Antibiotic consumption at community pharmacies : a multicenter repeated prevalence surveillance using WHO methodology

Background: Antibiotics are losing their effectiveness because of the rapid emergence of resistant bacteria. Unnecessary antimicrobial use increases antimicrobial resistance (AMR). There are currently no published data on antibiotic consumption in Pakistan at the community level. This is a concern given high levels of self-purchasing of antibiotics in Pakistan and variable knowledge regarding antibiotics and AMR among physicians and pharmacists. Objective: The objective of this repeated prevalence survey was to assess the pattern of antibiotic consumption data among different community pharmacies to provide a baseline for developing future pertinent initiatives. Methods: A multicenter repeated prevalence survey conducted among community pharmacies in Lahore, a metropolitan city with a population of approximately 10 million people, from October to December 2017 using the World Health Organization (WHO) methodology for a global program on surveillance of antimicrobial consumption. Results: The total number of defined daily doses (DDDs) dispensed per patient ranged from 0.1 to 50.0. In most cases, two DDDs per patient were dispensed from pharmacies. Co-amoxiclav was the most commonly dispensed antibiotic with a total number of DDDs at 1018.15. Co-amoxiclav was followed by ciprofloxacin with a total number of 486.6 DDDs and azithromycin with a total number of 472.66 DDDs. The least consumed antibiotics were cefadroxil, cefotaxime, amikacin, and ofloxacin, with overall consumption highest in December. Conclusion: The study indicated high antibiotic usage among community pharmacies in Lahore, Pakistan particularly broad-spectrum antibiotics, which were mostly dispensed inappropriately. The National action plan of Pakistan on AMR should be implemented by policymakers including restrictions on the dispensing of antimicrobials

Activation Energy Performance through Magnetized Hybrid Fe3O4–PP Nanofluids Flow with Impact of the Cluster Interfacial Nanolayer

The current work investigated the mass and heat transfer of the MHD hybrid nanofluid flow subject to the impact of activation energy and cluster interfacial nanolayer. The heat transport processes related to the interfacial nanolayer between nanoparticles and base fluids enhanced the base fluid’s thermal conductivity. The tiny particles of Fe3O4 and PPy were considered due to the extraordinary thermal conductivity which is of remarkable significance in nanotechnology, electronic devices, and modern shaped heat exchangers. Using the similarity approach, the governing higher-order nonlinear coupled partial differential equation was reduced to a system of ordinary differential equations (ODEs). Fe3O4–PPy hybrid nanoparticles have a considerable influence on thermal performance, and when compared to non-interfacial nanolayer thermal conductivity, the interfacial nanolayer thermal conductivity model produced substantial findings. The increase in nanolayer thickness from level 1 to level 5 had a significant influence on thermal performance improvement. Further, the heat and mass transfer rate was enhanced with higher input values of interfacial nanolayer thickness