Antibiotics

Surgery is the art of practice or work of treating diseases, injuries or deformities by manual or operative procedures. Before the start of operative procedures, a very brief course of antibiotics is initiated. This study aims to study the antibiotic utilization in surgical prophylaxis. This was a prospective and observational study conducted on 303 patients for a period of 06 months with the approval of institutional ethical committee from the Apollo multi specialty hospital & research center. Those who satisfied the study criteria were consented and participated for the study. Among 303 patients 183 male and 120 females were enrolled for the study. Most of the participants were in the age group of 31- 40 years. 205 patients had a clean- contaminated wound. Inj. Cefuroxime was the most prescribed prophylactic and post-surgical antibiotic in this study to avoid surgical site infection. None of the patients had developed any surgical site infections and the results which were satisfiable. Rational therapy with antibiotics helped patients to improve the quality of life by reducing financial and physical burden.

This pilot study aims to assess the prescribing pattern of beta lactam antibiotics in paediatric subjects. Informed consent as per ICMR guidelines were obtained from caretakers of pediatric subjects. Case records were analyzed to identify the prescribing pattern of antibiotics. Required data were collected using a suitably designed proforma. 30 subjects with a mean age 6.5±1.35 years were involved in the study. 66.67% of the subjects belongs to male respondents and 33.33% belongs to female population. 56.67% of the subjects were involved in the age category of 2 to 5 years and 6.67% of subjects belongs to age category in between 10 to 12 years. 76.67% of pediatric subjects have a diagnosis of respiratory tract infection. No cases of CNS disorders were reported. 43.33% of Ceftizoxime, 23.33% of Cefotaxime, 13.34% of Amoxicillin+ Clavulanic acid, 10% Cefuroxime, 6.67% Ceftriaxone and 3.33% of Cefaperazone+ Tazobactum were prescribed for these pediatric subjects for various infectious states. Use of antibiotics in pediatric subjects requires great care considering the increased incidence of antibiotic resistance. From this pilot study beta lactam antibiotics were found to be prescribed commonly due to its safety and efficacy in pediatric subjects.

Emerging Multidrug-resistant problem is a major concern. Klebsiella sp. can lead to a wide range of disease causing pathogen namely  pneumonia, urinary tract infections, septicemia, meningitis, diarrhea and soft tissue infections and development of MDR against commonly used antibiotics making the case difficult to manage. Total 525 Clinical samples were screened for isolation of Klebsiella sp. Total 36 isolates belonging to Klebsiella sp. Were obtained. 29(8.06%) isolates were associated with urinary tract infection (UTI), 6(12%) with sputum and 1(1.54%) was associated with blood. Antibiogram study of these isolates revealed that all these isolates are resistant to several antibiotics out of 34 antibiotics tested. Cold and hot acacia leaf petroleum ether extract, cold and hot acacia leaf chloroform extract, cold and hot acacia leaf acetone extract, cold and hot acacia leaf methanol extract and cold and hot acacia leaf water extract were used for synergistic study. Qualitative phytochemical analysis these leaf extracts showed the prominent presence of alkaloids, Carbohydrates and glycosides, proteins and amino acids and phytosteroids. The studies on these extracts of Acacia polycantha and antibiotics on susceptibility of resistant Klebsiella isolates showed that both cold and hot solvent extracts are effective on antibiotics. The effectiveness shown by these extracts may be useful in evaluating the efficacy of combination therapy against MDR-Klebsiella sp.

Antibiotic Prophylaxis should be appropriate to reduce the risk of postoperative surgical infections. Surgical Site Infections (SSIs) are responsible for Increased Mortality and Morbidity rate during surgical operations which lead to major complications. The inappropriate and overuse of antibiotics effects the cost and efficacy of drugs which leads to the resistant bacteria. To assess the pattern of antibiotic usage in surgical in-patients and for Postoperative wound infections. The present study is a prospective observational study done for a period of six months in Basaweshwara Medical College and Research Centre, Chitradurga in surgical ward. A Total of 162 patients were enrolled into the study. Among them, Surgical Site Infection (SSIs) was found in 37 (22.8%) patients and patients without SSIs are 125 (77.2%). The patients with age group 25-60 years were 104 (64.2%) in which SSIs are more (23).According to the study male patients underwent more surgeries (107 (66%)) in which 21 (56.8%) are with SSIs. Infection rate were more in males when compare to females in the study. A total of 265 antibiotics were used among 162 patients in which third generation cephalosporins are more preferred. The study concludes that there is a proper need to control the use of antibiotics appropriately. The inappropriate use leads to economic burden and resistance. SSIs may decrease the quality of life of the patients. Hence minimization of SSI is also very important in the developing countries by maintaining infection control plans by suitable organizations which makes an impact on the infections

The distribution of resistance to ampicillin, penicillin, erythromycin, tetracycline, and amoxicillin among Gram negative bacteria in the hospital wastewater samples was investigated. The emergence of resistance among the Gram negative bacterial population varied considerably in different drug and water sampling sites. Gram negative bacteria showed lower drug resistant viable count (1.23x104-7.0x102) in site-II (receiving treated wastewater), as compared to more polluted site-I (1.28x104-5.0x102), III (2.22x104-5.0x102) and site-IV (1.63 x104-2.0 x102) respectively. Viable counts of Gram negative bacterial population were recorded higher against erythromycin from sampling site-III. Lower viable counts of Gram negative bacteria were recorded against tetracycline in site-I and IV. Percentage MIC of antibiotic among the isolates observed higher in tetracycline and erythromycin than the other antibiotics. Isolates of Gram negative bacteria showed their tolerance level (MIC) in the range of 2.5-640μg/ml against the antibiotics. Maximum number of isolates exhibited their MICs at lower concentration range 2.5-5μg/ml against tetracycline. A few number of isolates also showed their MIC at lower concentration of other antibiotics tested from all the sampling sites.

Lactic acid bacteria are a group of gram positive, non-sporing, cocci or bacilli, which produce lactic acid as the major end product in carbohydrate fermentations. Lactic acid bacteria were isolated from different diary sources . Disease causing pathogenic bacteria from clinical specimen were collected. Antimicrobial activity of the above pathogens were tested with a set of conventional antibiotics by the disk diffusion method. Antibacterial effects of the lactic acid bacteria against the above bacterial pathogens were done by agar well diffusion method. 10 pathogenic bacteria, resistant to minimum of three antibiotics  were selected for the study. Results of antibacterial activity of the lactic acid bacteria in the study revealed, a varying type of  inhibition, which was later used for comparison. The study was performed to check whether Lactic acid bacteria could be used in patients with antibiotic resistance.