ABSTRACT
Introduction : Urinary Tract Infection (UTI) is a common infection and a major health problem. Considering the bacterial resistance developed globally, knowledge regarding sensitivity and resistance pattern of isolated uropathogens in a defined area becomes critically important for choosing appropriate antimicrobial agents for treatment. Objectives : We conducted this study to detect the common UTI causing microorganisms and to evaluate their culture sensitivity pattern in a Tertiary Care Hospital. Methods : This retrospective record based observational study was conducted over a period of two months (January and February, 2021). Patients in the General Ward in the Department of General Medicine, Medical College, Kolkata whose urine samples were collected within 48 hours of admission were included. Identification of bacteria was done by standard microbiologic methods and using Kirby disc diffusion test their antimicrobial susceptibility test was performed. The causative organisms for UTI along with its antibiotic sensitivity pattern were retrospectively reviewed and analysed. Results : Among 150 culture positive samples 34.67% were from male and 65.33% were from female with highest prevalence in the age group of 21-30 years (22.67%). Most prevalent uropathogens isolated was Escherichia coli (E coli) (60.66%) followed by Enterobactor (21.33%) and Klebsiella (9.33%). E coli showed most sensitivity against ceftazidime, clarithromycin, piperacillin-tazobactam and clindamycin (100% in all cases). Resistance (>70%) of E coli was found against levofloxacin and cefotaxime. Conclusion : The present study reveals microbiological profile regarding UTI in patients attending our hospital. As resistant to first line antibiotic is increasing, antibiotic stewardship programme should be strengthened. Antibiotic policies agreed among Clinicians, Microbiologists and Pharmacologists will guide good prescribing, provide maximum coverage for treating infections and ensure antibiotic cycling.
ABSTRACT
Rheumatoid arthritis (RA) is an autoimmune disease affecting about 1% of people, with the highest incidence between 40 and 70 years. Methotrexate is a folic acid antagonist that has good efficacy and safety in the treatment of RA. Methotrexate (MTX) and non-steroidal anti-inflammatory drugs are often concomitantly administered in clinical practice for the treatment of RA. In this case report 46 year old male patient, a known case of rheumatoid arthritis was admitted with history of knee joint pain and swelling. Methotrexate was initially started in a dose of 7.5 mg per week, dose was then increased to 15 mg per week. Six weeks later, the patient complained of oral ulcerations, erythematous, itchy and edematous rash on all four limbs and trunk. The patient was re-evaluated and was diagnosed with Stevens-Johnson syndrome. All the previous medications were stopped. The patient was treated with steroids, prophylactic antibiotics and antifungal drugs. The lesions started to heal after 5 days of hospitalization. Thus the treatment of Rheumatoid arthritis with methotrexate should be carefully considered due to its increased toxicity and risk of severe skin reactions.
ABSTRACT
Background: To assess the prescribing indicators in prescriptions of private practitioners in Kolkata. Methods: In the observational, retrospective, cross-sectional survey, 1830 prescriptions of private practitioners were collected over a 5 years period and assessed using core prescribing indicators as per the World Health Organization “How to investigate drug use in health facilities” tool. Results: Overall the average number of drug per prescription was 3.05±0.91. No drug was prescribed by generic name. Prescriptions with an antibiotics and injections were 30% (549/1830) and 8.12% (149/1830), respectively. Drugs prescribed from essential drug list (EDL) were 29.38% (1640/5582). Conclusion: Poly-pharmacy, lack of generic prescribing, low rate of prescriptions from EDL is the present prescribing scenario of private set-up based practitioners of Kolkata. Regulation and intervention is required to improve the irrational prescribing practices.