortality due to the disease itself and its diverse complications like coronary artery disease, hypertension, renal complication, retinal damage, neurological disorders, incidence of stroke at different sites, generalised infections etc. With such multifactorial background of high prevalence , progressive nature of the disease, availability of multiple therapeutic regimens prescribed on trial and error basis, the treatment is individualised and neither complete nor satisfactory. Objectives: This study was undertaken to analyse the current prescribing pattern in obese patients of type 2 diabetes mellitus with regard to drug/drugs precription ,dose, duration of treatment and frequency of change of drugs. Methods: This is a prospective, parallel group, comparitive observational study. The enrolled obese patients were divided as a)New diabetic b) Old diabetic(<3 years duration). Each category was further divided into four subgroups according to the treatment recieved a)Monotherapy-only Metformin b)Combination therapy- Metformin+another antidiabetic groups,preferably sulfonylureas, alphaglucosidase inhibitors or DPP 4 inhibitors c)Triple therapy( Metformin+SU+Voglibose or Gliptins or Glitazones) d)Insulin with other oral hypoglycemic drugs. Results: In the study of prescribing pattern, it was observed that most prescriptions in this tertiary care hospital were found to be in compliance with the ADA guidelines. Metformin monotherapy was prescribed as initial treatment. Sulphonylureas/ Gliptins / Alpha glucosidase inhibitors/ thiazolidinediones were used as second line therapy mostly anyone, in addition to metformin or as monotherapy according to patient requirement, tolerability and cost.Conclusions: The antidiabetic medications prescribed in this hospital,were found to be in compliance with ADA guidelines with metformin being the first line of treatment followed by sulfonylureas and alphaglucosidase inhibitors