RESUMEN
Background: To limit the emergence and spread of antibiotic resistance, adjustments in the antibiotic regimen should be done according to the results of blood cultures as soon as they are available. This study was planned to determine the effect of blood culture and sensitivity tests on the antibiotics use in ICU patients of a tertiary care teaching hospital. Methods: This chart review retrospective study was carried out in ICU patients of a tertiary care teaching hospital. The data was collected from patients’ medical record file in a case record form which included patient’s demographic details, provisional diagnosis/or diagnosis, blood culture reports, and antimicrobial treatment (both the empiric treatment as well as the change made after the release of the blood culture results). The effect of blood culture results on antibiotic treatment was analysed. Results: A total of 245 patients were subjected to blood culture during the period of 6 months with an average of 40.8/month. 86 (35.1%) patients showed positive blood culture results, while 159 (64.9%) patients showed negative blood culture results. 55 patients discharged after the release of blood culture and sensitivity results. Antibiotic regimens were modified or changed in 26 (47.27%), and in 29 (52.72%) there was no modification. Most commonly used antibiotic after blood culture reports were meropenem (34.62%) followed by 11.54% of each teicoplanin, piperacillin+ tazobactum and tigecyclin. Conclusions: Blood culture reports help in management of critically ill patients if bacteria are resistant to previously used antibiotic, but do not help in narrowing the therapy in ICU patients.
RESUMEN
Background: Same drug can be sold for different prices under different brand names due to various reasons. Branded medicine is the original product that has been developed by a pharmaceutical company and generic medicine is a copy of the original branded product, marketed after the expiry date of the patent and hence supposed to be of low cost as compared to their branded versions. The objective was to compare the costs of various branded and generic medicine and to ascertain the rationality of emphasizing generic versus branded prescription. Methods: Prices of 50 commonly used branded and generic medicines available as both branded and generic forms and in same concentration, dosage form and combination were selected and the percentage difference in the mean cost of generic and branded medicines was calculated. Results: The mean cost of 26 generic medicines out of the selected 50 medicines was higher than their branded versions. Mean cost of 20 branded medicines was higher than generic ones, and cost of 4 medicines was approximately same. Percentage difference in the mean costs of branded and generic medicines varied from <10% to >70%. Conclusions: Most of the drugs available in the market have brand names whether they are branded or generic medicines. Hence, doctor should write a cheapest known brand with the name of the generic salt in bracket so that the patient can buy another if that brand is not available. Furthermore, the Drug Controller of India should release a website where every doctor should be able to fi nd the cheapest and approved drugs in the market.