Rational Use Of Antibiotics Research Articles

Metagenomics by next-generation sequencing (mNGS) in the etiological characterization of neonatal and pediatric sepsis: A systematic review.

Pediatric and neonatal sepsis is one of the main causes of mortality and morbidity in these age groups. Accurate and early etiological identification is essential for guiding antibiotic treatment, improving survival, and reducing complications and sequelae. Currently, the identification is based on culture-dependent methods, which has many limitations for its use in clinical practice, and obtaining its results is delayed. Next-generation sequencing enables rapid, accurate, and unbiased identification of multiple microorganisms in biological samples at the same time. The objective of this study was to characterize the etiology of neonatal and pediatric sepsis by metagenomic techniques. A systematic review of the literature was carried out using the PRISMA-2020 guide. Observational, descriptive, and case report studies on pediatric patients were included, with a diagnostic evaluation by clinical criteria of sepsis based on the systemic inflammatory response, in sterile and non-sterile biofluid samples. The risk of bias assessment of the observational studies was carried out with the STROBE-metagenomics instrument and the CARE checklist for case reports. Five studies with a total of 462 patients were included. Due to the data obtained from the studies, it was not possible to perform a quantitative synthesis (meta-analysis). Based on the data from the included studies, the result identified that mNGS improves the etiological identification in neonatal and pediatric sepsis, especially in the context of negative cultures and in the identification of unusual microorganisms (bacteria that are difficult to grow in culture, viruses, fungi, and parasites). The number of investigations is currently limited, and the studies are at high risk of bias. Further research using this technology would have the potential to improve the rational use of antibiotics.

Awareness, practices and perceptions of community pharmacists towards antimicrobial resistance and antimicrobial stewardship in Libya: a cross-sectional study

BackgroundCommunity pharmacists play a vital role in promoting appropriate use of antibiotics in the community. This study evaluated the practices and perceptions of community pharmacists towards antibiotic use, antibiotic resistance, and antimicrobial stewardship in Libya.MethodsA cross-sectional study was conducted among community pharmacists in Libya using a 47-item validated, pre-tested online questionnaire. Data was collected from December 2021 to February 2022 and was analysed using descriptive and inferential analyses.ResultsOf the 114 questionnaires included in the analysis, 54.4% were females, 78.1% had < 10 year working experience (78.1%), and 81.6% had a Bachelor of Pharmacy. Most (78.1%) strongly agreed/agreed that community pharmacists have an important role to play to reduce antibiotic resistance. Overall, the participants had a moderate perception towards antimicrobial resistance (median score: 21.5; IQR [16–28] out of 35.0). More than 40% supply antibiotics when patients requested them specifically, because if they do not supply them, patients will just go to another pharmacy. About 47% strongly agreed/agreed that if a patient cannot afford a full course of antibiotics all in one go, they will give them a smaller amount that they are able to afford at that time, even when a longer duration of treatment is required. Most (66.7%) had no previous involvement in antibiotics awareness campaign due to ‘I have never heard about the campaign’ (48.7%) and ‘I do not have enough time to participate’ (22.4%). Overall, the perception towards antimicrobial stewardship was good (20 [13–25] out of 25.0). Raising awareness of rational antibiotic use, including antimicrobial resistance, among pharmacy students (83.4%) and patient education by pharmacists in community pharmacies at the time medicines are supplied to patients (81.6%) were the most common strategies to improve rational use of antibiotics in community pharmacy.ConclusionsCommunity pharmacists in Libya recognise their role in reducing antimicrobial resistance. They had a moderate perception towards antimicrobial resistance and a good perception towards antimicrobial stewardship. However, inappropriate antibiotic practices were common. The most common strategies to improve rational use of antibiotics in community pharmacy were raising awareness about the rational antibiotic use among pharmacy students and patient education by community pharmacists at the time antibiotics are dispensed to patients. Regulations are needed to restrict dispensing antibiotics without prescription among community pharmacists.

Evaluation the Rationality of Clinical Outcomes of Antibiotic Use and Patterns of Bacterial Resistance to Antibiotics in Children with Pneumonia

Pneumonia is a respiratory infection that attacks the lungs in the lung parenchyma tissue or alveoli. Pneumonia is one of the leading causes of death in children worldwide. Rational use of antibiotics can reduce the risk of antibiotic resistance. This study used observational analytics with a retrospective cohort design. The research subjects were pediatric patients with a diagnosis of pneumonia who were hospitalized at Dr. Sardjito Yogyakarta period 1 January – 31 December 2020. The rationality of the use of antibiotics was evaluated using the Gyssens method. The clinical outcome observed was the patient's condition improving or not improving after 3 to 5 days of antibiotic administration. Chi-Square test to see the relationship of antibiotic rationality to clinical outcomes and multiple logistic regression analysis to analyze the relationship of confounding variables to clinical outcomes. From 141 patients, 211 antibiotic regimens were obtained, with details of 186 empiric antibiotics and 25 definitive antibiotics. The rational use of antibiotics in empirical and definitive antibiotics was 140 regimens (75.27%) and 22 regimens (88%). Total irrational antibiotics (category I-VI) from empirical and definitive antibiotics were 24.73% and 12%, respectively. There is a significant relationship between the rationality of antibiotics with clinical outcomes both empirical and definitive antibiotics (p&lt;0.05). Meanwhile, for confounding variables, there was no significant relationship to the clinical outcome (p&gt;0.05). The most common bacteria were Klebsiella pneumoniae and Acinetobacter baumanii. Klebsiella pneumoniae was the most resistant to ampicillin, ampicillin sulbactam and ceftriaxone antibiotics and Acinetobacter baumanii was the most resistant ampicillin.

Healthcare-Associated Bloodstream Infections Due to Multidrug-Resistant Acinetobacter baumannii in COVID-19 Intensive Care Unit: A Single-Center Retrospective Study.

Healthcare-associated infections are an emerging cause of morbidity and mortality in COVID-19 intensive care units (ICUs) worldwide, especially those caused by multidrug-resistant (MDR) pathogens. The objectives of this study were to assess the incidence of bloodstream infections (BSIs) among critically ill COVID-19 patients and to analyze the characteristics of healthcare-associated BSIs due to MDR Acinetobacter baumannii in an COVID-19 ICU. A single-center retrospective study was conducted at a tertiary hospital during a 5-month period. The detection of carbapenemase genes was performed by PCR and genetic relatedness by pulsed-field gel electrophoresis (PFGE) and multilocus-sequence typing. A total of 193 episodes were registered in 176 COVID-19 ICU patients, with an incidence of 25/1000 patient-days at risk. A. baumannii was the most common etiological agent (40.3%), with a resistance to carbapenems of 100%. The blaOXA-23 gene was detected in ST2 isolates while the blaOXA-24 was ST636-specific. PFGE revealed a homogeneous genetic background of the isolates. The clonal spread of OXA-23-positive A. baumannii is responsible for the high prevalence of MDR A. baumannii BSIs in our COVID-19 ICU. Further surveillance of resistance trends and mechanisms is needed along with changes in behavior to improve the implementation of infection control and the rational use of antibiotics.

Importance of antibiotic therapy in post-surgical patients

Antibiotics are the class of medication that prevent the infections that is caused by bacteria; antibiotics make it difficult to grow or multiply or directly killing them. But the widespread misuse of antibiotics can also lead to serious consequences. In the case of post-operative patients, the empirical antibiotics should be selected based on the site of infection, etiology, and pharmacokinetics of the antibiotics. Therefore, the rational use of empirical antibiotics is based on the increase in the total count and also the spike in temperature. The review focus on the time, duration, rationality, and selection of empirical antibiotics, and antibiotic prescription patterns in different departments and different age groups.

Fighting Antimicrobial Resistance in Neonatal Intensive Care Units: Rational Use of Antibiotics in Neonatal Sepsis.

Antibiotics are the most frequently prescribed drugs in neonatal intensive care units (NICUs) due to the severity of complications accompanying neonatal sepsis. However, antimicrobial drugs are often used inappropriately due to the difficulties in diagnosing sepsis in the neonatal population. The reckless use of antibiotics leads to the development of resistant strains, rendering multidrug-resistant pathogens a serious problem in NICUs and a global threat to public health. The aim of this narrative review is to provide a brief overview of neonatal sepsis and an update on the data regarding indications for antimicrobial therapy initiation, current guidance in the empirical antimicrobial selection and duration of therapy, and indications for early discontinuation.

Risk factors of brain abscess in neonatal meningitis: a propensity score-matched study.

Brain abscess is a rare but life-threatening complication of meningitis. The purpose of this study was to identify clinical features and potentially relevant factors of brain abscess in neonates with meningitis. This study was a propensity score-matched case-control study of neonates with brain abscess and meningitis in a tertiary pediatric hospital between January 2010 and December 2020. A total of 16 neonates with brain abscess were matched to 64 patients with meningitis. Demography, clinical characteristics, laboratory results, and pathogens were collected. Conditional logistic regression analyses were performed to identify the independent risk factors associated with brain abscess. The most common pathogen we found in the brain abscess group was Escherichia coli. Risk factors of brain abscess were identified: multidrug-resistant bacterial infection (OR, 11.204; 95% CI, 2.315-54.234; p = 0.003), C-reactive protein (CRP) > 50mg/L (OR, 11.652; 95% CI, 1.799-75.470; p = 0.010). Conclusion: The risk factors of brain abscess are multidrug-resistant bacterial infection and CRP > 50mg/L. Monitoring the level of CRP is essential. Bacteriological culture and rational use of antibiotics are necessary for the prevention of MDR bacterial infection as well as the occurrence of brain abscess. What is Known: • Morbidity and mortality of neonatal meningitis have declined, but brain abscess associated with neonatal meningitis is still life-threatening. What is New: • This study investigated relevant factors related to brain abscess. • It is important for neonatologists to perform prevention, early identification, and appropriate interventions for neonates with meningitis.

Implementation research for promoting access and rational use of antibiotics for children: lessons learnt from Tanzania.

Implementation research (IR) has proved to be a potential catalyst in facilitating the uptake of evidence-based innovations into routine practices and thereby maximizing public health outcomes. IR not only focuses on the effectiveness of the innovations but also identifies and addresses the barriers and facilitators to maximize their uptake into routine practices. This article describes the processes undertaken to implement a research project aimed at promoting access and rational use of antibiotics for children (PARAC). It also provides an overview of the lessons learnt during its implementation in Tanzanian hospital and community settings.

Improving patient knowledge on rational use of antibiotics using educational videos

Providing proper knowledge on the rational use of antibiotics plays a role in the success of the treatment process of infectious diseases and the prevention of antibiotic resistance. In this modern digital era, healthcare professionals can utilize video as a medium for patient education. This study was meant to determine the efficacy of a video-based educational intervention in improving the levels of knowledge on the rational use of antibiotics. The study used a quasi-experimental pretest-posttest with a control group design and involved 140 participants. Data collection utilized a questionnaire that was carried out from July to December 2021 at the Special Region of Yogyakarta, Indonesia. The intervention was conducted for four weeks with a lecture and group discussion using video as educational media. The results of this study found that educational videos significantly improved the levels of knowledge on the rational use of antibiotics, known by an increase in the mean value of the treatment group by 2.590 with a p-value of 0.001, and a difference in the mean value of posttest scores of both groups by 1.900 with a p-value of 0.001. It could be concluded that video could be utilized as an effective medium of patient education, notably the use of antibiotics.

Predictors of antibiotic use in pregnant women attending Najran University Hospital, Saudi Arabia.

To determine the prevalence of antibiotic use by pregnant women in Najran, Saudi Arabia. A total of 125 women aged 18 to 45 with a full-term pregnancy participated from October to December 2019. Age, order of current pregnancy, body mass index (BMI), history of miscarriage, and comorbidity were used to estimate antibiotic use. The majority were Saudis (67.2%), aged 30-35 (39.2%) years, with no history of miscarriage (53.6%), second order of pregnancy (26.4%), and going through weeks 20-25 of pregnancy (21.6%). A total of 26.4% of pregnant women had antibiotic prescriptions in the study population. Pregnant women under 30 years were less likely to receive antibiotics. The results found an association between maternal age, order of pregnancy and antibiotic use during pregnancy. An association was observed between maternal BMI and the occurrence of adverse drug reactions after antibiotic use. In addition, a history of miscarriage was negatively associated with the use of antibiotics during pregnancy. These predictors of antibiotic administration have the potential to serve as general health indicators and to direct preventative strategies aimed at increasing the rational use of antibiotics.

Development of a Real-Time PCR Assay for Detection of Macrolide Resistance Mutations in Mycoplasma genitalium and Its Application for Epidemiological Surveillance in Russia.

A real-time PCR assay based on probe fluorescence quenching by a primer was developed and validated for detection of macrolide resistance (MR)-associated mutations in the 23S rRNA gene of Mycoplasma genitalium. The assay involves identification of any nucleotide substitutions at positions 2058, 2059, and 2611 of 23S rRNA (Escherichia coli numbering) by the probe-based melting curve analysis immediately after amplification and was capable of detecting target mutations in clinical specimens and spiked samples with 92% sensitivity and 100% specificity. We applied this new assay to assess the prevalence of MR-associated mutations in 949 nonduplicate urogenital samples positive for M. genitalium by routine diagnostic PCR, which were collected from symptomatic patients in five cities in the European part of Russia during the period 2009-2019. Forty-three (4.92%) samples revealed the presence of MR mutations, and no trend toward an increase in resistance prevalence was observed over the 10-year period of the study. The most commonly detected mutations were A2058G (26/43; 60.47%) and A2059G (13/43; 30.23%), while other mutations were rare: A2058T (3/43; 6.98%) and C2611T (1/43; 2.33%). The data obtained underline the need for regular epidemiological monitoring to ensure effective patient management, rational use of antibiotics, and prevention of further spread of resistance.

The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication.

An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with health professionals from ten hospitals and health officers of ten provincial health offices in ten different provinces and observation towards its documents. The sample location was selected by purposive sampling. Informants at the hospitals were hospital directors, chairmen of the AMR-CP team, chairmen of the medical committee, persons in charge of the microbiology laboratory, clinicians, nurses, clinical pharmacists, and those program managers at the provincial health offices who are responsible for administering antibiotics. Information is first collected and then a thematic analysis is applied along with triangulation to confirm the validity of information from multiple sources, including document observation results. The analysis is adapted to the framework of the system (i.e., input, process, and output). Results show that hospitals in Indonesia already have the resources to implement AMR-CP, including AMR-CP team and microbiology laboratories. Six hospitals examined also have clinicians trained in microbiology. Though hospital leadership and its commitment to implementing AMR-CP are favorable, there is room for improvement. AMR-CP teams organize routine activities for socialization and training, develop standard operating procedures (SOPs) for antibiotic use, antibiotic patterns surveillance, and bacterial mapping. Some obstacles to implementing AMR-CP policies are posed by the human resources, facilities, budget, antibiotics and reagent shortages, and clinician compliance with SOPs. The study concludes that there was an improvement in antibiotic sensitivity patterns, rational use of antibiotics, use of microbiological laboratories, and cost-efficiency. It recommends the government and healthcare providers continue to improve AMR-CP in hospitals and promote AMR-CP policy by making the regional health office of the hospital a representative of the regional government.

Effect of Enrofloxacin on the Microbiome, Metabolome, and Abundance of Antibiotic Resistance Genes in the Chicken Cecum.

Enrofloxacin is an important antibiotic for the treatment of Salmonella infections in livestock and poultry. However, the effects of different concentrations of enrofloxacin on the bacterial and metabolite compositions of the chicken gut and changes in the abundance of resistance genes in cecum contents remain unclear. To investigate the effects of enrofloxacin on chickens, we orally administered different concentrations of enrofloxacin to 1-day-old chickens and performed 16S rRNA gene sequencing to assess changes in the gut microbiomes of chickens after treatment. The abundance of fluoroquinolone (FQ) resistance genes was measured using quantitative PCR. Metabolomics techniques were used to examine the cecal metabolite composition. We found that different concentrations of enrofloxacin had different effects on cecum microorganisms, with the greatest effect on cecum microbial diversity in the low-concentration enrofloxacin group at day 7. Enrofloxacin use reduced the abundance of beneficial bacteria such as Lactobacillaceae and Oscillospira. Furthermore, cecum microbial diversity was gradually restored as the chickens grew. In addition, enrofloxacin increased the abundance of resistance genes, and there were differences in the changes in abundance among different antibiotic resistance genes. Moreover, enrofloxacin significantly affected linoleic acid metabolism, amino acid metabolism, and signaling pathways. This study helps improve our understanding of how antibiotics affect host physiological activities and provides new insights into the rational use of drugs in poultry farming. The probiotics and metabolites that we identified could be used to modulate the negative effects of antibiotics on the host, which requires further study. IMPORTANCE In this study, we investigated changes in the cecum flora, metabolites, and abundances of fluoroquinolone antibiotic resistance genes in chickens following the use of different concentrations of enrofloxacin. These results were used to determine the effects of enrofloxacin on chick physiology and the important flora and metabolites that might contribute to these effects. In addition, these results could help in assessing the effect of enrofloxacin concentrations on host metabolism. Our findings could help guide the rational use of antibiotics and mitigate the negative effects of antibiotics on the host.

Hematogenous septic arthritis after second degree burn and rational use of antibiotics

A 51-month-old female patient, who has meningomyelocele, presented with complaints of pain, fever, and inability to move her left leg from the hip while receiving antibiotic treatment after a localized second degree burn (9%). Physical findings, radiographic findings, and aspiration fluid from the hip joint were consistent with septic arthritis (SA). Methicillin-sensitive staphylococcus aureus growth was observed in wound culture, blood culture and synovial fluid culture sent after the operation. As the clinical condition of the patient with hematogenous spread was stable, treatment with ampicillin-sulbacsite was started. In burn patients, SA should be suspected in cases with fever and joint movement limitation, and it should be predicted that infections related to the burn may be pathogenic for SA. A rational antibiotic approach should be adopted in order to prevent resistance. Cases occurring after the development of large surface burns are available in the literature, and our case is the first pediatric case to develop septic arthritis after small surface area burn.

Occurrence, distribution, and ecological risks of antibiotics in Honghu Lake and surrounding aquaculture ponds, China.

Antibiotics are largely applied in aquaculture to increase production and control diseases, while how the antibiotics used in pond farming influence the distribution of antibiotics in receiving water seasonally is still not well understood. In this study, the variations of 15 frequently used antibiotics in Honghu Lake and surrounding ponds were investigated seasonally to figure out the impact of pond farming on antibiotics distributions in Honghu Lake. Results showed that the antibiotic concentrations in fish ponds ranged from 11.76 to 389.8ng/L, while in crab and crayfish ponds were lower than 30.49ng/L. The predominant antibiotic in fish ponds was florfenicol, followed by sulfonamides and quinolones, with generally low concentrations. Sulfonamides and florfenicol were the main antibiotics in Honghu Lake, affected by the surrounding aquaculture water partially. The antibiotics residue in aquaculture ponds showed obvious seasonal characteristics, with the lowest in spring. From summer, the concentrations of antibiotics in aquaculture ponds gradually increased and reached a peak in autumn, and the seasonal variation of antibiotics in the receiving lake was also related to the antibiotics in the aquaculture ponds. Risk assessment analysis showed that antibiotics such as enrofloxacin and florfenicol in fish ponds posed a medium and low risk to algae, and Honghu Lake acted as a natural reservoir of antibiotics and poses increased risks to algae. In general, our study demonstrated that aquaculture represented by pond farming brought significant risks of antibiotic pollution to natural water bodies. Therefore, reasonable control of the fish antibiotics usage in autumn and winter, as well as the rational use of antibiotics in aquaculture and the use of antibiotics before pond cleaning, is required to reduce the migration of antibiotics from aquaculture surface water to the receiving lake.

Antimicrobial stewardship implementation before and during the COVID-19 pandemic in the acute care settings: a systematic review

IntroductionAntibiotics are widely administered for various indications, leading to increased antimicrobial resistance (AMR) in acute care hospitals. Since the onset of the COVID-19 pandemic, Antimicrobial Stewardship (AMS) effective strategies should be used to maintain the rational use of antibiotics and decrease the threat of Antimicrobial Resistance (AMR).AimThis systematic literature review aims to investigate the AMS intervention Before-the-pandemic (BP) and During-the-pandemic (DP) from the literature.Design and settingSystematic literature review of primary studies on AMS implementation in acute care settings.MethodsRelevant studies published between 2000 and March 2021 were obtained from Medline (via PubMed), OVID, CINAHL, International Pharmaceutical s, Psych Info, Scopus, Web of Science, Cochrane Library, OpenGrey, and Google Scholar, using a comprehensive list of search terms. Public Health England (PHE) toolkit was agreed upon as a gold standard for the AMS implementation.ResultsThere were 8763 articles retrieved from the databases. Out of these, 13 full-text articles met the inclusion criteria for the review. The AMS implementation was identified in the included studies into AMS strategies (Core strategies & Supplemental strategies), and AMS measures BP and DP.ConclusionThis Systematic literature review summarises AMS implementation strategies and measures all over the previous 20 years of research. There are many lessons learnt from COVID-19 pandemic. The proper selection of the AMS implementation strategies and measures appeared to be effective in maintaining the appropriate use of antibiotics and decreasing the AMR threat, especially during the COVID-19 pandemic. Further studies are required to provide empirical data to evaluate the AMS implementation and identify which of these strategies and measures were effective BP and DP. In order to be prepared for any emergency/crisis or future pandemics.

The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia.

Pneumonia is the number one cause of disease and deaths in children under five years old, outside the neonatal period, with the greatest number of cases reported from resource-limited settings. The etiology is variable, with not much information on the local etiology drug resistance profile in many countries. Recent studies suggest an increasing contribution from respiratory viruses, also in children with severe pneumonia, with an increased relative contribution in settings that have good vaccine coverage against common bacterial pathogens. Respiratory virus circulation was greatly reduced during highly restrictive measures to contain the spread of COVID-19 but rebounded once COVID-19 restrictions were relaxed. We conducted a comprehensive literature review of the disease burden, pathogens, case management and current available prevention of community acquired childhood pneumonia, with a focus on rational antibiotic use, since the treatment of respiratory infections is the leading cause of antibiotic use in children. Consistent application of revised World Health Organisation (WHO) guidance that children presenting with coryzal symptoms or wheeze can be managed without antibiotics in the absence of fever, will help to reduce unnecessary antibiotic use, as will increased availability and use of bedside inflammatory marker tests, such as C-reactive protein (CRP) in children with respiratory symptoms and fever.

Fosfomycin Resistance in Clinical Isolates of Escherichia coli from Urinary Tract Infections in a Tertiary Care Hospital

Background: Fosfomycin is called an old-new antibiotic, because it was reintroduced for the treatment of urinary tract infections. The rampant use of antibiotics has led to Fosfomycin resistance reported from different parts of the world. The purpose of this study was to find out the frequency of Fosfomycin resistance in clinical isolates of Escherichia coli (E. coli) from urinary tract samples. Methods: This cross-sectional study, including n=314 patients, was conducted in the Microbiology laboratory at Pakistan Naval Ship SHIFA Hospital, Pakistan from January to June 2022. Urine samples were inoculated on agar at 37±2°C for 24-48hrs. The growth of E. coli was confirmed by API 10S as per recommended Clinical Laboratory Standard Institute (CLSI) guidelines. Susceptibility testing was performed by the standard Kirby Bauer Disc Diffusion method. The Chi-square test was applied to categorical variables. p-value ≤ 0.05 was considered statistically significant. Results: Out of 314 clinical isolates, 171 (54.5%) were females and 143 (45.5%) were males (mean age 49±10.3 (6-81) years). Sixty-six (21%) isolates were found resistant to Fosfomycin while 248 (79%) were sensitive. A significant difference was found between the gender (p=0.035), whereas, 29 (17.0%) females and 37 (25.9%) males were found resistant to Fosfomycin. Conclusion: The resistance to Fosfomycin is increasing and it is an impending threat as oral treatment options are limited in urinary tract infections. However, improved surveillance may help in controlling nosocomial infection along with the rational use of antibiotics can prevent and reduce its spread. Keywords: Fosfomycin; Culture; Susceptibility; Urinary Tract Infections (UTIs).

Antibiotic resistance and rational outpatient antibiotic treatment of upper respiratory tract infections in children

On the eve of the season of respiratory infections, we would like to draw the attention of outpatient doctors to the fact that 80–90 percent of winter diseases affecting the nose, ears, throat and lungs are of viral origin. Improper and excessive consumption of antibiotics increases the risk of antibiotic resistance, and thus humanity enters the post-antibiotic era. The World Health Organization warns that the problems that antibiotic resistance could cause in the future can be compared to the spread of AIDS in the 1980s. The principles of rational use of antibiotics should always be based on the assumption that antibiotics are causal drugs, and their overuse very often leads to resistance, which negatively affects the entire population. Irrational antibiotic therapy can also lead to discomfort, worsening of acute and chronic pain. It is also important to know that in the post-antibiotic era, science has other options for fighting bacteria, such as vaccination, immunotherapy, and strengthening individual immunity. The correct attitude of doctors to the prevention of diseases and rational treatment with antibiotics can help reduce the resistance of bacterial strains, discomfort and pain.

Analysis of Antibacterial Usage Pattern as per ATC/DDD WHO Coding Methodology to Match in Various Clinical Department of Tertiary Care Hospital

The WHO advises using the Defined Daily Dose (DDD) as a unit of measurement and the Anatomical Therapeutic Chemical (ATC) classification system for tracking and researching drug use. The main objective of the study is to examine changes in drug utilization. Evaluate interventions on prescribing patterns of antibiotics at The Oxford medical college hospital and research Centre. Patient demographics and drug charts are collected using specified case report form for a period of 6 months using random sampling method. Case report form includes patient demographics, laboratory data, diagnosis, and drug chart with frequency, dose, dosage and route of administration. Out of 183 cases analyzes 45.4% were female and 54.7% were male. Most of the cases were in the group of 20 to 31. Average duration of hospitalization in our study population was around 5 days. A total of 299 antimicrobial were prescribed in 183 cases. Cephalosporins were the most preferred antibiotic followed by other antibiotic class. Ceftriaxone was the most common drug among the cephalosporin. Antibiotic prescribing in the hospital is empirical, we would like to recommend that antibiotic selection should be based on the results of cultural and sensitivity testing whenever possible. The percentage of drug prescribed in generic form was found to be less. We recommend larger scope prospective study to emphasize on ensuring of rational use of antibiotics.