Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.
Background: Infections due to resistant micro-organisms considerably increase the mortality rate, treatment cost, disease spread and duration of illness. The development of antibiotic resistance (AMR) is increasing steadily increasing over the last 10-15 years, which is a real threat to disease management. Many studies states that about 20-50% of antibiotic use unnecessary so decreasing the use of antibiotics is the first step to curb the AMR.Methods: A questionnaire based prospective interventional study among the doctors. Systemic random sampling was applied. The pre tested structured questionnaire was used. Data’s were summarised in the excel sheet, analysed by proportions, percentages and other statistical methods like Student t test, Fisher test and Chi square test were used to check the association. The p>0.05 was considered as significant.Results: Out of 200 doctors, preliminary screening of 170 was included in the study and finally 156 participants were actively selected for analysis of results. Out of 156 participants, 55.1% were MBBS Intern and 44.9% were doctors. High significance (p=0.0001) were found between pre and post knowledge, attitude and practice of doctors.Conclusions: Further modes of studies have to perform to identify the determinants of attitude behaviour and motivation that lead people to use and misuse antibiotics. For effective outcome many more qualitative and quantitative studies are required. In addition, health care system should follow proper regulation and prescription policy as well as controls for prescription of antibiotic drugs.
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