RESUMEN
Background: The aim of study was to determine the utilization pattern of antimicrobial agents in obstetrics and gynaecology department. Antimicrobial agents are one of the most commonly used drugs word wide and has main contribution in human health system. UTI infection is one of the most widespread bacterial infections of genitourinary tract which can be treated by AMAs. The main aim of this study is; to identify the pattern of drug utilisation of antimicrobials in prescriptions, to analyse the utilisation of different classes of drugs and to identify the outcome of the treatment. Methods: This prospective, observational and analytical study was conducted in patients of obstetrics and gynaecology department of MMIMSR, Mullana after obtaining approval from institutional ethical committee. Demographic data, medical history, prescribed treatment details (drug name, dose, frequency, dosage form etc) and diagnosis, type of UTI, laboratory investigations and outcome of treatment was evaluated. Results: A total 242 female patients were registered, out of which 200 were included in the study as 42 were dropouts. Majority of female patients were belonging to the age group of 18-37 (63%). Most of the female patients had uncomplicated UTI 188 (94%) (p value=0.35), 186 (93%) had significant pyuria and 64 (32%) had urine culture positive (p value= 0.01). Burning micturation and frequency were the most common symptoms observed in 146 (73%). In the study 67(33.5%) females were pregnant and 133 (66.5%) were non pregnant (p value= 0.01). Out of 200 patients 64 (32%) had positive urine cultures and 136 (68%) had negative urine culture reports. E. coli 28 (14%) was the most common bacteria isolated followed by Klebsiella 16 (8%). Average number of drugs prescribed per prescription to non-pregnant was 3.97 and to pregnant were 4.67. In majority of prescriptions, the drugs were prescribed by oral routes (51%) and most of the drugs prescribed were generic (57%). Most of the patients (93%) were recovered from UTIs in 5-7 days of treatment. Conclusions: Our study concluded that the uses of AMAs for UTI were found to be rational and according to the causative organism and susceptibility pattern.
RESUMEN
Emphysematous pyelonephritis is a severe infection characterized by the presence of gas within the renal parenchyma tissues. It is a life threatening complication of bacterial interstitial nephritis, and it mainly occurs in patients with diabetes mellitus. We report a case of a 37 year old female who complained of fever and pain in left lumbar region on admission. Her past medical history included uncontrolled type 2 diabetes mellitus. On USG (ultrasonography), left kidney swollen and show echogenic linear specs with dirty shadowing suggestive of air in pelvicalyceal system (PCS). She was treated with intensive antibiotic therapy in high doses. On repeat USG there was marked reduction in air shadow in kidney and patient improved clinically.