Antimicrobial resistance (AMR) is increasing and it is a serious public health problem worldwide. Nepal is considered as one of the contributors for rising AMR due to the most prevalent irrational use of antibiotics. In this review, we have assessed the practices of antibiotic prescription and dispensing, and antibiotic resistance of commonly encountered bacteria in Nepal. There is exponential increase of therapeutic consumption of antibiotics either without clinician’s prescription or irrational prescription. Almost half of the population in Nepal was found to purchase antibiotics easily from the nearby pharmacies without clinician’s prescription. Irrational prescription is exceeded in remote areas which could be due to lack of access with health posts and hospitals. The third generation cephalosporins, which are considered as the last resort antibiotics were found to be relatively prescribed and dispensed higher as compared to other classes of antibiotics. Despite the existing limited functional surveillance system, antibiotic resistance among bacteria is increasing in Nepal because of irrational prescription, dispensing and consumption of antibiotics without prescription.
Background: Urinary tract infection (UTI) is a common cause of hospital visits. There is an increasing trend of resistance of uropathogens to antibiotics worldwide. The aim of this study was to identify the common uropathogens, along with their antimicrobial susceptibility. Methods: This retrospective cross-sectional study was conducted from April 2018 to April 2020 at Beni hospital. All patients with urinary tract infection visiting Beni hospital during this time and who had urine culture sensitivity tests done were included in this study. Urine samples were first cultured on cystine lactose electrolyte-deficient agar by a semi-quantitative technique, and then incubated aerobically for 18–24 h at 37 °C. The identified bacterial isolates were tested for antimicrobial susceptibility by the Kirby–Bauer disc diffusion technique. Results: Of the 1173 samples, 164 (14%) samples showed significant growth. Escherichia coli (74%) was the most common causative organism. E. coli was sensitive in 113 cases (95%) out of 119. Amikacin was tested in 87 isolates that showed 99% sensitivity. Other commonly used antimicrobial agents had lower sensitivity rates: gentamicin (83%), ciprofloxacin (75%), ceftriaxone (59%), cefixime (56%), cotrimoxazole (55%), cefotaxime (41%), and ampicillin (38%). Conclusions: E.coli is the most common pathogen associated with urinary tract infection. Nitrofurantoin and amikacin can be good empirical agents for treating UTI in patients coming to Beni hospital.
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