CEPHALOSPORIN UTILIZATION EVALUATION IN A UNIVERSITY TEACHING HOSPITAL: A PROSPECTIVE STUDY

Objective: Cephalosporins are among the commonly used class of antibiotics in hospitals and healthcare facilities world-wide and the use of newer generation of Cephalosporins have increased in the developed countries with limited number of studies investigating the drug prescribing and utilization pattern in the hospital setting. Hence the present study was carried out aiming to systematically evaluate the prescribing and sensitivity patterns of various Cephalosporins in Medicine and Surgery inpatients in a University teaching Hospital of Mangalore district, Karnataka, India. Methods: Cephalosporin utilization was evaluated in 400 inpatients of Medicine and Surgery department of a University teaching Hospital in a cross sectional prospective study for 5 months duration between June 2011-October 2011. Results: 239(59.8%) patients from Medicine department and 161(40.2%) patients from Surgery department were enrolled in the present study. Patients with age group greater than or equal to 60 years received Cephalosporins maximum with 34% and 28% from Medicine and Surgery wards respectively. The median length of hospital stay was 10 days. The most widely prescribed formulation was parenterals (69%). The third-generation Cephalosporins were widely prescribed. 131 patients (32.8%) were prescribed Cephalosporin for surgical propylaxis and 56 patients (14%) to prevent infections. Culture test was performed in only 66(16.5%) cases, only 43 specimens showed positive culture test. Metronidazole was the most commonly co prescribed drug. Conclusions: This study revealed the wider usage of Cephalosporins especially third-generation Cephalosporins. The treatment regimens implemented in most of the cases were without doing any culture sensitivity test which lead to irrational prescribing. Key words: Cephalosporins, surgical prophylaxis, Drug utilizatio

Mucin-bacterial interactions in the human oral cavity and digestive tract

Mucins are a family of heavily glycosylated proteins that are the major organic components of the mucus layer, the protective layer covering the epithelial cells in many human and animal organs, including the entire gastro-intestinal tract. Microbes that can associate with mucins benefit from this interaction since they can get available nutrients, experience physico-chemical protection and adhere, resulting in increased residence time. Mucin-degrading microorganisms, which often are found in consortia, have not been extensively characterized as mucins are high molecular weight glycoproteins that are hard to study because of their size, complexity and heterogeneity. The purpose of this review is to discuss how advances in mucus and mucin research, and insight in the microbial ecology promoted our understanding of mucin degradation. Recent insight is presented in mucin structure and organization, the microorganisms known to use mucin as growth substrate, with a specific attention on Akkermansia muciniphila, and the molecular basis of microbial mucin degradation owing to availability of genome sequences