Main Article Content
Abstract
Background
Antimicrobial agents are some of the most widely, injudicious and therapeutically drug used in various conditions ranging from simple bacterial infections to various life threatening conditions. AMA are a double edged sword, hence their indiscriminate & inappropriate use has already lead to the emergence of resistant strains of many bacteria, lack of efficacy, increased side effects. Antibiotic stewardship programs (ASP) implicit to improve systematic approach, rational use of antimicrobial agents and improve patient outcomes. Rationality in the use of antimicrobial agents will surely control the emergence of antibiotic Resistance, avoidance of combinational drugs, also it will curb the side effects. Careful titration of AMA is imperative to ensure the ideal treatment outcomes.
Objectives
Assessed the Prescription pattern in infectious diseases. Assessed the efficacy of mono therapy, dual therapy and triple therapy, multiple therapy. Monitored the clinical outcomes in patient treated with different antimicrobial therapy in infectious diseases. Analyzed the antibiotic sensitivity pattern of common microorganisms. Detected Adverse drug reactions. Evaluated the Rational and Irrational use of drugs. De-escalation of antimicrobial therapy (stewardship programme)
Results
A total of 300 patients were included in our study, which shows a female preponderance with 154 (51%) in the age group of 40-49yrs. And 146 (49%) male patients mostly in the age group of 60-69yrs. And most frequent clinical conditions were LRTI 118 (40%). The most common AMA prescribed were beta lactum and betalactam inhibitors 197 (35%). The most common Antimicrobial agents were Ceftriaxone 85. Sensitivity pattern was studied in which out of 54 bacterial culture isolates, 32 cultures were gram -ve bacteria and 22 culture were gram +ve bacteria. Most prescribed regime was mono therapy 153 (51%) in which mostly given was ceftriaxone 49 (32%), cefoperazone/ salbactum 27 (18%) and dual therapy 95 (31%) in which mostly given was doxycycline+ ceftriaxone 8 (9%). Comparison of clinical outcomes in infectious diseases, cured patients were 224, controlled patients 61, no improvement patients were 15. The occurrence of 24 ADR were detected. The second most objective was performing stewardship programme in which a total of 64 cases out of 300 cases were de-escalated. According to NCDC guidelines, out of 300 patients, 78% were rational and 22% were irrational. In conclusion,
Conclusion
An antibiotic use policy should be framed. Formation of a multidisciplinary team to oversee drug use and periodically review microbial sensitivity patterns will be helpful. Longitudinal surveillance of drug use should be carried out.