ABSTRACT
Background: Complicated UTIs (cUTIs) are leading causes of the gram negative bacteraemia. The objective of this study was to compare efficacy and safety Cefotaxime/ Sulbactam (CTS) and Piperacillin/ Tazobactam (PT) combinations in complicated Urinary Tract Infections.Methods: Total 80 patients admitted in the hospital due to cUTI were enrolled. 31 patients were given CTS while 49 patients were given PT. Clinical symptoms were registered and scored as mild (1) moderate (2) or severe (3). The follow-up of were done daily till the patient is discharged. Thereafter, one follow up visit was done within 4 to 9 days of after discharge, termed as test of cure (TOC), and, one late follow up visit after 6 to 8 weeks was done, known as late follow up visit (LFU). Clinical assessments and microbiological analysis were done at the time of TOC and LFU.Results: At TOC visit, in CTS and PT groups, clinical scores were 1.25�47 and 0.86�35, respectively (p<0.005). Rate of clinical improvement at TOC visit was 92.00% and 92.68% while microbiological clearance was 84.00% and 87.80% with CTS and PT groups respectively. At LFU visit, clinical scores CTS and PT in groups were 1.30�56 and 1.32�37, respectively, suggesting significant improvement from baseline (p<0.005). Clinical cure rate at LFU visit was 88.00% and 87.80% while microbiological cure rate at LFU visit was 76.00% and 82.91% in CTS and PT groups respectively.Conclusions: Results suggest that both regimens have no significant difference for the treatment of cUTI. CTS and PT both are equally efficacious in treatment of cUTI.
ABSTRACT
Objective: To compare the efficacy and safety of different oral and parenteral iron preparations in patients with anemia. Methods: An observational, prospective study in patients of anemia in pregnancy and chronic kidney disease (CKD) receiving iron sucrose, oral ferrous ascorbate and ferrous sulfate were included. Demographic details, clinical history, baseline hemoglobin, anemia indices data were recorded in a case record form. The patients were followed up monthly for 12 weeks and observed for clinical and haematological improvement and adverse drug reactions (ADRs). The data was analyzed using paired t-test, unpaired t-test and Fisher`s exact test. Results: Out of 232 patients, 84 received iron sucrose, 62 ferrous ascorbate and 86 ferrous sulfate. Oral and parenteral iron preparations significantly (P<0.0001) improved mean hemoglobin, anemia indices and serum ferritin at the end of study. However, mean increase in hemoglobin and anemia indices were significant (P<0.0001) with iron sucrose (4.42 ± 0.17gms/dL) as compared to ferrous ascorbate (3.45 ± 0.1) and sulfate (3.3 ± 0.4). Increase in serum ferritin was more and rapid (at 4 weeks) with iron sucrose as compared to ferrous ascorbate in CKD patients. Surprisingly, ADRs were more in patients treated with oral ferrous sulfate (86%) and ascorbate (71%) compared to iron sucrose (63%). Conclusion: Parenteral iron sucrose improves hemoglobin. anemia indices and replenish iron stores rapidly and is well tolerated than oral iron preparations.