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Introdução:A administração de varfarina com antibióticos é desafiador devido ao aumento do risco de episódios hemorrágicos. Objetivo:Frente a isto, este estudo objetivou investigar as interações medicamentosas mais frequentes entre a varfarina e antibióticos. Metodologia:Foram realizadas buscas nas bases de dados PubMed, Biblioteca Virtual em Saúde (BVS) e Scientific Eletronic Library Online (Scielo) com os termos MeSH warfarin, drug interactions e antibacterial agents. Foram considerados artigos publicados em inglês e português, sem restrição de data. As interações medicamentosas foram classificadas de acordo com o drugs.com. Resultados:Um total de 19 artigos foram incluídos. Foram identificadas 85 interações medicamentosas sendo as mais prevalentes entre varfarina e antibióticos ß-lactâmicos (50%) e quinolonas e fluoroquinolonas (33%). Em relação a classificação, 41% interações medicamentosas foram importantes e 53% moderadas. Não foram encontradas interações medicamentosas entre a varfarina e dois antibióticos (2%, diritromicina e cefonicida) no drugs.com, apesar dos estudos confirmarem a interação medicamentosa. Além do uso de antibióticos, sabe-se que os níveis de coagulação durante o uso de varfarina pode ser influenciado por fatores como adesão do paciente ao tratamento, dieta, presença de infecções e uso de diversos medicamentos. Dessa forma, a compreensão sobre a influência dos antibióticos no metabolismo da varfarina é comprometida. Conclusões:Portanto, para assegurar que a terapia anticoagulante e antibiótica seja eficaz e segura para os pacientes, é crucial desenvolver estratégias de supervisão e acompanhamento. Adicionalmente, é fundamental realizar estudos adicionais para aprofundar o entendimento da interferência dos antibióticos na via metabólica da varfarina (AU).

Introduction:Administering warfarin with antibiotics poses challenges due to the increased risk of hemorrhagic episodes. Objective:Therefore, this study aimed to investigate the most frequent drug interactions between warfarin and antibiotics. Methodology:Searches were conducted in PubMed, Virtual Health Library (BVS), and the Scientific Electronic Library Online (Scielo) using the MeSH terms warfarin, drug interactions, and antibacterial agents. Articles published in English and Portuguese were considered, with no date restrictions. Drug interactions were classified according to drugs.com. Results:A total of 19 articles were included. 85 drug interactions were identified, with the most prevalent being between warfarin and ß-lactam antibiotics (50%) and quinolones/fluoroquinolones (33%). Regarding classification, 41% of DIs were categorized as major and 53% as moderate. No drug interactions were found between warfarin and two antibiotics (2%, dirithromycin and cefonicid) on drugs.com, despite studies confirming the drug interaction. In addition to antibiotic use, it is known that coagulation levels during warfarin therapy can be influenced by factors such as patient adherence to treatment, diet, presence of infections, and use of multiple medications. Therefore, understanding the influence of antibiotics on warfarin metabolism is compromised. Conclusions:Hence, to ensure that anticoagulant and antibiotic therapy is effective and safe for patients, it is crucial to develop supervision and monitoring strategies. Additionally, further studies are fundamental to deepen the understanding of antibiotics' interference in the metabolic pathway of warfarin (AU).

Introducción: La administración de warfarina con antibióticos presenta desafíos debido al aumento del riesgo de episodios hemorrágicos. Objetivo: Por lo tanto, este estudio tuvo como objetivo investigar las interacciones medicamentosas más frecuentes entre la warfarina y los antibióticos. Metodología: Se realizaron búsquedas en las bases de datos PubMed, Biblioteca Virtual en Salud (BVS) y ScientificElectronic Library Online (Scielo) utilizando los términos MeSH warfarina, drug interactions y antibacterial agents. Se consideraron artículos publicados en inglés y portugués, sin restricciones de fecha. Las interacciones medicamentosas se clasificaron según drugs.com. Resultados: Se incluyeron un total de 19 artículos. Se identificaron 85 interacciones medicamentosas, siendo las más prevalentes las entre warfarina y antibióticos ß-lactámicos (50%) y quinolonas/fluoroquinolonas (33%). En cuanto a la clasificación, el 41% de las interacciones medicamentosas fueron importantes y el 53% moderadas. No se encontraron interacciones medicamentosas entre la warfarina y dos antibióticos (2%, diritromicina y cefonicida) en drugs.com, a pesar de que los estudios confirmaron la interaccion medicamentosa. Además del uso de antibióticos, se sabe que los niveles de coagulación durante la terapia con warfarina pueden estar influenciados por factores como la adherencia del paciente al tratamiento, la dieta, la presencia de infecciones y el uso de múltiples medicamentos. Por lo tanto, la comprensión de la influencia de los antibióticos en el metabolismo de la warfarina está comprometida. Conclusiones: Por tanto, para garantizar que la terapia anticoagulante y antibiótica sea efectiva y segura para los pacientes, es crucial desarrollar estrategias de supervisión y seguimiento. Además, son fundamentales realizar estudios adicionales para profundizar en la comprensión de la interferencia de los antibióticos en la vía metabólica de la warfarina (AU).

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Background: Self-medication is prevalent globally, making the processes easier but raising potential hazards like antibiotic resistance. College students, influenced by social media, exhibit alarming self-medication behaviours. This cross-sectional study surveyed undergraduate students across medical, nursing, and non-health science institutions to assess the self-medication habits, knowledge and attitude of students. Methods: This descriptive cross-sectional study was conducted across various educational institutions from August 2023 to February 2024, targeting undergraduate students aged 18 and over. Using a pre-validated questionnaire, data on socio-demography, self-medication with antibiotics, and related knowledge were collected via Google Forms. The sample size was doubled to 1175 for better statistical power. Data analysis was performed using standard statistical tools. Results: Analysis of data demonstrated that a substantive proportion of students self-medicate with antibiotics. For medical students, convenience was the biggest issue and for non-medical students, it was cost-saving coupled with distrust in doctors. The most common complaint received for self-medication was throat pain. Medical students used textbooks for necessary information whereas non-medical students went to local shops for advice. Patterns differed somewhat in comparison with international studies, indicating regional differences. Strikingly, medical students predominantly relied on academic knowledge and previous experiences while using antibiotics, whereas non-medical students often obtained antibiotics from shops or the internet, making them vulnerable to misdiagnosis and inappropriate treatment. Conclusion: This highlights the importance of implementing specific interventions to reduce unsafe self-medication practices in students.

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Antibiotic resistance presents signicant challenges in geriatric care, where aging-related factors such as weakened immune systems, polypharmacy, and frequent hospitalizations increase susceptibility to multidrug-resistant infections. This review explores the causes and contributing factors of antibiotic resistance in elderly populations, including inappropriate prescribing practices and frequent exposure to healthcare environments. It also examines the health risks, such as higher morbidity, mortality, and prolonged hospital stays, associated with resistant infections. Current strategies, including antibiotic stewardship programs, education for healthcare providers, and enhanced infection control, are discussed. Additionally, emerging research on alternative therapies, new antibiotics, and personalized medicine approaches is highlighted. Addressing antibiotic resistance in older adults requires a multifaceted approach to ensure more effective treatment and improve overall outcomes for this vulnerable population.

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Background: Antibiotics are frequently prescribed to critically ill patients admitted to intensive care units (ICUs). About 30–60% of antibiotics prescribed in ICUs are unnecessary, inappropriate, or suboptimal and contribute substantially to the development of antimicrobial resistance. Aims and Objectives: The present study was undertaken to assess the use of antibiotics based on the World Health Organization (WHO) access, watch, and reserve (AWaRe) index in a multidisciplinary ICU of a medical college and hospital in Eastern India. Materials and Methods: The descriptive past record-based study was carried out among patients admitted in the multidisciplinary ICU of a medical college and hospital over 6 months. Information from the ICU bed head tickets (BHTs) was captured in a data record form and analyzed. Results: A total of 97 BHTs were reviewed, and 257 antibiotics were prescribed to 90 patients. The prevalence of antibiotic use was 92.78%. Average number of antibiotics per patient was 2.85. In most instances (88.89%, 80), either two (28.88%), three (27.77%), or even four (20%) antibiotics were used. Frequency of use of AWaRe antibiotics was 21.43% (51/238), 67.23% (160/238), and 11.34% (27/238), respectively. Meropenem (15.12%, 36), piperacillin-tazobactam (36, 15.12%), and ceftriaxone (35, 14.70%) were the three most frequently prescribed watch group antibiotics. Most antibiotics were used empirically (60%), and 40% (36/90) use was targeted. Conclusion: Empirical treatment with antibiotics is common in ICUs. The WHO AWaRe tool may check the injudicious and unnecessary use of antibiotics and thus promotes the rational use of antibiotics and prevent the development of antibiotic resistance in ICUs.

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Background: The progress in creating novel antibiotics has been lethargic in recent decennium, in spite of the pressing demand. Those on the brink of entering the medical field – final-year undergraduates, interns, and postgraduate residents – represent the forthcoming cohort of antimicrobial prescribers. It is imperative that they possess a comprehensive understanding and a conscientious approach to antibiotic prescription. This is crucial to address antibiotic resistance sagaciously and pave the way for judicious management. Aims and Objectives: The aims and objectives of the study are to assess understanding and attitudes about antibiotics, resistance, and related factors among undergraduate, intern, and postgraduate medical students. Materials and Methods: A group of 144 individuals (35 final-year medical students, 72 interns, and 37 resident doctors) completed a pre-validated questionnaire. Data collected included basic antimicrobial information, treatment protocol comprehension, and attitudes toward antimicrobials. Percentages were calculated for categorical data, and Chi-square tests were used for statistical analysis (significance level P < 0.05). Results: 86.8% correctly identified infections requiring antibiotics; 12.5% mistakenly thought that both viral and bacterial infections needed antibiotics. 93.8% said that antibiotics could be used for treatment and prophylaxis. 94.4% agreed that overuse and misuse cause antibiotic resistance. 31.3% and 62.5% identified macrolides and fluoroquinolones as common for upper respiratory infections and urinary tract infections, respectively, with a P < 0.05. 71.52% knew about infection control programs, and 48.6% were aware of their institute’s antibiotic policy. Conclusion: Despite strong foundational knowledge about antibiotics, gaps remain. The study’s findings could help set new goals for teaching medical students proper antibiotic knowledge and attitudes toward antibiotic recommendation.

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Introduction: One of the greatest threats to global development and public health is antimicrobial resistance (AMR). The ability of bacteria and other microbes to resist the drugs used to inactivate them is known as AMR. According to estimates, bacterial AMR caused 4.95 million fatalities worldwide in 2019 in addition to directly causing 1.27 million deaths. Methodology: In this cross-sectional descriptive study using convenient sampling method, 422 out patients were recruited from the tertiary care hospital in our district between December 2023 and March 2024. We inquired about sociodemographic characteristics and reasons for self-medicating with antibiotics. Results: 353(83.6%) patients were self-medicating due to previous successful use of antibiotic. 122(28.9%) believed that antibiotics are used to treat all infections. 80 (18.95%) participants in the age group of 36- 44 years were self-medicating with antibiotics

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Antibiotics (ABs) resistance is a worldwide health issue. However, there is a lack of awareness toward the proper use of ABs. This study was designed to assess the awareness of antibiotic usage and antibiotic resistance (ABR) among the public. A population-based survey was executed from September to November 2023. A validated questionnaire was administered to 600 participants. Data were analyzed through Statistical Package for the Social Sciences version 25. Multivariate regression was administered to identify associated factors with awareness. The results revealed a high prevalence of ABs consumption. The public knowledge of ABs was suboptimal where (50.2%) of the participants had sufficient knowledge. Moreover, it is worth highlighting that respondents hold a generally positive attitude (72.3%) and satisfactory practice (69.7%). Participants who are older, male, educated, married, and employed typically have significantly higher mean scores in knowledge, attitude, and practice. Public awareness about proper antibiotic usage and ABR is a vital public health concern. Considering the current study’s findings, ongoing educational activities should emphasize the importance of improving the public’s judicious use of ABs, which may help curb the spread of ABR. Educational campaigns to improve health literacy regarding dispensing, purchasing, prescribing, and using ABs are recommended particularly for the target groups.

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Spontaneous bacterial peritonitis (SBP) is a life-threatening infection in patients with cirrhosis and ascites. Early recognition and prompt treatment with empirical antibiotics, albumin administration, and supportive care are essential to improve outcomes. This review discusses the pathogenesis, clinical manifestations, diagnosis, treatment, and prevention strategies for SBP, emphasizing the importance of timely intervention. Preventive measures, including secondary prophylaxis with antibiotics, are recommended for high-risk patients to reduce recurrence rates. Enhanced diagnostic techniques and tailored treatment approaches are critical for managing SBP effectively.

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Background: The menace of antimicrobial resistance (AMR) disproportionately affects low and middle-income countries. The general public plays a major role in the emergence and spread of AMR. Aim and Objectives: (1) The aim and objectives of the study are to assess the current knowledge, attitude, and practices regarding antibiotic usage in the general population of Karnataka; (2) to identify demographic characteristics associated with particular knowledge, attitude, and practices; and (3) to determine whether a person’s attitudes toward and knowledge of risks associated with taking antibiotics affected the practices relating to antibiotic use. Materials and Methods: An online cross-sectional survey was conducted using a structured and validated questionnaire using the Google Forms platform. The questionnaire consisted of participant’s demographic data and questions to assess the knowledge, attitude, and practices pertaining to antibiotic use. Chi-square test was used to assess the association between demographic variables and knowledge, attitude, and practice scores. Linear regression was used to examine the association between knowledge, attitude, and practice scores. Results: 510 respondents were included in the study. The performance of the participants in all three domains in our study was average with only 48.43% securing a “good” score. 20.20% believed that antibiotics were used to treat viral infections, 48.43% were aware of the meaning of antibiotic resistance, 37.06% believed that antibiotics which worked earlier can be re-used, 30.20% believed that there is no need to complete the antibiotic course, and 32.94% thought that antibiotics could be shared with friends. 14.9% said that they had received antibiotic without prescription. Scores improved significantly with increase in the level of education (P < 0.001) and the occupational level of the participants (P < 0.001). Linear regression analysis demonstrated a positive effect of knowledge and attitude on practice regarding antibiotic use (P < 0.001). Conclusions: The current study reiterates that the level of knowledge regarding antibiotics and AMR in the Indian public is only average. A combination of educational programs and stringent legislation should be implemented to limit the menace of AMR.

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Mechanosensitive channels are integral membrane proteins in bacterial cell membranes as well as archaea, and eukaryotes. The role of these bacterial mechanosensitive channels is essential for protecting cells from structural damage during hypoosmotic shock. Mechanosensitive channel of small conductance (MscS) and mechanosensitive channels of large conductance (MscL) are the predominant channels in E. coli. Activation of mechanosensitive channels typically occurs when the bacterial membrane senses tension or distortion. Overall, the ecological niche of bacteria shapes the selective pressures acting on mechanosensitive channels, leading to their adaptation to specific environmental conditions. Bacterial mechanosensitive channels contribute to the ability of bacterial pathogens to adapt to and survive within the host environment, as well as to modulate interactions with host cells and tissues during infection. They could also act as entrance gates for specific antibiotic classes into bacterial cells. Accordingly, it was discovered that nitrofuran nifuroxazide and tuberactinomycin viomycin depended on both Ec-MscS and Ec-MscL for enhanced efficacy. Several compounds have been identified that directly target mechanosensitive channels. For example, ramizol has been shown to reduce the gating threshold of MscL and MscS channels, while styrylbenzene inhibits MscL channels in S. aureus, Streptococcus pneumoniae, and Clostridium difficile. Bacterial mechanosensitive channels are versatile drug targets due to their role in promoting bacterial virulence and host colonization, serving as entry points for antibiotics, and being structurally distinct from mammalian counterparts. These special structures which are meant to protect the cell can also be harnessed as drug targets, thereby increasing the susceptibility of the bacterial cell to target antibiotics. This feature has been harnessed to reduce the burden of antibiotics resistance and its attendant effect on global healthcare complications. The aim of this review is to examine the various physiological, drug resistance and pathogenicity roles of these mechanosensitive channels as well as their usefulness as potential drug targets.

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Objectives: The introduction of the study discusses the prevalence of Urinary Tract Infections (UTIs) as a common hospital-acquired infection worldwide. The specific goals of the study were to isolate and identify the organisms causing UTIs, and determine their antimicrobial sensitivity patterns. Material and Methods: A total of 150 consecutive urine samples were collected over a 24 month period from selected surveillance units Medical-Surgical ICU (MICU) Respiratory ICU (RICU) Pediatric ICU (PICU). Microbiological culture, subsequent bacterial identification and antimicrobial susceptibility test were performed for the positive samples. The prevalence of the causative agents was analyzed according to the patient’s gender and age group. Results: A total of 45 uropathogens were isolated, with Enterococcus spp. being the most common at 33.3%. The study found that Nitrofurantoin antibiotic had the highest sensitivity at 77% against Enterococcus spp. The study also found that nosocomial infections lengthened hospital and intensive care unit stays, and during the surveillance period eight patients expired, who were infected by Enterococcus spp., Klebsiella pneumoniae, Enterobacter spp. and Klebsiella spp. Conclusion: The conclusion section of the study highlights that the study documented the pathogenic effect of Enterococcus spp., which was responsible for the majority of infections. This study may be useful for future studies to assess the genetic profile of the MDR gene of isolated microorganisms and to early assess the methods for detecting pathogenic organisms in clinical samples in order to save lives in critical care units. The study also suggests that Nitrofurantoin antibiotic was found to be the most effective against urinary tract isolates of Enterococcus spp.

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Aims: The aim of the study is to assess antibiotic utilization patterns among critically ill and post-operative ICU patients, with the goals of optimizing prescribing practices, evaluating adherence to guidelines, and minimizing risks associated with antibiotic resistance. Study Design: Prospective Observational. Place and Duration of Study: BAPS Pramukh Swami Hospital, Surat between November 2022-March 2023. Materials and Methods: The study included 108 patients directly admitted to the ICU, selected based on specific inclusion criteria. Eligible patients were aged 18 years or older and categorized as critically ill or post-operative patients requiring ICU admission. Additionally, patients needed to have been prescribed at least one antibiotic, whether for prophylactic or therapeutic purposes. Detailed demographic and clinical data were recorded for each patient using a pre-established case report form. The study aimed to analyze adverse events associated with antibiotic usage among these ICU patients, utilizing Microsoft Excel for data analysis. Results: The total number of prescribed antibiotics was 235, the empirically prescribed antibiotics were Cefoperazone + Sulbactam 54 (21%) followed by Ceftriaxone (14%) and Meropenem (12%). The multiple therapy was prescribed in 63 (58%) patients. The most utilized were from WHO Watch Class 163 (69%). The value obtained for the average number of antibiotics per encounter was 2.15 (WHO optimal value: 1.6 – 1.8). The adverse events associated with antibiotics were observed in 16 patients. A culture sensitivity test was performed in 28.7% of patients. The most common pathogen detected was E.coli and K. pneumoniae. Conclusion: The study reflects the requirement of antimicrobial stewardship practice, which should focus on promoting rational antibiotic prescription, which will help in combat with critical resistance issues in the future

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Probiotics are live microorganisms that have been identified as natural alternatives to antibiotics, which are typically used to treat bacterial infections causing many diseases in both humans and animals. It discusses the benefits and drawbacks of probiotics and presents evidence from recent clinical trials and experimental models, showcasing their potential to protect human and animal health. Probiotics have demonstrated potential in enhancing health and aiding in the treatment and prevention of various conditions such as antibiotic-associated diarrhea (AAD), irritable bowel syndrome (IBS), and periodontal diseases. The human gut harbors a diverse microbial community crucial for intestinal health. Disruptions in this microbiome are linked to diseases like inflammatory bowel disease (IBD), cancer, cardiovascular disease, and metabolic disorders. Probiotics help restore gut microbiota balance, particularly during antibiotic treatments, reducing AAD incidence. They alleviate IBS symptoms and maintain oral health by modulating oral biofilm, reducing pathogen colonization, and enhancing immune response. Additionally, probiotics exhibit anti-carcinogenic properties by inhibiting bacterial enzymes involved in carcinogen formation and binding aflatoxins, thereby reducing cancer risk. Although antibiotics are life-saving drugs for bacterial illnesses, their excessive and inappropriate usage has led to increased bacterial antimicrobial resistance (AMR) and host microbiota imbalance, or dysbiosis. AMR is a major global health threat, potentially leading to millions of deaths annually. Thus, finding and creating antibiotic substitutes is imperative. Evidence suggests that probiotics can counteract infections, modulate immune responses, and regulate gut flora to preserve overall human health. This analysis also examines the potential use of probiotics by their various mechanism to act against infections

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Background: The World Health Organization (WHO) states that Antimicrobial resistance (AMR) is a serious public health issue that is only getting worse. Antibiotic misuse leads to serious complications such as prolonged hospital admissions, high death rates, and increased financial load. While a number of factors have been identified as contributing to the development of AMR, inappropriate antibiotic usage has been identified as the primary cause. Taking antibiotics more often than prescribed, not taking them to their full recommended dosage, sharing prescription medications, storing medication for later use to treat the same symptoms, and obtaining antibiotics without a prescription are some of the factors that contribute to antimicrobial resistance (AMR). Aims and Objectives: The aims and objectives of the study are to assess the knowledge, attitudes, and practices of public regarding the use of antimicrobial use and antimicrobial resistance; evaluating potential corrective measures to address the problem; selecting effective communication strategies to raise awareness; and to analyze the factors associated with a higher level of knowledge about antimicrobial resistance. Materials and Methods: A descriptive cross- sectional study was carried out after obtaining approval from the Institutional Ethics Committee, from July 28th, 2022, to September 28th, 2022, with a sample size of 488 voluntary participants from general public visiting outpatient departments (OPDs) of Rajiv Gandhi Government General Hospital (RGGGH), Chennai. The participants’ knowledge, attitude, and practices regarding the use of antibiotics and antimicrobial resistance were assessed through a questionnaire in English and translated into the local language (Tamil). Results: A total of 488 responses were received from patients visiting the various OPDs of RGGGH, Chennai. Among the respondents, the majority were females 257 (52.7%) of age groups, 18–25 years (172, 35.2%). The respondents were also grouped based on their level of education and found that most of them had completed class 12, 218 (44.7%). Previous history of antibiotic use was assessed and found that 417 (85.5%) participants had taken antibiotics within the past 12 months before the study. Our study found that the majority of respondents (280, 57.4%) knew that the full course of antibiotics should be taken as directed. Practices of acquiring antibiotics were also assessed in our study and found that 301 respondents (61.7%) said they have never purchased antibiotics without consulting a doctor. The proper use of antibiotics was another question that participants were asked and 288 (59%) participants answered that they had received this explanation from health-care workers. The knowledge about antibiotic use was assessed and found that the majority of participants (368, 75.4%) correctly identified urinary tract infection as a disease that can be cured by antibiotics. Our study also revealed that most of the participants (317, 64.9%) had awareness about the antibiotic resistance from thegiven list of terms related to issue of antibiotic resistance. Conclusion: The majority of the general people who visited the RGGGH’s OPDs revealed good attitudes and awareness regarding the severity of antimicrobial resistance (AMR) and the significance of using antibiotics appropriately. Their knowledge, attitudes, and behaviors are determined to be highly satisfactory. There were afew minor fallacies, such as the idea that antibiotics work well against colds. To more accurately assess the baseline circumstances of the broader population, there is a greater need for research in this field using multicentric approaches and a modified demographic focus.

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Infection of Pseudomonas aeruginosa has been responsible for economic losses in younger birds. This research was designed to report and document multidrug resistant P. aeruginosa recovered from chicken during infection. Sixty-seven freshly dead chicken were used in this research, the trachea, the liver, and the heart were targeted for P. aeruginosa isolation. The isolates were identified based on the cultural, morphological, and biochemical characteristics. Antimicrobial test was carried out on the pure isolates using the disc diffusion method. A total of 23 isolates of P. aeruginosa were recovered; 19 isolates were recovered from the trachea, 3 from the liver and 1 from the heart. All the isolates were showing green pigment on nutrient agar, they were all Gram-negative rods, motile, catalase and citrate positive. The result of the antibiotic susceptibility showed that ampicillin was most resisted with a resistance of 95.7% (22) while gentamicin was least resisted with 39.1% (9), and 69.5% (16) of the isolates were showing resistance to more than three antibiotics. The most encountered resistant pattern was AMP, TLY with 87%. The result from this study revealed that multidrug resistant P. aeruginosa in poultry may be emerging and serving as a reservoir for resistant P. aeruginosa gene.

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Treating aggressive periodontitis (AgP) is quite challenging. Conventional treatment for aggressive periodontitis involves systemic antibiotics (AB) with scaling and root planing (SRP). However, antimicrobial photodynamic therapy (aPDT) presents a promising alternative due to its targeted action and reduced side effects. This suggests the need to analyse and compare both treatments to determine the best approach for effective management of AgP. A systematic literature searches in three databases: PubMed, Google Scholar, and Cochrane, and a hand search of relevant scientific journals was performed. The eligible studies included randomized controlled trials (RCTs) with parallel-group design, comparing aPDT to AB as adjuncts to SRP for treating AgP. Studies published in English language between January 2003 and December 2023 were included. Studies were assessed for quality using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB 2) and were classified as high-quality studies. Five RCTs meeting eligibility criteria were selected and underwent qualitative analysis. The clinical parameters assessed in studies were Pocket Probing Depth (PPD), Bleeding on Probing (BOP), and Clinical Attachment Level (CAL). Two studies reported significant improvements in all parameters with both therapies, three studies indicated a greater reduction in clinical parameters in the AB group compared to aPDT. Adjunctive use of AB with SRP results in significant clinical outcomes compared to SRP and aPDT. According to the studies of this systematic review 4-5 applications of aPDT with an interval of 7 days, and a follow-up period of 6 months are beneficial in treating AgP.

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Background: Pharmaceuticals in the environment is known since last two decades. As hospitals and pharma industries, household medicines also need proper disposal otherwise they will gradually find their way into environment. So, we did a survey of residents in major metro city to understand their medicine wastage as well as disposal practices. Methods: Pharmaceuticals in the environment is known since last two decades. As hospitals and pharma industries, household medicines also need proper disposal otherwise they will gradually find their way into environment. So, we did a survey of residents in major metro city to understand their medicine wastage as well as disposal practices. Results: The water samples screened for antibiotic presence were all negative from 10 locations. A total population of 749 people, from 165 houses were included in the study. Leftover medicines were found in 75.8% houses, of which 5.36% houses had leftover antibiotics. Garbage disposal (58.2%) was the most commonly observed method of medicine disposal. Good attitude towards proper antibiotic disposal was independently significant with higher education (OR=2.5, 95% CI= 1.05-6.17), employment (OR=2.1, 95% CI= 1.05-4.3), and upper middle-class families (OR=2.4, 95% CI= 1.08-5.21). Conclusions: Lack of proper guidelines for household medicine disposal across the country is reflected in our community too. Although this study could not detect antibiotics in the canal water, the emerging resistance pattern across the state reflects it could be there. Therefore, immediate action on medicine waste collections needs to be implemented.

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Background: Acute appendicitis is one of the most common acute surgery events. Appendicitis must be considered in every patient who presents with acute abdominal pain. Its main treatment is surgery. However medical management before and after the surgery has an important impact on the treatment. Single or multiple-dose regimens of antibiotics may rely on the patient’s medical situation and the patient’s susceptibility to infection. The present study was therefore planned to evaluate the effectiveness and outcomes of the single dose of antibiotics in patients undergoing laparoscopic appendectomy. Aim of the study is whether a single dose of antibiotic in laparoscopic appendectomy is sufficient. Materials and Methods: The retrospective case study was conducted in Department of General Surgery, Dhiraj Hospital, SBKS, Vadodara, Gujarat, India from March 2023 -September 2023 among 50 patients scheduled for laparoscopic appendectomy. Results: Out of 50 patients, majority 80% were males and 20% were females. Most common symptom was right iliac fossa pain. Out of 50, 34 patients underwent planned laparoscopic appendectomy while 16 underwent emergency laparoscopic appendectomy. Out of 50 patients, 10 patients had SSI. In 10 patients with SSI, swab culture of the wound was done out of which 8 patients were negative and 2 patients were positive for infection. Only 10% of the patients had wound infection. Conclusion: For basic, uncomplicated acute appendicitis, single dose of prophylactic antibiotics will help in cases of laparoscopic appendectomy. There is no necessity for the post-operative administration of antibiotics.

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Background: Antibiotics are commonly used in dermatology for infectious and inflammatory diseases. A study on the pattern of prescriptions will help in establishing fundamental data to enhance the utilization pattern of medications, elevate the standard of treatment, and enable prescribers to identify issues associated with drug usage, including adverse drug reactions, antibiotic resistance, drug interactions, and polypharmacy. Aim and Objective: The aim of the study was to describe the prescription pattern of antibiotics given to inpatients with dermatological disorders. Materials and Methods: This was a record-based descriptive study where the case records of 240 inpatients of the dermatology department of a tertiary care teaching hospital during the period from January 2019 to January 2022 were studied. The demographic profile, pattern of skin diseases reported, and pattern in antibiotic drugs usage were recorded with the help of a predesigned pro forma. Results: The mean age of the study population was 52.04 ± 16.91 years with male to female ratio 2.62:1. The most common skin disease diagnosed was Psoriasis (17.91%). Out of the 518 antibiotics prescribed to the patients in the study, the most preferred route of antibiotic administration was oral (48.84%). The most common oral antibiotic was cloxacillin (37.94%) while the most common parenteral antibiotic prescribed was cefotaxime (83%). Fusidic acid (78%) and mupirocin (16%) were commonly prescribed among the topical antibiotics. Amoxicillin- clavulanic acid combination (76%) was commonly prescribed among the fixed drug combinations. Among the topical antibiotics, 8.78% were prescribed as fixed-dose combination with steroids. Antibiotics (29%) constitute the major class of drugs among prescriptions followed by steroids (14%) and antacids (11%). Most of the prescribed antibiotics belonged to the Access group of antibiotics according to AWaRe classification of antibiotics (63.2%). Conclusion: The most common class of antibiotics prescribed was beta-lactam group of antibiotics. The study will help in formulating guidelines for rational prescription of antibiotics with special reference to dermatological cases and create awareness among physicians for effective therapeutic outcome. This will avoid the burden of antimicrobial resistance and pave pathway for the strengthening of economy.

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Cephalosporins are the commonly used group of antibiotics in hospitals and healthcare facilities around the world. The inappropriate use of antibiotics, especially broad-spectrum antibiotics in hospitals, leads to antibiotic resistance. Drug utilization pattern is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. Third-generation cephalosporins are the most commonly prescribed broad-spectrum antibiotics, evenbefore culture sensitivity resultsareavailable. The objective ofthe current study was carriedout to evaluate the drug utilization and prescribing pattern of third generation cephalosporins in the in-patient department of surgery wards of a tertiary care teaching hospital. A predesigned data collection form was used to collect the data and it was analyzed using Microsoft Excel. A total of 120 inpatients were enrolled in the study. Among 120 patients, male were predominant 92 (76.7 %). More number of patients enrolled between the age group of 51-60 years [32 (26.7%)]. Patients with comorbidities were 51 (42.5 %). This research study can help provide feedback to prescribers, thereby increasing awareness and improving patient care through appropriate medication use. From this study, it was clear that intravenous form of third generation cephalosporins are predominantlyused.This study showedthatdrugsarepredominantlyprescribedbybrandnames.