No abstract

Graphical abstract

Lower respiratory tract infections (LTRIs) are responsible for the vital causes of morbidity and mortality in all ages. In recent years, antibiotic resistance among respiratory pathogens is increasing emergently. The present study aimed to find out the bacterial etiology of LRTIs in Bangladesh and to update the clinicians about the current scenario of antibiotic resistance in lower respiratory tract infections. A total 64 bacterial pathogens from 100 patients with LRTIs were isolated from sputum specimens from a teaching hospital in Savar, Bangladesh between July-2014 to June-2015. The sputum specimens received within this year were subjected to analysis with microscopy, culture and susceptibility testing using conventional bacteriologic methods. Out of 100 processed sputum samples 64 (64%) cases had established bacterial etiology. Staphylococcus aureus (57.81%) was found to be the predominant organism in LRTIs followed by Streptococcus pneumonia (25%), Klebsiella and Pseudomonas species. Males (64.06%) were found to be more susceptible to LRTIs than that of females (35.93%). In antimicrobial susceptibility testing, grampositive organisms showed maximum sensitivity to imipenem (94.6%), meropenem (97.3%) and cefotaxime (75%). The resistance pattern varied for different organisms. Staphylococcus aureus isolates were mostly resistant to amoxicillin and ceftazidime (89.2%), whereas, Streptococcus pneumonia was to ceftazidime, amoxicillin and cotrimoxazole (81.2%). In case of gram negative isolates, Klebsiella sp. was mostly resistant to ceftriaxone, ceftazidime and amoxicillin (100%). Escherichia coli were resistant to amoxicillin, cotrimoxazole and vancomycin (100%). Therefore, appropriate identification of the causative organisms and their antibiotic resistance is crucial for right choice of antibiotic therapy in LRTIs.

BackgroundStevia, Stevia rebaudiana (Bertoni), has become an important economic plant for its commercial use as a sweetener. Stevia plays a significant role in the healthcare practice of different cultures and in population. Previous animal and clinical studies demonstrated the efficacy of Stevia against chronic diseases like diabetes and hypertension. This study aimed to investigate the beneficial effect of Stevia in chronic kidney disease (CKD) patients after three (3) months of treatment along with the conventional antihypertensive and anti diabetic medications.MethodsA prospective, interventional, randomized, single-blind, placebo-controlled trial has been done with 97 participants. Stevia capsule (250 mg) or matching placebo was given to the participants twice daily along with Angiotensin-II Receptor Blocker (ARB) and/or Ca2+ Channel Blocker (CCB). First follow up visits were done after 3 months of the interval. Blood and urine samples were collected for the biochemical tests. A structured questionnaire was used for the baseline assessment. Informed consent was taken from each participant.ResultsBoth hypertension and diabetes were found to be associated with CKD. Most of the participants (52.3%) of Stevia group were in CKD Stage II. Significant changes were found in Serum creatinine (p < 0.027), Serum Uric acid (p < 0.009), Fasting blood sugar (p < 0.041) and Postprandial blood sugar (p < 0.013) and Microalbumin (p < 0.041) level in the treatment group.ConclusionThe initial result demonstrated that Stevia has the potential for a significant improvement of some biochemical parameters in CKD patients. After completion of the nine (9) months clinical trial, the constructive effect of Stevia can be confirmed in this group of patients.

Drug-drug interactions (DDIs) represent an important clinical problem. During inpatient admissions, infants, children, and adolescents are typically exposed to different medications, increasing their risk of potential drug-drug interactions (pDDIs). While drug interactions are reported to be common, there are only few publications of the prevalence of such interactions among pediatric patients in Bangladesh. The present study tries to estimates the prevalence and characteristics of pDDI exposure of pediatric patients treated in children’s hospitals. This observational retrospective study was carried out on 155 patients admitted to a children’s hospital located at Dhaka during January 2019 to August 2019. The medications of the patients were analyzed for pDDIs by using Medscape drug interaction checker. The prescriptions were analyzed for demographic characteristics, medical and detailed drug history. Drug-drug interactions (DDIs) were evaluated for total numbers, types and severity of DDIs. Total 155 prescriptions with mean age 2.12±2.08 years were analyzed and a total of 25 pDDIs were recorded. The prevalence of pDDI was 17%, of which 12 (48%) were pharmacodynamic interactions, 10 (40%) were pharmacokinetic interactions and 3 (12%) of unknown mechanism. According to the severity of interaction, 4 (18%) cases were categorized as serious, 15 (55%) cases as moderate and 6 (27%) cases as minor. The occurrence of DDIs were significantly associated (r=0.912, p<0.05) with the number of drugs prescribed. The present study has identified pDDIs and also documented interactions in pediatrics patients. It has highlighted the need for screening prescriptions of pediatric patients for pDDIs and proactive monitoring of patients who have identified risk factors in order to promote detection and prevention of possible adverse drug interactions. Bangladesh Pharmaceutical Journal 24(2): 91-98, 2021