Study of current prescribing pattern of antimicrobial drugs in indoor cases of enteric fever in a tertiary care hospital

Rathod, Pravin S.; Patil, Praveenkumar T.; Choure, Balwant K.; Patil, Amit

doi:10.18203/2319-2003.ijbcp20160120

Cited by 4 publications

(7 citation statements)

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“…In total, 45.71% of the in-patients received a combination of two antibiotics at some point. This data of ceftriaxone usage and combination drug usage corroborate with the study of Rathod et al 27 In this work, azithromycin was the most commonly prescribed drug in OPD followed by cefixime. Nearly 11% of the patients had received a combination of azithromycin 1gm /day and cefixime 400 mg twice a day.…”

Section: Discussionsupporting

confidence: 91%

A study on the clinical spectrum, prescription pattern and diagnosis of enteric fever in a tertiary care hospital of North India

Chatterji

Sharma²,

Kaur³

et al. 2022

Int J Community Med Public Health

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Background: Enteric fever is a major public health concern in developing countries. Lack of diagnostics diagnosis and antimicrobial resistance challenges in treatment of enteric fever. Timely diagnosis and proper management of fever are essential to reduce the complications and emergence antibiotic resistance.Methods: A prospective observational study was conducted on 71 subjects between February 2018 and December 2019. Spectrum of the disease, antimicrobial resistance and prescription pattern were observed and performances of various diagnostic methods (like culture, serology and loop mediated isothermal amplification) were determined.Results: The most commonly observed clinical features included gastrointestinal complaints, anaemia, leukopenia, splenomegaly and hepatitis. Blood culture was positive for 49.3% (35/71) of the cases using conventional culture method. All samples positive by LAMP were also culture positive, out of which 80% (28/35) were S. typhi and 20% (7/35) were S. paratyphi A. Antimicrobial susceptibility to ciprofloxacin was 39.3% and 28.6% and ampicillin susceptibility was 32.1 and 28.6% in S. typhi and S. paratyphi A respectively. Only one multidrug resistant isolate was noted, while none was resistant to ceftriaxone or azithromycin. Cefixime and azithromycin combination therapy led to the earliest defervescence of fever.Conclusions: Oral combination therapy may be a good option to treat enteric fever and oral combination therapy may be a good option to treat enteric fever and performance of LAMP seem to be as good as culture with a shorter turnaround time. LAMP can be used to obviate the need of culture in resource limited settings.

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Section: Discussionsupporting

confidence: 91%

A study on the clinical spectrum, prescription pattern and diagnosis of enteric fever in a tertiary care hospital of North India

Chatterji

Sharma²,

Kaur³

et al. 2022

Int J Community Med Public Health

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“…The age bracket in this study is similar; however, we report a tremendous fall in MDR typhoid cases and a surge in cefixime and CFX resistance. The reason behind this difference in results is likely the evolving pattern of antibiotic prescription over these years and the problems with inappropriate use of antibiotics as has been previously discussed [6,8].…”

Section: Discussionmentioning

confidence: 99%

“…The most salient factor driving a change in prescription patterns is the emergence of drug resistance. Traditional first-line drugs (e.g., chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) have failed to provide sufficient eradication since the late 1990s due to multidrug-resistant (MDR) typhoid [5,6]. The incidence of MDR typhoid has been reported to be 17% to 23% in South Asia [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Traditional first-line drugs (e.g., chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) have failed to provide sufficient eradication since the late 1990s due to multidrug-resistant (MDR) typhoid [5,6]. The incidence of MDR typhoid has been reported to be 17% to 23% in South Asia [6,7]. The trend shifted from first-line antityphoidal drugs to first- and third-generation cephalosporins and fluoroquinolones (FQ) (second-line agents for typhoid), and azithromycin [6,8].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of MDR typhoid has been reported to be 17% to 23% in South Asia [6,7]. The trend shifted from first-line antityphoidal drugs to first- and third-generation cephalosporins and fluoroquinolones (FQ) (second-line agents for typhoid), and azithromycin [6,8]. Concurrently, newer studies have started to report increasing antimicrobial resistance to one or more second-line antityphoid agents [8-10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antimicrobial Susceptibility Patterns of Salmonella Species in Southern Pakistan

Laghari

Hussain

et al. 2019

Cureus

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Introduction Typhoid fever is a major infectious disease among the pediatric population of Pakistan. With inappropriate use of antibiotics and rising trends of multidrug-resistant (MDR) and extended drug-resistant (XDR) typhoid, it is becoming a public health emergency. This study evaluated the current trends in antibiotic susceptibilities to Salmonella (S) typhi and paratyphi A, B, and C in southern Pakistan. Materials and methods This cross-sectional study, conducted in the Pediatrics Department, Civil Hospital, Jamshoro from July to December 2018, included children with S. typhi and S. paratyphi A and B strains isolated from the laboratory-based culture of blood samples. Results There were 223 (81.1%) children with S. typhi and 52 (18.9%) with S. paratyphi isolates. Their mean age was 5 ± 3 years. The most common age group with S. typhi strains was two to five years (n = 102; 37.1%). Previous trials of antibiotics were taken by 162 (58.9%) children; 65 (40.1%) of these were physician-prescribed. Cefixime was most commonly taken (66.6%), followed by ciprofloxacin (33.3%). Cefixime and ceftriaxone showed 60.9% and 65.8% sensitivity, respectively. Ciprofloxacin sensitivity was seen in 50.1% S. typhi isolates. There were six (2.6%) cases of MDR typhoid and two (0.9%) cases of XDR typhoid. Conclusion Resistance to second-line antityphoid agents is increasing. Therefore, there is a need to modify prescribing behavior. The outbreak of XDR typhoid among children is an alarming public health concern for Pakistan. Widespread antibiotic stewardship programs must be conducted.

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Defying the odds: Determinants of the antimicrobial response of Salmonella Typhi and their interplay

Chowdhury,

Mukherjee,

Chatterjee

et al. 2023

Molecular Microbiology

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Salmonella Typhi, the invasive serovar of S. enterica subspecies enterica, causes typhoid fever in healthy human hosts. The emergence of antibiotic‐resistant strains has consistently challenged the successful treatment of typhoid fever with conventional antibiotics. Antimicrobial resistance (AMR) in Salmonella is acquired either by mutations in the genomic DNA or by acquiring extrachromosomal DNA via horizontal gene transfer. In addition, Salmonella can form a subpopulation of antibiotic persistent (AP) cells that can survive at high concentrations of antibiotics. These have reduced the effectiveness of the first and second lines of antibiotics used to treat Salmonella infection. The recurrent and chronic carriage of S. Typhi in human hosts further complicates the treatment process, as a remarkable shift in the immune response from pro‐inflammatory Th1 to anti‐inflammatory Th2 is observed. Recent studies have also highlighted the overlap between AP, persistent infection (PI) and AMR. These incidents have revealed several areas of research. In this review, we have put forward a timeline for the evolution of antibiotic resistance in Salmonella and discussed the different mechanisms of the same availed by the pathogen at the genotypic and phenotypic levels. Further, we have presented a detailed discussion on Salmonella antibiotic persistence (AP), PI, the host and bacterial virulence factors that can influence PI, and how both AP and PI can lead to AMR.

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Study of current prescribing pattern of antimicrobial drugs in indoor cases of enteric fever in a tertiary care hospital

Cited by 4 publications

References 3 publications

A study on the clinical spectrum, prescription pattern and diagnosis of enteric fever in a tertiary care hospital of North India

A study on the clinical spectrum, prescription pattern and diagnosis of enteric fever in a tertiary care hospital of North India

Antimicrobial Susceptibility Patterns of Salmonella Species in Southern Pakistan

Defying the odds: Determinants of the antimicrobial response of Salmonella Typhi and their interplay

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