SARS-CoV2 is transmitted primarily through oral mouth secretions and respiratory droplets. Commercial mouthwashes, povidone iodine (PI), hydrogen peroxide (HP) and chlorhexidine (CHX) have been tested in cell culture and RT-PCR studies for their efficacy to reduce SARS-CoV2 burden. Here, we evaluated SARS-CoV2 burden in whole mouth fluid (WMF) and respiratory droplets (RD) samples before and after the use of PI, HP or CHX mouthwashes in hospitalized COVID-19 patients using RT-PCR and rapid antigen test (RAT). Thirty-six SARS-CoV2 RT-PCR-positive in-patients were randomly assigned to one of the four groups: 20 and 60 minutes after 1% w/v PI or 1.5% HP; 90 and 180 minutes after 1.5% HP or 0.2% w/v CHX. WMF and RD samples were collected concurrently at baseline and after the two different time points. RD (92%) showed a higher reduction in SARS-CoV2 burden than WMF samples (50%; p=0.008). SARS-CoV2 burden was statistically lower at both 20 minutes (p=0.02) and 60 minutes (p=0.03) with PI; at 20 minutes with HP (p=0.0001); and 90 minutes with CHX (p=0.04). The overall and individual mean logarithmic reductions in the WMF and RD samples were greater than 1.0 at 20, 60 and 90 minutes after PI, HP or CHX. RAT-positive patients at 90 minutes post-treatment (n=3) demonstrated a one log increase in virus copies. Among the three RAT-negative post-treatment patients, SARS-CoV2 burden declined by one log in two while the third patient had a slight increase in RNA copies. In conclusion, we have shown for the first time that the mouthwashes, PI, HP and CHX can reduce the SARS-CoV2 burden in the concurrently collected RD and WMF samples. RAT is more appropriate than RT-PCR to evaluate the efficacy of the mouthwashes.

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Objectives: (1) To determine the antimicrobial susceptibility pattern in pediatrics, (2) to identify the pattern of empirical antibiotic usage, (3) to determine the cost analysis of generic antibiotic usage pattern, (4) to assess the different dosage forms of antibiotics.Methods: A retrospective observational study was carried out. The study population included the medical records of children aged day 1-15 years with bacterial infection who got admitted in the pediatric department of the hospital. The average cost for each generic dosage form of antibiotic was calculated.Result: Among the 176 cases taken for the study, sepsis (35.8%) was found to be the most common disease. Bacterial infection showed gender predominance in males (62.5%) and occurrence of sepsis was highly found in age groups of 0-1 years (55.68%). Among the 14 causative organisms, methicillin-resistant coagulase negative staphylococci (61.93%) was predominant in Gram-positive and Escherichia coli (38.06%) for Gram-negative. Highly prescribed drug for empirical therapy was considered to be amikacin (39.20%). Widely prescribed antibiotics were amikacin (21%), ceftriaxone (15.1%), ampicillin (12.34%) and meropenem (9.57%), among which meropenem was found to be of high cost. Conclusion:It should be taken care that the drug should be given not only based on the sensitivity pattern but can also consider the economic affordability of the patient, with reference to existing brands from the formulary. This would help in reducing the burden of health-care cost for the patients.

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