A questionnaire based survey on knowledge, attitude and behaviour of antibiotic usage and resistance among undergraduates in South Indian teaching hospital

Background: Antibiotic resistance has become a global threat in the field of medicine. Multiple causes like antibiotic abuse, irrational usage of antibiotics, over the counter availability of antibiotics etc., have been put forth as culprit leading to antibiotic resistance. The present study aims at evaluating the knowledge, attitude and behaviour of antibiotic usage and resistance among undergraduates in South Indian teaching hospital.Methods: A cross-sectional, questionnaire-based survey conducted in undergraduate MBBS students including 5th to 9th semester at Department of Pharmacology. The questionnaire comprised off: Demographic data; Knowledge including 12 questions using Four-point likert scale; Attitude and behaviours consisting of 8 questions of Yes/No type. Data were analysed in the software SPSS version 24.0. Association among categorical variable were analysed with Analysis of variance (ANOVA) followed by post hoc Bonferroni test.Results: Among 455, 382 students completed the survey instrument and the response rate was 87%. Statistically significant (p=0.002) results have been obtained for the correct responses of knowledge questionnaire. The order of “good knowledge” about antibiotic usage and resistance according to semesters are graded as VIII>VI>V. Unfortunately, there were no significant results seen with attitude and behaviour.Conclusions: The study concluded that, though there was adequate theoretical knowledge among undergraduate students however they lack in their attitude and behaviour regarding antibiotic usage and resistance. Therefore, they need to improve their attitude and behaviour over antibiotic usage and resistance

Doxycycline induced fixed drug eruption: a case report

Fixed drug eruption (FDE) is an adverse drug reaction seen with various groups of drugs are antibiotics such as trimethoprim -sulphamethoxazle, pencillin, tetracyclines, non steroidal anti- inflammatory drugs like ibuprofen, aspirin etc. Doxycycline belongs to tetracycline groups of antibiotics. We herein present the case of Doxycycline induced fixed drug eruption. A 35-year - old man presented to our hospital, with a 2-day history of itching and hyperpigmentation over the chest. Patient developed skin lesion 2 days after and he started taking Doxycycline 100 mg twice a day for skin infections. Dermatological examination revealed multiple well defined hyperpigmented patches seen over the anterior aspect of the chest. Doxycycline was discontinued immediately, and the skin lesions resolved spontaneously within 2 weeks. Causality assessment by using Naranjo adverse drug reaction probability scale and WHO Uppsala monitoring scale categorize the reaction as Doxycycline was the probable cause for the adverse drug reaction. Severity assessment by using modified Hartwig and Siegel ADR severity assessment scale labelled the reaction as mild-level 2. The causative drug or drugs and cross reactants should be avoided in future to prevent recurrence of similar skin reactions

A retrospective analysis of acute poisoning cases admitted to a tertiary care hospital in South India

Background: Acute poisoning is a medical emergency and a global public health problem. The poisoning pattern varies across countries and even between different regions within a country. The aim of this was to explore the demographic, etiological, and clinical characteristics of acute poisoning cases admitted to a tertiary care hospital in Puducherry, South India.Methods: This was a retrospective hospital record based study of acute poisoning cases admitted to our hospital during the period from January 2015 to December 2017. The patients’ demographic, etiological and clinical characteristics were analyzed.Results: Of the total of 275 cases of acute poisoning, majority of them were in the age group of 21- 30 years (32%) and were females (58.5%). Most of the cases were suicidal in nature (75.3%). Majority of the patients consumed a single poisonous agent (92.7%) and the route of poisoning was oral in all of them. Majority of the patients (56.7%) reached the hospital within 2 hours of exposure to the poison with median duration of hospital stay of 2 days, and mortality of 2.9%. Majority of the suicidal poisonings were associated with abuse of insecticides (39.4%), rodenticides (19.7%) and plant seeds (14.4%); whereas the accidental poisonings were mostly due to household agents (79.1%).Conclusions: Our study shows that the majority of the poisoning cases occurred with a single poisonous agent consumed orally, for suicidal purposes in young age group and women. Pesticides and plant seeds were commonly abused for committing suicides and household agents dominated the list of causes for accidental poisoning

Assessment of drug attitude, medication adherence and quality of life among psychiatric patients in South Indian population: a cross sectional study

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL

Prescription audit of a teaching hospital in South India using World Health Organization core prescribing indicators – A cross-sectional study

Aim: World Health Organization (WHO) core prescribing indicators are highly standardized tools in reliably assessing the essential aspects of drug utilization pattern. It is critical that the rational use of drug prescribing is scrutinized for the utmost benefit of patient welfare. In this study, we aim to assess the prescription pattern and prescribing behavior of physicians using the WHO-recommended core prescribing indicators at a teaching hospital in South India. Materials and Methods: A prospective, descriptive cross-sectional study was conducted in the general medicine outpatient department of a tertiary care hospital for a period of 1 month in June 2019. A total of 600 prescriptions were sampled based on the WHO “How to investigate drug use in health facilities” document recommendation. The WHO guidelines and methods were observed to ensure data reliability. Descriptive statistical analyses such as frequencies, percentages, mean, and standard deviation were used to present the data. Results: The WHO core prescribing indicators analysis revealed that the average number of drugs per encounter was 2.38 ± 1.1 and only 796 (55.4%) of the drugs were prescribed by generic name. Whereas, the percentage of encounters prescribed with an antibiotic 44 (7.3%) and an injection 63 (10.5%) was less than the ideal recommendations as per WHO and 1265 (88%) of the drugs were prescribed from the National List of Essential Medicines. Conclusion: This study on prescription pattern audit done using the WHO core prescribing indicators highlights that prescriptions encountered with antibiotic and injection use were in accordance with the WHO recommendations