Background. Scombrotoxinism is an acute toxin-induced illness caused primarily by bacterial synthesis of histamine in decomposed fish. Case Report. Immediately after taking 2-3 bites of cooked salmon, a clerical worker developed oral burning, urticaria, and asthma. In the emergency department, she was diagnosed with “allergies”; scombrotoxinism was never considered. She then developed wide-ranging symptoms (e.g., chronic fatigue, asthma, anxiety, multiple chemical sensitivity, and paresthesiae) and saw many specialists (in pulmonology, otorhinolaryngology, allergy, toxicology, neurology, psychology, and immunology). During the next 500+ days, she had extensive testing (allergy screens, brain MRI, electroencephalogram, electromyogram, nerve conduction velocity, heavy metal screen, and blood chemistry) with essentially normal results. She filed a workers' compensation claim since this injury occurred following a business meal. She was evaluated by a Qualified Medical Evaluator (GL) on day 504, who diagnosed scombrotoxinism. Comment. Scombrotoxinism should be considered in all patients presenting to the emergency department with “oral burning” or allergy symptoms following “fish consumption.” Initial attention to such history would have led to a correct diagnosis and averted this patient's extended illness. Specialist referrals and tests should be ordered only if clinically indicated and not for diagnostic fishing expedition. Meticulous history is crucial in resolving clinical dilemmas.
Objectives: The aim of this study is to identify the use and consumption of antibiotics in tertiary care hospital by using Anatomical and therapeutic chemical classification and Defined daily dose index. Material and Methods: A point prevalence study was conducted at tertiary care hospital. A total of 640 patients were included in this study and taken from different medical departments. Patient's demographic and biological data was collected from the medical records. Antibacterial drugs were classified according to ATC/ DDD index and antibiotic consumption was measured by DDD/ 100 Patient days. Results: The mean age of 640 patients was 44 (sd 13.53). About 78% of the antibiotics are prescribed from the NLEM (2018-2019). The consumption of antibiotics is higher in departments like surgery (92.18%), Orthopaedics (87.5%) and General medicine (81.25%) followed by Gynaecology (78.13%) and Pulmonology (50.2%). The DDD/ 100 Patient days in Gynaecology were 19.4, in Pulmonology unit 45.2, in surgical unit 24.82, in General medicine unit 33.6 and in Orthopaedics 30.23. Discussion: In our study the rate of utilisation of antibiotics was found to be 78%. Broad spectrum antibiotics like cephalosporin's and aminoglycosides are prescribed frequently in the hospital which leads to increase in the microbial resistance. The DDD of ceftriaxone (1250) and cefixime (400) is higher when compared to aminoglycosides i.e. amikacin (700). Conclusion: The DDD of cephalosporins is higher when compared to other antibiotics. Inappropriate use of antibiotics leads to increase in the microbial resistance. Prescribers are forced to use broad spectrum antibiotics when other antibiotic therapy options are not available.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.