Antibiotics prescription pattern in COVID-19 patients presenting in DHQ Teaching Hospital Sahiwal; Is Pakistan heading towards Post-COVID Antibiotic Resistance Era?

Waseem, Muhammad; Rafiq, Maryam; Munir, Adeela; Kamal, Zahid; Aziz, Nauman; Iqbal, Muhammad Junaid

doi:10.37939/jrmc.v25i1.1656

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…It has been reported that Pakistan is the third highest consumer of antibiotics in the world after India and China [18]. It has been reported that 100% of patients of COVID-19 were given antibiotics, especially azithromycin before hospitalization [19]. A case of an azithromycin-resistant strain of XDR S. typhi has already been reported [20].…”

Section: Discussionmentioning

confidence: 99%

A Patient With Fever, Loose Motions and Jaundice: Hickam’s Dictum or Occam's Razor

Noor¹,

Rahim²,

Amin³

et al. 2022

Cureus

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Infectious diseases like malaria, typhoid, leptospirosis, and dengue fever are the leading causes of morbidity and mortality in developing countries like Pakistan. Although rare, it is possible to have coinfection with organisms that are endemic in a region, causing diagnostic and therapeutic dilemmas.Leptospirosis is caused by Gram-negative spirochetes. Leptospira are widely distributed and are transmitted by contamination of water and food by the urine of infected animals like rodents. Leptospirosis is characterized by fever, body aches, abdominal pain, and hepatic and renal involvement. Laboratory abnormalities include cytopenia, elevated bilirubin, alanine aminotransferase, and abnormal renal function tests.Typhoid fever is caused by Salmonella typhi (S. typhi), which is transmitted by fecal contamination of drinking water and food items. The clinical manifestations of typhoid fever include fever, abdominal pain, and diarrhea. Laboratory abnormalities include cytopenia and mildly deranged liver function tests. A strain of S. typhi resistant to all antibiotics except azithromycin and carbapenems was isolated in 2016 in Pakistan. Most of the clinical manifestations and laboratory abnormalities of leptospirosis and typhoid fever overlap.There have been case reports of coinfection of S. typhi and Leptospira, but there is no report of coinfection of extensively drug-resistant (XDR) S. typhi and Leptospira. We present a case of a 20-year-old man with fever, loose motions, and jaundice from Peshawar, Pakistan who had coinfection of Leptospira and XDR S. typhi. The attending physicians should adopt Hickam's dictum instead of Occam's razor approach.

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Section: Discussionmentioning

confidence: 99%

A Patient With Fever, Loose Motions and Jaundice: Hickam’s Dictum or Occam's Razor

Noor¹,

Rahim²,

Amin³

et al. 2022

Cureus

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“…Chen et al reported that only 1% of the COVID-19 patients showed positive results for presence of bacterial coinfection but 71% of the patients had been put onto empirical antibiotic therapy. 18 20 If the same practice continues we might land up in a pandemic bigger and worse than COVID-19 itself and it will be termed as post Covid Antimicrobial resistance.…”

Section: Clancy Et Al and Lehmann Et Al In Their Studiesmentioning

confidence: 99%

Bacterial Co-infections and Susceptibility patterns among admitted COVID 19 patients during 3rd wave of pandemic, in a Tertiary Care Hospital. Lahore.

Hussain

Abid

Ahmed

et al. 2023

TPMJ

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Objective: To check the Bacterial Co-infections and Susceptibility patterns among admitted COVID-19 patients during 3rd wave of pandemic. Study Design: Descriptive Cross Sectional study. Setting: Department of Microbiology, Combined Military Hospital Lahore Pakistan. Period: May 2021 to August 2021. Material & Methods: Six hundred and twelve COVID-19 positive patients having positive bacterial cultures were processed, Antibiotic susceptibility testing was done by Kirby-Bauer diffusion technique, all antibiotics were reported using breakpoints recommended in clinical and laboratory standards institute (CLSI 2021). Results: Out of 612 patients, 348 (56.9%) were male and 264 (43.2%) were female. Mean age of the patients was 57.2 ± 14.4 years with a range of 22 to 89 years. Bacterial coinfection was present in 70.4% of the patients. Gram negative bacteria (94.4%) were more prevalent in COVID-19 patients as compared to gram positive isolates (5.6%). Antibiotic sensitivity pattern of Staphylococcus aureus showed a high resistance against penicillin, ampicillin, tetracycline and doxycycline. Conclusion: Our study reported a high prevalence of bacterial coinfections in COVID-19 patients infected during the third wave of pandemic. A high percentage of gram negative species were identified in our study population, this could be due to the suppression in the immunity of individuals due to severity of COVID-19 infection and already present Antimicrobial resistance.

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Prevalence and Misuse of Antibiotics during Omicron (Covid-19) Pandemic in Pakistan

Wazir (RPH)

2023

JPDMHD

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Introduction: The prevalence of self -medication with antibiotics is quite high in Pakistan as compared to developed countries. Antibiotics are often taken erroneously for certain ailments, without having the appropriate and sufficient knowledge of their use. As a result, this carries potential risks for the individual as well as the community, in form of several side effects such as antibiotic resistance. Therefore, the prevalence of self-medicated antibiotics in COVID-19 Omicron Pakistan needs to be studied and evaluated. Methods: An online based cross-sectional survey was conducted using a self-administered, self-made and validated questionnaire to address this key issue in Pakistan. This questionnaire was delivered country wide and making it sure that it would reach all the provinces including the capital of Pakistan. The questionnaire included general as well as specific questions in such a way that it targeted almost every single person having at least certain knowledge about medicines especially antibiotics. Data was collected using self-administered questionnaires and analyzed using SPSS version 21. Results: A total of 390 respondents were included in the final analysis. In this study men made up the majority of respondents, 240 (61.5%), and females made up about 150 (38.5%). Self-medication was quite prevalent in our study population with 125 (32.1%) out of 390 (100%) individuals were using any of the drugs since the start of pandemic. The most commonly utilized medications were cephalosporin, ceftriaxone (32.1%). Followed by macrolides, azithromycin, clarithromycin which was used by 119 (30.5%) participants. And penicillin, amoxicillin with clavulanic acid (17.4%) and fluoroquinolones, ciprofloxacin (7.2%) while the percentage of use of other antibiotics is 12.8%. The most common reasons reported for the usage of these medications included fatigue, cough, sore throat and runny nose which was about (48.7%). Conclusion: Our study revealed common self-medication practices among General population. It is a significant health issue especially during the pandemic times, with high consumption reported as a prevention or treating symptoms of Omicron.

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Antibiotics prescription pattern in COVID-19 patients presenting in DHQ Teaching Hospital Sahiwal; Is Pakistan heading towards Post-COVID Antibiotic Resistance Era?

Cited by 3 publications

References 20 publications

A Patient With Fever, Loose Motions and Jaundice: Hickam’s Dictum or Occam's Razor

A Patient With Fever, Loose Motions and Jaundice: Hickam’s Dictum or Occam's Razor

Bacterial Co-infections and Susceptibility patterns among admitted COVID 19 patients during 3rd wave of pandemic, in a Tertiary Care Hospital. Lahore.

Prevalence and Misuse of Antibiotics during Omicron (Covid-19) Pandemic in Pakistan

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