Introduction: Antimicrobial stewardship programme (AMSP) is an important strategy to contain antimicrobial resistance (AMR) in the community. Materials and Methods: A point prevalence survey was carried out in October 2018 in accordance with ECDC 2013 document. The survey was carried out on a single day in intensive care units, acute medical, acute surgical and family wards of a tertiary care hospital in western India. Results: Less than 44% of admitted patients in acute wards were found to be prescribed with antimicrobial agents (AMA). The culture report of clinical specimen sent was positive for pathogen growth in 21% samples. Cephalosporins, penicillins and quinolones were the most commonly prescribed AMA on inpatients of the hospital. Of these, 70% were administered parenterally and 46% were given for more than one week. 70% of the empirical therapy was found to be effective. Pathogens resistant to many WHO WATCH group AMA and aztreonam, a RESERVE AMA have been isolated in the survey. Two of the isolated pathogens showed sensitivity to less than 3 antibiotics. Conclusion:The present survey has revealed a high prevalence of infectious disease burden and antimicrobial usage in acute wards of our hospital.

Background: Prescription analysis is the simplest method to observe the current treatment practice in any health-care setting. Biopharmaceuticals are a class of drugs that hold great promise in treating diseases. In recent years, there has been an increase in their consumption. The present analysis was carried out to obtain data on the prescribing patterns and the prevalence of the use of biologics in two departments of a tertiary care hospital through a cross-sectional study. Methodology: The study was conducted as an observational study in the departments of rheumatology and endocrinology of a tertiary care hospital in western India. Data were collected from the prescription notebooks or medical case sheets of patients on treatment in the outpatient departments (OPDs) or wards by the rheumatologists or endocrinologists of the hospital. The World Health Organization core drug use indicators for drug prescription analysis were calculated. Results: A total of 4684 drugs had been prescribed in the 874 patient encounters analyzed with the average number of drugs per prescription being 5.36. While 13.3% of prescriptions in the rheumatology department contained a biologic, more than 55% of prescriptions in the endocrinology department contained a biologic. The commonly used biologics were infliximab and etanercept in the rheumatology department and insulin analogs in the endocrinology department. Conclusion: The use of eight types of biologics in rheumatoid arthritis patients in this study is an indicator of active monitoring of the disease and early intervention. The present study has brought out the rational use of biologics such as infliximab and etanercept in rheumatology and insulin analogs in the endocrinology departments of the hospital.

Antimicrobial resistance is a condition in which microorganisms no longer respond to medications that were previously effective against them. This makes infections more difficult to cure, necessitating greater doses, and leads to increase morbidity and mortality. Antimicrobial therapy failure is frequently caused by the spread of resistant infections, which eventually replace susceptible pathogens. Antibiotics are a type of medicine employed for a limited time and for specific indications. As a result, there isn't much incentive to research and development of newer antibiotics. The temporal utility of antibiotics keeps decreasing as we use them. Hence it is a continuous ordeal, and we need new agents to fight the war against infection. This article attempts to summarize the newer anti-bacterials and some alternative approaches.

Objective: A study to analyse the appropriateness of use of antibacterials in acute wards of a tertiary care hospital. Design: A pharmacoepidemiological research study. Intervention: Non-interventional descriptive study. Main Outcome Measure: The antibacterial prescriptions were analyzed for their adherence to or deviation from the standard national treatment guidelines. Results: There were a total of 207 patients comprising of 35 in acute medical ward, 65 in ICU, 53 in acute surgical ward and 54 in family ward, who were prescribed antibacterials. These consisted of a total of 383 prescription counts for appropriateness of AMA use. One third of the antibacterial prescriptions of inpatients surveyed were for prophylactic use followed by the treatment of respiratory and gastrointestinal diseases. The highest prescription counts were seen with carbapenems followed by nitroimidazoles, cephalosporins, aminoglycosides and penicillins. 99% of the prescriptions were appropriate for the dose used and 49.6% of the prescriptions were inappropriate for duration of use. 74.5% of the surgical prophylaxis prescriptions were used for more than 24 hours. Ceftriaxone and cefotaxime were used instead of the recommended cefazolin, for prophylaxis. High percentage of deviation was observed with prescriptions of cefotaxime and metronidazole for empirical use. No definitive use of antimicrobials for infections was observed in the ICU. Conclusion: A high percentage of appropriateness was observed for dose of antibiotic used. The main targets identified for improvement are duration of antimicrobial use, choice of drug for surgical prophylaxis and the definitive use of antimicrobial agents. Keywords: adherence to treatment guidelines, antibiotic audit, antimicrobials.