Monoclonal antibodies (mAbs) as alternatives or more often as complementary to the conventional antimicrobials are being developed for the management of infectious conditions for the past two decades. These pharmacotherapeutic strategies are inevitable as the burden of antimicrobial resistance is far-reaching in recent times. MAbs are part of the targeted pharmacotherapy armamentarium with high degree of specificity – hence, exert comparatively superior efficacy and tolerability than the conventional polyclonal antisera. So far, only five mAbs have been approved for the management of infectious states – since, the marketing authorization (1998) given to palivizumab (Synagis®) for the prophylaxis of lower respiratory tract disease caused by respiratory syncytial virus in pediatric patients. Ibalizumab-uiyk (Trogarzo™) used for the management of multidrug resistant HIV-1 infection not yielding to at least 10 antiretroviral drugs previously was approved recently. Among the three antibacterial mAbs, raxibacumab (ABthrax®/ Anthrin®) and obiltoxaximab (Anthim®) are indicated for the treatment and prophylaxis of inhalation anthrax due to Bacillus anthracis; bezlotoxumab (Zinplava®) is used to reduce the recurrence of Clostridium difficile infection. There are also around 30 and 15 mAbs in different phases of development for viral and bacterial conditions. As alternatives to the traditional antivirals and antibacterials, the antimicrobial mAbs are the need of the hour. These mAbs are more relevant in the management of conditions like emerging viral outbreaks wherein there is a lack of prophylactic vaccines. The current cutting-edge engineering technologies revolutionizing the production of mAbs include phage-displayed antibody libraries, cloning from single-memory B cells or single-antibody-secreting plasma B cells, proteomics-directed cloning of mAbs from serum clubbed with high-throughput sequencing techniques. Yet, the cost of manufacture continues to be the main limiting factor.

Cetirizine, a piperazine-derivative second-generation antihistaminic, is used for a wide variety of disorders such as urticaria, eczema, and allergies. Adverse reactions due to this drug are usually rare, especially fixed drug eruption (FDE), a delayed cell-mediated hypersensitivity reaction, is scarce. Here, we report a case of cetirizine-induced FDE. A 34-year-old female developed hyperpigmented, itchy patches over both forearms, legs, feet, and right side of the chest after taking tablet cetirizine for dry cough with similar episode 2 years back on the same sites. The patient responded slowly with conservative treatment and the lesions disappeared after 10 days. She was advised to avoid the causative in near future. This case report highlighted FDE due to an antihistaminic which themselves will be prescribed to treat allergies.

Background: Anemia is one of the most common medical complications encountered during pregnancy. India is among the countries with maximum prevalence of anemia in the world. The commonly used treatment for iron-deficiency anemia is oral iron preparations such as ferrous sulfate, ferrous gluconate, ferrous ascorbate, ferrous fumarate, and parenteral iron sucrose. Aims and Objectives: The aims of this study were to assess the mean change in the hemoglobin levels from baseline up to 60th day of treatment with different iron supplements and to assess its cost effectiveness ratio. Materials and Methods: This was a prospective interventional clinical end point study conducted at Sri Venkateshwaraa Medical College Hospital and Research Center, Puducherry, India, from December 2019 to December 2020, among 84 antenatal women (>14 weeks) with iron-deficiency anemia. After getting ethics committee approval, the participants who fulfilled the inclusion and exclusion criteria were randomized to respective treatment groups. Group 1 (n = 21) received ferrous sulfate 200 mg, Group 2 (n = 21) received ferrous ascorbate 200 mg, Group 3 (n = 21) received ferrous fumarate 200 mg twice daily for a period of 60 days, and Group 4 (n = 21) received Iron sucrose 200 mg, based on iron requirement in divided doses and administered once in 2 weeks for a period of 60 days. Hemoglobin (Hb), RBC count, mean corpuscular volume, mea n corpuscular Hb (MCH), MCHC, WBC, platelet count, and cost of the treatment were assessed before and at the end of 60 days. Data were analyzed using GraphPad Prism software version 7.0 using Student “t”-test and one-way ANOVA. Results: We observed a significant (P < 0.001) rise in the mean Hb level from 10.4 ± 0.4, 10.4 ± 0.5, 10.4 ± 0.5 and 8.5 ± 0.3 to 11.2 ± 0.6 (P = 0.0001), 11.1 ± 0.6 (P = 0.0001), 11.3 ± 0.8(P = 0.0001), and 10.9 ± 0.6 (P = 0.0001) in Group 1, 2, 3, and 4, respectively. The average cost effectiveness ratio, with respect to Groups 1, 2, 3, and 4 was Rs. 675, Rs. 1782.9, Rs. 1110.7, and Rs. 786.7 per increase in Hb%, respectively. Conclusion: The outcome of this study proved the effective role of various oral ferrous iron preparations and all of them were found to be equally efficacious in improving the Hb concentration. However, the injectable iron sucrose showed a significant improvement in mean hemoglobin percentage compared to the various oral preparations. However, on analyzing the cost-effectiveness ratio, it was found out that the cost incurred per increase in Hb% was less in ferrous sulfate group, followed by iron sucrose, ferrous fumarate, and ferrous ascorbate. The results of this study can be helpful in pharmacoeconomical decision making while selecting a cost effective iron supplement for treating iron-deficiency anemia.

Cefixime, a third generation cephalosporin and ornidazole, a nitroimidazole is used for a wide variety of conditions like urinary tract infections, otitis media, pharyngitis, uncomplicated gonorrhea and anaerobic infections. Fixed drug eruption (FDE) is commonly associated with anticonvulsants, antimicrobials and NSAIDs. Here we report a case of a rare cefixime and ornidazole combination induced fixed drug eruption. A 39 year old male developed hyper-pigmented patches over both forearms and left thigh after consuming fixed dose combination of cefixime and ornidazole tablet for the treatment of urinary tract infection.

Background: Coronavirus disease 2019 (COVID-19) pandemic is still spreading worldwide and it has resulted in severe economic disruptions and unrivalled challenges to health-care system. Aims and Objectives: This study was planned to evaluate the knowledge, attitude, practice, and acceptability of COVID-19 vaccination among medical professionals. Materials and Methods: A questionnaire-based cross-sectional study was conducted on 276 medical professionals working in Puducherry using convenience sampling method. Data were collected using self-administered questionnaire. Descriptive statistics such as frequencies and percentages were computed. Statistical analysis was done using SPSS software 28.0 Version. Pearson’s Chi-square analysis and multinomial regression analysis were performed. Results: Among the 276 respondents, 71 (25.7%) were affected with COVID-19 infection, 274 (99.2%) got vaccinated. Two doses were taken by 90.6% and 24 (8.7%) had received one dose of vaccination during the study period. Adequate knowledge was seen (P = 0.029) among the doctors who received two doses of vaccination (P = 0.019). Positive attitude was observed among the professionals who were vaccinated with CoviShield (P ≤ 0.001) and received two doses of vaccination (P = 0.003). About 79% of participants experienced common side effects due to vaccination. About 83.3% of participants were willing to take Booster dose and their choice of vaccine was CoviShield 76.4%, Covaxin 21.7%, and only 12% endorsed Sputnik V. About 69.2% of them have accepted that after mass vaccination campaigns, COVID-19 infection has been reduced. Conclusion: The present study findings showed adequate knowledge, favorable attitude, good practice, and acceptability of COVID-19 vaccination. Public health officials should utilize this opportunity and engage the medical professionals in educational campaigns which could reduce the misconceptions and alleviate the fear about the vaccination among the general population.