Drug Prescribing Pattern of Antibiotics for Treatment of Methicillin Resistant Staphylococcus aureus.

Control of MRSA in hospital is essential. It can be achieved by proper implementation of hospital infection control measures, regular surveillance activity and selecting the right antibiotic is an important determinant of clinical outcome in such cases. Present paper deals with the antibiotics prescribing pattern for MRSA infections by doctors, which can be used to monitor the geographical spread and the selection pressure resulting from antibiotic usage. Material & Methods: For this study, a questionnaire was prepared which include list of antibiotics used for treatment of MRSA. A total of 83 doctors were surveyed, responses were received by 76 (91.6%) physicians (68 hospital setting or working in the hospital and 8 were skin specialist). Results: The vancomycin, an intravenous drug, was the most prescribed drug (53.9%). The amoxycillin+ calvulanic acid (Augmentin) and piperacillin+ tazobactum (Zosyn) were prescribed by physicians (53.9%) and (27.6%) respectively. Other cephalosporins (with or without sublactam combination) and carbapenems were prescribed by less than 20% doctors. The linezolid is next drug that was recommended by doctors (38.2%). Other drugs were prescribed by less than 20% of physicians which include amikacin, gentamicin, erythromycin, clarithromycin, levofloxacin, ofloxacin, ciprofloxacin, gatifloxacin, quinupristin-dalfopristin, clindamycin and rifampin. Mupirocin was prescribed by 4.5% of physicians. Conclusions: In conclusion, vancomycin remains a first-choice of drug by physicians for severe infections possibly caused by MRSA. As per them, other antibiotic agents may be appropriate to consider in some circumstances. Combination of â-lactam antibiotics, macrolides and aminoglycosides was generally to cover other gram-positive and/or gram-negative, aerobic and anaerobic organisms.

Detection of resistance to linezolid in Staphylococcus aureus infecting orthopedic patients.

Context: In today's medical scenario, the human race is battling the most intelligent enemy who has unending alternatives to combat with the potent elements they have produced against it. Aim: To study the resistance to linezolid among Staphylococcus aureus isolated from pus samples of orthopedic patients. Settings and Design: Pus samples were collected from dirty wounds of orthopedic patients undergoing long antimicrobial treatment programs. The sampling period was from July 2010 to June 2011. The samples were collected from different orthopedic hospitals of Nagpur (central India) representing a mixed sample of patients. Materials and Methods: One hundred pus samples were screened for S. aureus, by growth on mannitol salt agar (MSA), Baird-Parker agar (BPA), deoxyribonuclease test, tube coagulase test, and HiStaph latex agglutination test. Fifty-one S. aureus isolates were obtained which were further subjected to antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method (DDM). Minimal inhibitory concentrations (MICs) were determined by an automated system, the VITEK 2 system. Also, Ezy MIC strip method was carried out in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Results and Conclusion: Twelve linezolid-resistant S. aureus (LRSA) isolates were recovered from 51 S. aureus cultures tested for susceptibility to linezolid using the DDM, VITEK 2 system, and Ezy MIC strip method. The emergence of resistance suggests nosocomial spread and abuse of antibiotic.

Surveillance of antibiotic susceptibility pattern among shigella flexneri strain isolated in Nagpur district during three years period, January 2009-January 2012.

Objective : In the few cases of childhood dirrhea that require the antimicrobial therapy, the correct choice of the drug depends on detailed previous knowledge of local strains and pattern of antimicrobial resistance. Shigellosis is one of the most improtant examples of this group of intestinal infections. In order to establish such parameters in Nagpur city, this study was carried out to determine the antimcrobial resistance profile of Shigella flexneri isolated from patients suffering from diahhrea admitted to Various hoapitals in Nagpur district, India. Materials and Methods: The study included 110 stool samples collected from patients during the 3 year period. All the isolates were characterized and confirmed by VITEK® 2 GN ID cards and antimicrobial susceptibility was tested by VITEK® 2 AST test cards. Results: We received 73 positive cultures of S. flexneri out of 110 stool samples during three year periods of January 2009 to January 2012. S. flexneri strains presented a high resistance rate to Ampicillin (100%), Chloramphenicol (76.71%), Trimethoprime-sulfamethaxazole (TMP-SMZ) (68.49%) and low resistance to third- and fourth-generation Cephalosporin. None of the isolates was found to be resistant to Ciprofloxacin (MIC ≥ 4), Norfloxacin (MIC ≥12), and Nalidixic acid (MIC ≥30). Conclusion: Our results provide data on antimicrobial resistance to choose a proper antibiotic for the treatment of Shigellosis in our country. According to current findings, Quinolones and Cephalosporins are the drug of choice for the diarrheic patients. In conclusion, systematic monitoring is needed to identify changes in the antimicrobial resistance.