Background: Antibiotics, one of the frequently prescribed medications in modern medicine is plagued by misuse and consequent development of resistance. We report the knowledge and practice of antibiotic use and the extent of self-medication with antibiotics among health science students of a university in south India. Methods: A cross-sectional study was carried out that included students from various disciplines such as Medicine, Dentistry, Pharmacy, and Nursing. A random sample of 531 students, were recruited into the study and those students with a history of any chronic disease requiring long-term treatment were excluded. Results: Almost 58% reported using antibiotics in the last 3 months and 39% frequented its use over 3 times in a year. Thirty percent stated that they had procured antibiotics over the counter without a valid prescription. Common ailments that reportedly triggered antibiotic use, ranged from mild fever to skin infections. Medical (25%) & Dental (36%) students declared self-prescription as a frequent practice. b-lactam group was the most popular group of antibiotics, with over 44% vouching its use. Conclusion: There appears to be inadequate adherence to antibiotic policies among the study population warranting periodic training and monitoring. Establishment of an effective antibiotic stewardship could be the way forward.

Eschar in scrub typhus aids in early diagnosis and institution of appropriate therapy; however, the eschar positivity rates vary greatly in endemic regions. Multiple eschars in scrub typhus are a rare presentation. Our patient presented with fever and multiple eschars and was empirically started on doxycycline. Nested polymerase chain reaction from all the four eschars and from EDTA blood were positive for 56-kDa type-specific antigen which is specific for Orientia tsutsugamushi The patient recovered completely after 7 days of antibiotic treatment. He was from an area where scrub typhus was not observed previously. An eschar in an acute febrile patient from the "tsutsugamushi triangle" is a valuable sign in scrub typhus diagnosis. A search for multiple eschars in scrub typhus must be made by clinicians.

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