A prospective assessment of antimicrobial agents utilization pattern in a tertiary care hospital

Background: The antimicrobial resistance is increasing globally and, concurrently, downward trend in development of newer antibiotics is leading to a serious public health problem and economic consequences.Methods: Prescriptions with at least one antimicrobial were included in the study. A total of 242 prescriptions were included in the study. The antimicrobials were classified into different classes based on WHO-ATC classification.Results: A total of 281 antimicrobials prescribed in 242 prescriptions with an average of 1.16 per prescription. In most of the prescriptions, 1 antimicrobial were prescribed (88.43%). The routes of the antimicrobial administration were mostly oral 268 (95.37%) followed by injectable 13 (4.63%). The most commonly prescribed classes of antimicrobial in this study were antibacterials for systemic use (J01) (74.02%) followed by antimycobacterials (J04) (13.88%), antiparasitic drugs (P) (8.19%), antimycotics for systemic use (J02) (2.49%) and antivirals for systemic use (J05) (1.42%). Among antibacterials, the most commonly prescribed classes of antibacterial was various antibacterial FDCs (19.22%), followed by quinolones (18.86%), macrolides (18.15%), β-lactams (11.03%) cephalosporins (6.76%), penicillins (4.27%), aminoglycosides (2.84%), metronidazole (1.78%), clindamycin (1.78%) and tetracycline (0.36%). The total percentage of antimicrobials prescribed as Fixed Dose Combinations (FDCs) were 32.38%.Conclusions: The present study has reported that most commonly prescribed antimicrobials were quinolones followed by macrolides and β-lactams. Recommendations to change the ongoing prescribing practices should be based on the Standard Treatment Guidelines, EDL and Antibiotic policy or by following the information, education, and communication (IEC) interventions

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

Background: Data on the prevalence of osteoporosis in HIV patients in Asian population is scarce this study was done to find out the prevalence of osteoporosis in HIV infected patients and its correlation with CD4 counts.Methods: This cross- sectional study was conducted in NACO- ART center of tertiary care hospital. Total 115 HIV patients were included in this study which were divided into ART naive (n= 69) and patients taking ART (n= 46). We analysed BMD by DEXA in 115 HIV positive patients and 78 HIV negative age and sex matched controls. Correlation of BMD with a CD4 count and ART regimen was studied.Results: BMD was found to be low in HIV positive patients. T score in HIV positive patients was significantly lower (p<0.05) as compared to the HIV negative control group. The prevalence of osteopenia and osteoporosis in HIV positive patients was 50.4% and 29.6% respectively, as compared to 23.1% and 2.6% in HIV negative controls. BMD showed relation with CD4 count. We did not find any statistical difference between any ART regimen and BMD.Conclusions: The prevalence of osteopenia and osteoporosis in HIV infected cases was higher as compared to HIV negative controls and higher in ART group as compared to ART naïve group. Low BMD levels show correlation with low CD4 count. We recommend that HIV positive patients especially with advanced stage of disease, low CD4 count should be screened for low BMD by DEXA scan for osteoporosis and managed accordingl

Investigation into repetitive concussion in sport (RECOS): study protocol of a prospective, exploratory, observational cohort study

Sport-related concussion management remains a diagnostic dilemma to clinicians in all strata of care, coaching staff and players alike. The lack of objective diagnostic and prognostic biomarkers and over-reliance on subjective clinical assessments carries a significant health risk of undiagnosed concussive episodes and early return to play before full recovery increasing the risk of sustaining additional concussion, and leading to long-term sequelae and/or unfavourable outcome. To identify a set of parameters (neuroimaging with neurophysiological, biological and neuropsychological tests) that may support pitch-side and outpatient clinical decision-making in order to objectively diagnose concussion, determine the severity of injury, guide a safe return to play and identify the potential predictors of the long-term sequelae of concussion. An exploratory, observational, prospective, cohort study recruiting between 2017 and 2020. The participants will have a baseline preseason screening (brain imaging, neuropsychological assessments, serum, urine and saliva sampling). If a screened player later suffers a concussion and/or multiple concussions then he/she will be assessed again with the same protocol within 72 hours, and their baseline data will be used as internal control as well as normative data. Inferential statistical analysis will be performed to determine correlations between biological, imaging techniques and neuropsychological assessments. This study was approved by the East of England-Essex Research Ethics Committee on 22 September 2017-REC 17/EE/0275; IRAS 216703. The results of this study will be presented at national and international conferences and submitted for publication in peer reviewed journals. ISRCTN16974791; Pre-results. [Abstract copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

A prospective assessment of antimicrobial agents utilization pattern in a tertiary care hospital

Background: The antimicrobial resistance is increasing globally and, concurrently, downward trend in development of newer antibiotics is leading to a serious public health problem and economic consequences.Methods: Prescriptions with at least one antimicrobial were included in the study. A total of 242 prescriptions were included in the study. The antimicrobials were classified into different classes based on WHO-ATC classification.Results: A total of 281 antimicrobials prescribed in 242 prescriptions with an average of 1.16 per prescription. In most of the prescriptions, 1 antimicrobial were prescribed (88.43%). The routes of the antimicrobial administration were mostly oral 268 (95.37%) followed by injectable 13 (4.63%). The most commonly prescribed classes of antimicrobial in this study were antibacterials for systemic use (J01) (74.02%) followed by antimycobacterials (J04) (13.88%), antiparasitic drugs (P) (8.19%), antimycotics for systemic use (J02) (2.49%) and antivirals for systemic use (J05) (1.42%). Among antibacterials, the most commonly prescribed classes of antibacterial was various antibacterial FDCs (19.22%), followed by quinolones (18.86%), macrolides (18.15%), β-lactams (11.03%) cephalosporins (6.76%), penicillins (4.27%), aminoglycosides (2.84%), metronidazole (1.78%), clindamycin (1.78%) and tetracycline (0.36%). The total percentage of antimicrobials prescribed as Fixed Dose Combinations (FDCs) were 32.38%.Conclusions: The present study has reported that most commonly prescribed antimicrobials were quinolones followed by macrolides and β-lactams. Recommendations to change the ongoing prescribing practices should be based on the Standard Treatment Guidelines, EDL and Antibiotic policy or by following the information, education, and communication (IEC) interventions