Analysis of antimicrobial susceptibility pattern of ocular infections at Regional Ophthalmic Institute in India

Background: Ocular infections are a result of alteration in the normal microbial flora of eye. They are not only responsible for increase in morbidity varying from self-limiting trivial infection to sight threatening infection but also blindness.Methods: Patients with ocular infections were recruited at Regional Institute of Ophthalmology, Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh. Bacterial profile in ocular infections and susceptibility pattern to commonly used antibiotics were analyzed amongst these patients. The isolated organism was then identified by colony morphology, gram stain and biochemical test following which in vitro susceptibility test was performed by Kirby-Bauer disc diffusion method and interpreted clinically.Results: Staphylococcus aureus and coagulase negative Streptococcus were most common etiological agents of ocular infections in the present study. It was observed that bacterial isolates were highly (in 100% of cases) susceptible to vancomycin and chloramphenicol among gram positive organisms. Gram negative organisms showed higher susceptibility to moxifloxacin, tobramycin and gentamycin. Pseudomonas was seen to have sensitivity towards ceftazidime and cefazolin.Conclusions: The present study gives an insight into use of ocular antimicrobials in northern India. These findings illustrate the need for constant bacterial surveillance before starting empirical treatment.

Topical corticosteroid misuse: observational study to evaluate pattern of abuse and adverse drug reactions

Background: Topical corticosteroids (TC) have a reputation as anti-acne, anti-blemish effects and popularly used as fairness creams. In India, there has been a rise in misuse of TC in last10 years. The present study was conducted to analyse the magnitude of adverse effects of topical corticosteroids abuse in dermatology outpatient department of a tertiary care hospital.Methods: A retrospective observational study was conducted on patients after categorizing them as a TC misuser by dermatologists. The socio-demographic data, chief complaints, details of drugs misuse and adverse drug reaction outcome was collected.Results: A total of 1240 patients was screened, out of which 80 patients misused TC without dermatologist prescription for their skin disease. TC was mainly misused by teenagers (43.8%). Misuse of topical corticosteroids was more common among females (76.3%). Betamethasone valerate (72.5%) was most common TC misused. Most common source of advice of TC misuse was friends (37.5%). Most common purpose of TC misuse was acne (55%) followed by cosmetic purposes (21.3%). The most common morphological varieties of adverse drug reactions were burning and itching sensation (53%) followed by increase severity of acne (44%).Conclusions: TC misuse was more common in teenage females. Most common adverse effect reported is burning and itch sensation followed by increase severity of acne. The study data indicates a significance of problem and requirement of urgent measures to control TC misuse.

Efavirenz induced drug hypersensitivity reaction

Efavirenz is the first line non-nucleoside reverse transcriptase inhibitor suggested by World Health Organization for newly diagnosed patients started on antiretroviral therapy. Dermatologic manifestations are the usual side effects associated with this drug. Authors hereby, present a case report of efavirenz induced drug hypersensitivity reported at a tertiary care hospital at Allahabad, Uttar Pradesh. The patient developed rashes and vomiting within a week of start of TLE regimen. Re-challenge test revealed confirmation of the adverse drug reaction by efavirenz. Change of the regimen was done for the patient following hospitalization for the event. This case report explains that strict pharmacovigilance is essential in the initial days of start of antiretroviral therapy. Further trials to improve the safety profile of the patients on ART are the need of the hour.