Antibiotics

Antibiotics are the most commonly prescribed drugs in hospitals. In developed countries, around 30% of the hospitalized patients are treated with antibiotics. Rational uses of drugs have attained more significance in present days in terms of medical, socio economical and legal aspects [1]. Pharmacists play a vital role in promoting the rational use of medicines. Medicines (drugs) cannot be used rationally unless all health care professionals involved in the pharmaceutical supply chain has access to know the complete information therapeutic indications of the drugs This study was carried out to collect patient’s relevant demographic information which includes Age, Sex, Occupation, Date of admission, Date of discharge, History of present illness, past medical history, Diagnosis and prescription drugs [2]. 1) The aim of the research is to study and to determine the prescribing patterns of antibiotics and use of antibiotic (Rational / Irrational) in a tertiary care hospital along with its beneficial and adverse outcomes. 2) Intervene strategies from pharmacist perspective to promote rational use of antibiotics to improve therapeutic outcomes in patients thereby improving quality of life (QOL) of patients [3]. The study was carried at Shadan Institute of Medical Sciences, Shadan Hospital, Hyderabad. Antibiotics are prescribed based on symptoms and laboratory investigations. Antibiotics are indicated for the treatment of bacteriologically proven infections and non-bacteriologically proven infections. It is a single centered, prospective observational study. Subjects of both genders who indicated with antibiotic therapy are taken into consideration and patients who had co morbid pathological conditions also included. Pediatrics, pregnant women and surgical cases were excluded from the study [4].175 patients were collected; 75 were male and 100 were female. Total numbers of antibiotics prescribed are 260. Median duration of hospitalization was 5 days. The most common prescribed antibiotics were Ceftriaxone, Ciprofloxacin, Azithromycin, Amoxicillin+Clavulanic acid, Amikacin & Doxycycline. On assessing the results of study, it was found that prescribed 260 antibiotics accounted for 100%, ceftriaxone indicated was 35% followed by ciprofloxacin was 10 % and azithromycin was 6%. Irrational prescriptions becoming a serious problem in the General medicine department. For the achievement of Rational use of antibiotic to treat infections caused by microorganisms, selection the appropriate antibiotic partly depends on symptoms suffered by the patients. Awareness programs should be launched and seminars should be conducted so as to minimize problems which are common at ward level [5]. News Letters and Drug bulletins about the rational use of antibiotics should be released periodically. Cost effective prescription should be encouraged. Formulation of a policy for hospital antibiotic use and educational programs especially for junior doctors also required.

Typhoid fever (Enteric fever) is a serious life-threatening illness caused by mostly Salmonella Typhi and also by Salmonella Paratyphi to a lesser extent. This study was carried out to isolate, identify Salmonella spp. from the blood samples of patients who were suspected of suffering from typhoid fever and to determine the antibiotic susceptibility pattern of the selected Salmonella spp. Salmonella spp. was detected in 122 of 1167 samples. Among which 87 (77.68%) were Salmonella Typhi and 25 (22.32%) were Salmonella Paratyphi. The most susceptible age group for Salmonella spp. is 21-30 years. Males (67.86%) are mostly infected by Salmonella spp. than females (32.14%). Salmonella Typhi (77.68%) was found as the predominant etiological agent of typhoid fever followed by Salmonella Paratyphi (22.32%) in our study. Salmonella spp. were resistant against Nalidixic acid, Co-trimoxazole and Pipercillin but sensitive against Ceftriaxone, Imipenem, Meropenem, Amikacin, Cefixime, Ceftazidime, Gentamicin, Cefotaxime. From this study, it can be concluded that these third generation antibiotics still can be used as effective drugs for the treatment of typhoid fever.  

Antimicrobials are a standout amongst the most usually prescribed medicines. However, they are often excessively and inappropriately used, which can lead to adverse effects (including fatality in a few cases) in individuals and the community as well. The duration of antimicrobial therapy needs to be sufficient to control the microbial infection and prevent relapse. The aim of this study is to estimate the duration of antimicrobial therapy in various infectious disease conditions and identify commonly prescribed antibiotics in infectious diseases. A Prospective Observational Study was conducted for one year (December 2013 - December 2014) on the patients diagnosed with infectious diseases of both sex and mean age of 39 ±16.8 years in a super specialty hospital, Hanamkonda, Warangal, Andhra Pradesh, India. During the study period a total number of 2500 patients were reviewed, among them 752 patients were enrolled in the study who has met the inclusion criteria. Among the patients enrolled, 456 (60%) patients were males and 297 (48%) patients were females. In total, of collected 7 infectious diseases, the longer duration of antibiotic treatment was required to diseases like pancreatitis and malaria that is around 18 days followed by liver abscess of 13 days, typhoid fever of 11 days and gastroenteritis and pneumonia with 10 days each. The shortest duration of 9 days of antibiotic therapy is sufficient for UTI.

This study was conducted in 78 roosters Hisex white layer to investigate the possible effect of use or misuse of antibiotics on liver and kidneys function as well as some other important organs. Three antibiotics of varying groups i.e., tylosin, ciprofloxacin and oxytetracycline were chosen for the study.  Antibiotics were daily orally administered in different doses as described in the experimental body. The possible adverse effect of antibiotics on liver and kidneys functions were followed by testing liver and kidneys serum biomarkers such as Glutamate oxido transaminase (GOT), Glutamate pyruvate transaminase (GPT), acid phosphatase (ACPase), alkaline phosphatase (ALKPase), total protein, albumin, globulin etc. Antibiotics residues clearance in plasma samples were also studied and correlated to administered dose. Histopathological investigations were further supported our biochemical data on the adverse effect of antibiotics on kidney, liver, heart, and other tissues. The present study clearly concluded a direct adverse effect of antibiotics, regardless of the chosen group, on liver and kidney and heart function.

Irrational prescribing of antibiotics is a major cause of antimicrobial resistance worldwide. Moreover the lack of attention by the physicians to the quality of prescriptions also play a key role in antimicrobial resistance and other problems such as patient medical record keeping, inappropriate dispensing and inadequate counseling by a pharmacist. The main purpose of the study was to evaluate the quality of prescription according to WHO guidelines and finding the antibiotic prescribing habits of physicians. The area of the study was limited to six branches of leading community pharmacy of Lahore. The concurrent method of study was used in the project. It was noted that generic prescribing was 1.7. Strength of drugs were 84.62%, dosage form 92.31%, dose 70.94%, frequency 74.36 %, duration 65.91 %. Basic patient information was the second set of parameters analyzed in the research. It was seen that body weight and address was present in 7.69 % and 5.98 % prescriptions respectively. Diagnosis was present in only 35 % of prescriptions. The study shows that Quinolones are the most prescribed anti-biotics (24.2%). The second most prescribed class was Cephalosporins (19.8 %). Third most prescribed class was Penicillins (13.66 %). Macrolides comprise of 8.07% of total prescribed. Others classes were Tetracyclins and Aminoglycosides (both 3.727%), Lincosamides 3.1%, and Carbapenems 2.4%.