Background: Antimicrobial drugs are life-saving drugs but they come with their own share of adverse drug reactions (ADRs). Institutional drug policy helps in the rational use of the antimicrobial for the given clinical condition. This helps in controlling the development of resistance as well as minimizing adverse events. Aims and Objectives: This study aims to share the pattern of adverse reactions seen to the commonly prescribed antimicrobials. Materials and Methods: This is a retrospective, observational study. The data of patients, admitted to a tertiary care center in North Kerala who reported adverse effects related to antimicrobial treatment, were obtained from the case files from the medical record library. ADRs with antimicrobials reported during the period from November 2018 to November 2019 were obtained and the data were expressed as percentages in Microsoft excel. Causality assessment was done using the world health organization casualty scale. Results: 92 case reports were analyzed. Among the different antimicrobials used, Ciprofloxacin was the most commonly prescribed antimicrobial (18.5%) followed by ceftriaxone (12%). 13 different patterns of ADRs were obtained following the use of these drugs, among which allergic reactions to drugs were the most common (71.7%) with a causality assessment showing it to be the probable cause. Conclusion: The monitoring of ADRs to antimicrobials is the need of the hour. This study helped in determining the different patterns of ADRs with antimicrobials. Active surveillance and complete reporting help in identifying these and reporting and managing them to prevent such occurrences in the future.

Ethambutol is one of the first line chemotherapeutic agents used in the treatment of tuberculosis used both in the intensive and continuation phase according to the new Revised National Tuberculosis Control Program guidelines. Patient acceptability is rather good with this drug as it produces comparatively lesser adverse effects. The most important and serious side effect reported is optic neuritis, resulting in loss of visual acuity, color vision and field defects. The incidence of optic neuritis is generally directly proportional to the dose and duration of ethambutol therapy. Here we report four cases of ethambutol induced optic neuritis in patients on fixed dose combinations (FDC) of ethambutol, isoniazid, pyrazinamide and rifampicin who presented in Ophthalmology OPD in a span of 2 months, between June and July 2019. Contradictory to the rare occurrence of ethambutol induced optic neuritis this comparatively higher incidence of optic neuritis is alarming. We observed that the presentation of ethambutol induced optic neuritis can vary and dose of ethambutol along with other factors can also contribute to it. So proper pre-treatment evaluation, dosage adjustment, periodic monitoring and early detection have a significant role in prevention and treatment of ethambutol induced optic neuritis.