Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF) without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropriate use of antibiotics in the country.Objective To provide an analysis of diagnosis, grading, and prescribing of antibiotics in pediatric inpatients with DF in a tertiary care teaching hospital in India.Methods Data from case sheets of all pediatric inpatients (n=370) diagnosed with DF without co-morbid conditions were collected with regards to diagnosis, grading, presence, and appropriateness of antibiotic usage according to the 2009 WHO Guidelines, the National Vector Borne Disease Control Program (NVBDCP) of India Guidelines, and the Hospital Infection Society (HIS) Guidelines.Results Platelet count determination (50% of the cases) was the major diagnostic method for dengue. Inappropriate grading of DF was seen in 20% of patients. Almost 75% of the 370 dengue cases were prescribed antibiotics for the expressed purpose of avoiding hospital-acquired infections. A single antibiotic was given in 225 cases (60.81%), 2 antibiotics in 33 (8.91 %) cases, and 3 antibiotics in 9 (2.43%) cases.Conclusions From the results it is clear that antibiotics were prescribed to treat DF where the antibiotics do not have any role. DF is a self-limiting viral infection that can be treated with proper management of hemodynamic status with IV fluids. To avoid the usage of antibiotics in the treatment of dengue, awareness has to be created in healthcare professionals regarding the treatment guidelines for dengue and appropriate use of antibiotics to avoid hospital acquired infections.

Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF) without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropriate use of antibiotics in the country.Objective To provide an analysis of diagnosis, grading, and prescribing of antibiotics in pediatric inpatients with DF in a tertiary care teaching hospital in India.Methods Data from case sheets of all pediatric inpatients (n=370) diagnosed with DF without co-morbid conditions were collected with regards to diagnosis, grading, presence, and appropriateness of antibiotic usage according to the 2009 WHO Guidelines, the National Vector Borne Disease Control Program (NVBDCP) of India Guidelines, and the Hospital Infection Society (HIS) Guidelines.Results Platelet count determination (50% of the cases) was the major diagnostic method for dengue. Inappropriate grading of DF was seen in 20% of patients. Almost 75% of the 370 dengue cases were prescribed antibiotics for the expressed purpose of avoiding hospital-acquired infections. A single antibiotic was given in 225 cases (60.81%), 2 antibiotics in 33 (8.91 %) cases, and 3 antibiotics in 9 (2.43%) cases.Conclusions From the results it is clear that antibiotics were prescribed to treat DF where the antibiotics do not have any role. DF is a self-limiting viral infection that can be treated with proper management of hemodynamic status with IV fluids. To avoid the usage of antibiotics in the treatment of dengue, awareness has to be created in healthcare professionals regarding the treatment guidelines for dengue and appropriate use of antibiotics to avoid hospital acquired infections.

Hydatid liver disease is commonly found in sheep farming areas. Hydatid cysts are confined to the liver and lungs in common. Many reports on hydatid cysts of liver and lungs were reported individually. Here, we report a case of hydatid cyst of the liver leading to the development of cysts in the lungs. The patient had previously underwent surgery for the removal of hydatid cysts in the liver but chemotherapy with albendazole was neither initiated immediately nor continued for 3 to 6 weeks after initiation. Later she presented with shortness of breath and cough along with fever and chills, for which she was diagnosed to have pleural effusion confirmed with pleural fluid analysis showing increase in ADA (Adenosine deaminase) and protein levels and USG (Ultrasonography) demonstrating loculations. Inspite of specific therapy, pleural effusion was not relieved and she was advised for CT chest which revealed multiple cysts in the lung. Suspecting for the liver cysts, USG abdomen was advised and it confirmed the presence of hydatid cysts in the liver. This helped to draw a conclusion that failure of earlier surgical intervention i.e excision of hydatid cyst of the liver lead to the development of cyst in the lungs that presented as pleural effusion. This case highlights the importance of chemotherapy along with surgical intervention before and after the surgery.