"Save Antibiotics, Save lives": an Indian success story of infection control through persuasive diplomacy.

BACKGROUND: Carbapenem resistant Enterobacteriaceae is a worldwide threat, with increasing prevalence in many countries. Restricted usage of higher end antibiotics, especially carbapenem is of great importance in tackling these super bugs. Purpose of this retrospective study was to analyse the impact of antibiotic stewardship activities on the prevalence of carbapenem resistant Enterobacteriaceae in our hospital. FINDINGS: In the first Quarter of 2009, average usage of carbapenem group of antibiotics was 955 vials a month while in 2010, the usage dropped to 745 vials per month. Carbapenem resistant E.coli rate dropped from 3.7% in 2009 to 1.6% in 2010 and Klebsiella rate reduced from 6% in 2009 to 3.6% in 2010. CONCLUSIONS: Strict antibiotic stewardship strategies in conjunction with good infection control practices are useful in restricting higher end antibiotic usage and reducing the prevalence of carbapenem resistant Enterobacteriaceae.

Pulmonary function in normal south Indian children aged 7 to 19 years.

There are only a few studies that have established reference standards for pulmonary function of Indian children. Reference standards for pulmonary function that are reported for Indian children are mainly from northern and western parts of the country and there is a paucity of data on pulmonary function in normal South Indian children. Therefore, pulmonary function tests (spirometry and maximal expiratory flow rates) were carried out in 469 South Indian healthy children (246 boys and 223 girls) between 7-19 years of age to derive regression equations to predict pulmonary function. The correlations of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were, in general highest with height followed by weight and age. Peak expiratory flow rate (PEFR), forced mid-expiratory flow (FMF) and forced expiratory flow rates at 25%, 50% and 75% of FVC (FEF25% FVC, FEF50%FVC and FEF75%FVC) were also significantly correlated with physical characteristics (age, height and weight). With a view to find out regression equations to predict spirometric functions based on physical characteristics (age, height and/or weight), the functions were regressed over all possible combinations of regressor variables, i.e. age, height and weight separately for boys and girls. The height influences the prediction equation in males to a great extent, whereas age and weight had greater influence in girls. Regression equations were derived for boys and girls for predicting normal pulmonary functions for children in South India. The pulmonary function measurements in South Indian children were similar to those reported for subjects from Western India and lower than those reported for Caucasians.