Knowledge, attitude, and practice toward antibiotic usage among general practitioners: A cross-sectional study

Background: In the developing countries like India, infections are still very common. About 50% of the patients presenting to general practitioners had fever as the complaint pointing that infective ailments still predominate. Aims and Objectives: The use of antimicrobials is very common in practice that leads to the development of antimicrobial resistance. Materials and Methods: A total of 120 GP’s were registered for the present study. Assessment was done based on the special questionnaire prepared for assessing the knowledge, attitude, and practice (KAP) of the GP’s. Results: Data were collected from the Google Forms, which was then analyzed using Statistical software. No statistical difference between KAP of all pathies was observed. There is a statistically significant positive correlation between number of patients attended per day and antibiotics prescribed. This correlation is strong between allopathy practitioners whereas it’s moderate in homeopathy and Ayurveda practitioners. There is a statistically significant association between KAP. Conclusion: Self-medication and modification in the treatment by the patients; unnecessary and improper use by physicians and pharmacists themselves giving antimicrobials without prescription are some of the common problems in irrational use of antimicrobials. From this study, we can conclude that KAP of GP’s has an association with usage of antibiotics and thus programs for promoting and improving KAP’s can be useful in managing the irrational use of antibiotics.

Use of information technology to improve patient compliance: A pilot study

Background: Compliance with treatment is the key link between treatment and outcome in medical care, non-compliance leads to failure of treatment. Noncompliance with antimicrobial agents (AMAs) is the important reason for Resistance to antimicrobials. Forgetting to take medicine is one of the important causes of non-compliance. Aim and Objectives: Hence, the present study was planned to evaluate the compliance for antimicrobial treatment in patients receiving a short course of antimicrobials, with or without reminding them to take medicine using a smartphone app. Materials and Methods: Prospective interventional study was planned in a tertiary care hospital after permission from the ethics committee. The present pilot work of the study was carried out on 30 patients receiving AMAs. Patients receiving a short course of chemotherapy were enrolled and stratified based on the frequency of administration of antimicrobials. They were then allocated alternately in control (15) and study (15) groups. After explaining the prescription to all, “Pill Reminder” app was downloaded on smartphones of participants in the study group. All were contacted to enquire about compliance at the end of the treatment period. Results: Baseline characteristics of participants in both groups were comparable. URTI, UTI Tinea cruris, Tinea capitis were the disorders for which they received AMAs. The frequency of administration was once/twice/thrice a day. Duration was 3–14 days in both groups. At the end of the study, 53.3% of patients in control group and 100% of patients in intervention group were compliant to the treatment. Conclusion: The use of the reminder app significantly improved patient’s compliance with medications. Further studies are required to validate these results.

False-positive widal in melioidosis.

Enteric fever is endemic in this part of the world, and Widal test is one of the time-honored laboratory tests that are being used for years to diagnose the disease. On the other hand, melioidosis is a newly emerging disease from this region, which is most often misdiagnosed or underdiagnosed by clinicians. It is well accepted that false-positive Widal reactions following certain non-typhoid Salmonella infections may occur commonly. Three cases of high titers of Widal test are described, where melioidosis was the actual diagnosis in every occasion and was never suspected until diagnosed microbiologically. All the patients had shown a partial response to ceftriaxone. Blood and pus cultures grew Burkholderia pseudomallei, whereas Salmonella typhi was not isolated from blood in any patient. With appropriate antibiotics, the patients showed clinical and microbiological improvement with lowering of Widal titers. These 3 cases show that high Widal titer in any patient may mislead the diagnosis of melioidosis, and further laboratory workup should always be done to rule out melioidosis, especially in cases with nonresponsiveness to treatment.

Rapid fluorescent focus inhibition test for rabies antibody estimation using murine neuroblastoma cell line.

A rapid fluorescent focus inhibition test (RFFIT) for rabies antibody estimation has been standardized in which murine neuroblastoma cell line, Neuro-2A and tissue culture microtiter plates were used. Serum samples from 105 human beings, 30 canines, 7 rabbits and 4 monkeys were tested by RFFIT. Of these, 33 human and 20 canine sera were also tested by the mouse neutralization test (MNT). Twelve human sera were tested by RFFIT, MNT and ELISA. There was 94 per cent correlation between the results obtained by RFFIT and MNT, while in 6 per cent of the sera tested, the RFFIT was found to be more sensitive than the MNT.