Background Repeated attacks of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have been attributed to bacterial infections. However, sputum microbiology for identifying the bacteriological profile is not performed usually and remains controversial. Thus, we performed a prospective, cross-sectional study to assess the clinico-bacteriological profile of the patients with AECOPD and antibiotic resistance pattern of bacteria isolated from sputum samples. The study involved 104 consecutive hospitalized patients, of either gender, aged 40–90 years, and diagnosed with AECOPD. Before initiating an empirical antibiotic therapy, the sputum samples of all the patients were collected and subjected to Gram staining, bacterial culture, and antibiotic sensitivity. Results The most common bacterial isolates were P. aeruginosa (30.7%) followed by K. pneumoniae (20.3%) and S. pneumoniae (8.6%). Both Gram-positive and Gram-negative bacteria were most sensitive to Meropenem (91%) followed by Amoxicillin-clavulanic acid (83%). However, these bacteria were most resistant to Cefoperazone-sulbactam (43%) followed by Levofloxacin (41%). P. aeruginosa and K. pneumoniae were most resistant to Cefoperazone-sulbactam (23%) followed by Fluoroquinolones (23–35%), while S. pneumoniae was most resistant to Ciprofloxacin (44%) followed by Amoxicillin-clavulanic acid (33%). Conclusions Isolation of P. aeruginosa, as the most common agent, further confirms its roles in severe attacks of AECOPD. The regularly used antibiotics were found to be resistant to most isolates, thereby suggesting that severity of AECOPD may be attributed to the prevalence of antibiotic-resistant strains.

Background: Inappropriate antimicrobial use contributes to antimicrobial resistance. Assessing knowledge, perception and attitude regarding antimicrobial use serves as a prelude to design and implement educational modules to promote rational antimicrobial use.Methods: An online questionnaire based cross-sectional study involving 338 medical students; under-graduates, interns and post-graduates was conducted in a medical college in south India. Chi-square test or Fisher exact test were used to determine association between variables.Results: Fifty percent of the participants (170/338) responded to the questionnaire. The responses were similar across undergraduates, interns and post-graduates. Majority of the responders had good knowledge regarding use of antimicrobials. Most of the participants (92.35%) expressed that a broad-spectrum antimicrobial should be started to treat a serious infection while awaiting culture and sensitivity reports and 88.82% did not prefer to use antimicrobial agents for common cold. Similarly, most of the respondents (93.56%) were aware of the fact that antimicrobial resistance is a global problem. However, many of them (74.71%) were not aware of antimicrobial stewardship programme in their college.Conclusions: This study revealed that most of the students had good knowledge, fair perception and positive attitude regarding the use of, and resistance to antimicrobial agents but not about stewardship programmes. Proactive measures are required to sensitise medical students on antimicrobial stewardship programmes.