Mohammed Imran
Shaheed Hasan Khan Mewati Govt Medical College
India
Title: Prospective evaluation of prescribing practice, antibiotic susceptibility pattern and adverse drug reactions of empirical antibiotics used in female patients with urinary tract infections
Biography
Biography: Mohammed Imran
Abstract
The urinary tract infections (UTI) in females are usually treated empirically with antibiotics even before the laboratory results of urine cultures are available. The prescriptions and drug resistance patterns are varied in each locality. Drug resistance may lead to the reduced efficacy, chances of foetal and maternal complications, inappropriate therapy, unnecessary burden of therapy and unwanted adverse drug reactions. In this prospective clinical study, 327 female patients from obstetrics and gynaecology department of 350 bedded university teaching hospitals were enrolledafter Institutional ethical clearance. The prescribing pattern, antibiotic susceptibility of the microorganism and adverse drug reactions were monitored for four months duration after obtaining the written informed consent. Among them 79.51% patients were married and maximum incidence (45.80%) of UTI was found during last trimester. It was more in 21-30 years age group (50.46%) and 75.84% were symptomatic. Amoxicillin-Clavulanic acid was prescribed in maximum patients 142(43.33%) followed by Nitrofurantoin 127(38.83%). Gram positives bacteria were found resistant to Amikacin, Ceftriaxone and Doxycycline whereas Gram negatives to Doxycycline, Cefixime, Ceftriaxone and Ofloxacin. Multi drug resistance (MDR = resistance in ≥ 2 drugs) was seen in most of the isolated bacterial uro-pathogens. The adverse drug reactions associated with such antibiotics were Amikacin (Headache 10%, Nausea & Vomiting 20%), Cefixime (Nausea 25%), Ceftriaxone (Watery stools 50%) and fluoroquinolones (metallic taste and nausea, photosensitivity with Ciprofloxacin). The increased incidence of UTI during gestation necessitates the appropriate choice of antibiotics for rationale treatment and to reduce the chances of ADRs by mandatory susceptibility patterns based pharmacotherapy prescribing practice.