RESUMEN
Background: Contribution of antibiotic prophylaxis in reducing surgical site infection for some procedures is well known. In spite of knowledge about the effectiveness of antibiotic prophylaxis, its administrative regimens are often inappropriate. Objectives: To study the pattern of use of preoperative prophylactic antibiotic and its relationship with surgical site infection (SSI) in a tertiary care teaching Hospital. Methods Hundred case records files of patients admitted in surgical wards of Jawaharlal Nehru Medical College, Aligarh who had undergone open bowel surgery, were randomly selected from the Central Record Section and analyzed for prescription pattern for prophylactic antibiotics according to World Health Organization prescribing indicators for number of antibiotics, antibiotics prescribed by generic name and antibiotics prescribed from ‘Essential Medicines’ List per encounter. Cost of antibiotics, commonly prescribed antibiotics and timing of administration were also studied. Patients who developed surgical site infection and those who did not were compared statistically. Results: Commonly administered antibiotics were Ceftriaxone, Metronidazole and Amikacin given intravenously just before surgery. No relationship was seen between patient’s age, type of surgery or site of disease and choice of antibiotics. No drug was prescribed by generic name. Total cost on antibiotics was Indian Rupees 73.1 to 218.0. Surgical site infection developed in 40 patients. No significant relationship found between administration of any antibiotics or their cost and development of surgical site infection. High degree of resistance to Fluoroquinolones followed by second and third generation Cephalosporins was found in infecting organisms. Conclusions: Prescribing pattern was not based on World Health Organization criteria for rational use of drugs and not evidence based. This study indicates the need for interventions to improve rational use of antibiotic prophylaxis in India.
RESUMEN
Objective: Staphylococcus aureus is one of the major resistant pathogens extremely adaptable to antibiotic pressure. Nigella sativa (black cumin) seed extracts and essential oil have been shown to possess antimicrobial activity against several bacteria but little work has been done on their effect against multidrug resistant S. aureus strains isolated from patients. So, we studied antibacterial activity of Nigella sativa against multidrug resistant clinical strains of Staphylococcus aureus. It was an experimental, in vitro study. Materials and methods: Nigella sativa (black cumin) seed essential oil and extracts were tested in varying dilutions against 40 clinical strains of Staphylococcus aureus which were isolated from patients attending a tertiary care teaching hospital in North India using disc agar diffusion technique on inoculated Muellar Hinton agar plates under standard laboratory conditions. The tested strains were resistant to 4 or more clinically used antibiotics belonging to at least 3 different classes. Results: The Methanolic extract and oil of Nigella sativa were found active against 38 and 35 multi-drug resistant strains respectively. Both the oil and Methanolic extract showed remarkable dose dependant antibacterial activity against the tested strains up to a dilution of 1:50 as evident from the zones of inhibition. Conclusion: Nigella sativa possesses antibacterial activity against multidrug resistant clinical strains of Staphylococcus aureus
RESUMEN
Adverse drug reactions (ADRs) are one of the leading causes of death among hospitalized patients and occur in 0.3 to 7 per cent of all hospital admissions. These may vary from mild rashes to severe reactions such as Stevens-Johnson syndrome (SJS). Antiepileptic drugs-induced SJS is a life-threatening severe cutaneous adverse reaction. We report here a case of phenytoin induced SJS in a 38 year old male patient presenting at emergency room. The patient responded to the treatment and was prescribed tab. Levetrecitam and remained symptom free since then.