Objectives Data from point prevalence surveys (PPSs) in India are scarce. Conducting PPSs is especially challenging in the absence of electronic medical records, a lack of dedicated resources and a high patient load in resource-poor settings. This multicentre survey was conducted to provide background data for planning and strengthening antimicrobial stewardship programmes across the country. Methods This inpatient PPS was conducted over 2 weeks in May 2019 simultaneously across five study centres in India. Data about patient characteristics, indications for antimicrobials use and details of each antimicrobial prescribed including supportive investigation reports were collected in predesigned forms. Results A total of 3473 admitted patients in wards and ICUs were covered across five study centres. Of these, 1747 (50.3%) patients were on antimicrobials, with 46.9% patients being on two or more antimicrobials. Out of the total antimicrobials prescribed, 40.2% of the antimicrobials were prescribed for community-acquired infection requiring hospitalization followed by surgical prophylaxis (32.6%). Third-generation cephalosporins and drugs from the ‘Watch’ category were prescribed most commonly. Only 22.8% of the antimicrobials were based on microbiology reports. Conclusions The survey demonstrated a high use of antimicrobials in admitted patients with a considerable proportion of drugs from the ‘Watch’ category. The targets for interventions that emerged from the survey were: improving surgical prophylaxis, decreasing double anaerobic cover, initiating culture of sending cultures and de-escalation with targeted therapy.

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Introduction:Antimicrobial resistance has been a global concern. Currently, interest has been focused on exploring antimicrobial properties of plants and herbs. One such botanical is Allium sativum (garlic).Aim:To evaluate the antimicrobial activity of fresh juice of garlic.Materials and Methods:Varying concentrations of fresh garlic juice (FGJ) were tested for their antimicrobial activity against common pathogenic organisms isolated at SSG Hospital, Vadodara, using well diffusion method. Moreover, minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) of FGJ were tested using broth dilution method. Sensitivity pattern of the conventional antimicrobials against common pathogenic bacteria was tested using disc diffusion method.Results:FGJ produced dose-dependent increase in the zone of inhibition at a concentration of 10% and higher. MIC of FGJ against the pathogens ranged from 4% to 16% v/v whereas MLC value ranged from 4% to 32% v/v with Escherichia coli and Staphylococcus aureus spp. showed highest sensitivity.Conclusion:FGJ has definite antimicrobial activity against common pathogenic organisms isolated at SSG Hospital, Vadodara. Further studies are needed to find out the efficacy, safety, and kinetic data of its active ingredients.

Background Caesarian section is one of the most commonly performed surgeries in India. Determination of the incidence as well as the clinical and financial burden of post caesarian surgical site infection (SSI), is of critical importance for all the stakeholders for rational and fair allocation of resources. Methods This study was a prospective observational case-control study. The mean direct and indirect cost of treatment for the cases were compared with the control patients. An unpaired t-test was used to compare the mean between the two groups. Results Out of 2024 patients, who underwent caesarian section during the study period, 114 had acquired incisional surgical site infection (ISSI), with the infection incidence being 5.63%. The total cost of illness due to post caesarian ISSI was almost three times higher compared to the non-infected matched control group. (P<0.0001). An average length of hospital stay in the ISSI patient group was 10 days longer than that in the control group (P<0.0001) and importantly total length of antimicrobial therapy(LOT) in patients with ISSI was also almost three times higher than the control group (P<0.0001). Conclusion The development of post caesarian SSI imposes a significant clinical as well as a financial burden. The study highlights the necessity of taking effective preventive measures to decrease the incidence of SSI.

Objective:Staphylococcus aureus has largely developed resistance to the multiple antimicrobial agents. Garlic (Allium sativum) is claimed to retard development of resistance and produce synergy with conventional antimicrobial agents. The aim of the present study was to evaluate the effect of combination of ampicillin with fresh garlic extract (FGE) against S. aureus by using in vitro method.Materials and Methods:Antimicrobial activity of FGE was studied by well diffusion and broth dilution methods. The effect of combination of ampicillin with FGE was studied by using checkerboard method against the clinical isolates of S. aureus. The organisms were exposed to individual antimicrobial as well the different combinations of the two agents and minimum inhibitory concentration was measured.Results:Synergistic interaction was observed by the combination of FGE with ampicillin for all the strains of S. aureus. Mean minimum inhibitor concentration (MIC) of ampicillin per se was 24 μg/ml. Addition of 30-60 mg/ml of FGE reduced MIC of ampicillin to <2 μg/ml.Conclusion:This in vitro study indicates synergism between FGE and ampicillin against S. aureus. Evaluation of these combinations in vivo may be warranted.