Policy document on antimicrobial stewardship practices in India

Walia, Kāmini; Ohri, V C; Madhumathi, Jayaprakasam; Ramasubramanian, V

doi:10.4103/ijmr.ijmr_147_18

Cited by 45 publications

(42 citation statements)

References 13 publications

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“…National Center for Disease Control (NCDC) had brought forth national antibiotic policyin 2016; for the management of infections at all levels of healthcare. [ 22 23 ] It is imperative to propagate these guidelines as these will help in guiding the rational use of antibiotics. However, the universal adaptation of these guidelines remains deficient due tobarriers viz.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic prescribing patterns and knowledge of antibiotic resistance amongst the doctors working at public health facilities of a state in northern India: A cross sectional study

Trikha

Dalpath

Sharma

et al. 2020

J Family Med Prim Care

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Objectives: The aim of the study is to understand antibiotic prescribing patterns and to understand knowledge of antibiotic resistance amongst the doctors working at public health facilities of a northern Indian state. Methodology: A cross-sectional study among doctors of the civil hospitals of Haryana state of India was conducted 2019. Data were collected by self-administered questionnaire from a total of 215 doctors posted at the 22 district hospitals. Results: The response rate was 98%. Doctors (66%) perceived antibiotic resistance as a very important global problem, a very important problem in India (68%) and as an important problem in their hospital (31%). Experience in years was significantly associated with considering hand hygiene (OR, 5.78; 95% CI, 1.6420.3; P = 0.005) and treatment of bacteria as per susceptibility report of the organism (OR, 0.54; 95% CI, 0.310.93; P = 0.03). Surgeons reported piperacillin-tazobactam (17%), cloxacillin (17%), and cephazolin (12.05%) and others (54.2%) as the first choice of antibiotics for infection after surgery. Doctors (52.3%) reported that they started antibiotics 12 hours before surgery; 15 (17%) prescribed antibiotics 6 hours before surgery; and 23 (27%) 1 day before the surgery. Time for stopping antibiotics after surgery, as reported by participants, was 1 day (15%), 23 days (35%), 57 days (44%), respectively. A total of 71 (83%) doctors thought that surgical incision could lead to post-surgical site infection. Conclusion: Findings of study can be utilized to enhance education on antimicrobial prescribing, antimicrobial surveillance, and prescribing patterns among doctors in our settings.

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Section: Discussionmentioning

confidence: 99%

Antibiotic prescribing patterns and knowledge of antibiotic resistance amongst the doctors working at public health facilities of a state in northern India: A cross sectional study

Trikha

Dalpath

Sharma

et al. 2020

J Family Med Prim Care

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“…However, the models for the implementation in the developing countries, especially in the public sector settings, are lacking. The Indian Council of Medical Research (ICMR) has taken many initiatives towards ASP1617.…”

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confidence: 99%

Antibiotic stewardship initiative in a Medicine unit of a tertiary care teaching hospital in India: A pilot study

et al. 2019

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Background & objectives:The models for implementation of antibiotic stewardship programme (ASP) in the acute care settings of developing countries are lacking. In most of the hospitals, patient turnover is high and a proper system for recording antibiotic-related information and tracking hospital-acquired infections is not in place. This pilot study was conducted in a tertiary care teaching hospital in north India to assess the feasibility of implementation of an ASP in a Medicine unit and to evaluate the effect of implementation as per the criteria applicable in this set up.Methods:A pre-post-quasi-experimental non-randomized study was conducted in two phases. In the first phase, current practices in the Medicine wards were observed. In the second phase, the ASP was implemented in a single Medicine unit, along with prospective audit and feedback, tracking of the process, as well as outcome measures. Patient risk stratification, blood culture on day one, day 3 bundle, dose optimization, de-escalation and intravenous to oral conversion of antibiotics were the key elements focused upon.Results:There was a significant improvement in the appropriateness of antibiotic prescription (66 vs. 86%, P<0.001) and reduction in the mean number of antibiotics used per person (4.41 vs. 3.86, P<0.05) along with decrease in the duration of hospital stay (17 vs. 14 days, P<0.05). There was a significant improvement in sending of blood cultures on day one during the stewardship phase (P<0.001).Interpretation & conclusions:The ASP approach used in our pilot study may be feasible and beneficial. However, it needs further confirmation in other settings and on a large scale.

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“…[11] As per ICMR data, 2019, it is the third most common isolate from clinical samples (12%) following Escherichia coli and Klebsiella pneumoniae and carbapenem resistance was seenin 694 50% of the isolates from ICU, followed by 35% from ward and 20% from OPD which is a matter of grave concern. [12] Lymphadenitisis a novel manifestation of Pseudomonas aeruginosa infection. Bacterial causes of axillary lymphadenitis include cat-scratchdisease, staphylococcal or streptococcalinfections, mycobacterialinfections,tularemia and brucellosis.…”

Section: Discussion:-mentioning

confidence: 99%

Unilateral Axillary Lymphadenitis Caused by Pseudomonas Aeruginosa- A Rare Case Report

Bhattacharya¹,

Chakrabarti²,

Majumdar³

2020

IJAR

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Pseudomonas aeruginosa has been reported as the causative organism of a wide spectrum of infections ranging from wound infections to fatal Ventilator Associated Pneumonia (VAP), mainly in nosocomial and ICU setup. Patients usually have a known history of immunocompromised state, including burn patients and patients with Diabetes Mellitus. The recent advent of Carbapenem Resistant Pseudomonas aeruginosa (CRPA) has presented with a unique diagnostic and therapeutic challenge. Very few literatures exist regarding Pseudomonal infections manifesting as axillary lymphadenitis. Here, a case of unilateral axillary lymphadenopathy in an apparent immunocompetent host is reported from a tertiary care hospital in North Eastern India.

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Policy document on antimicrobial stewardship practices in India

Cited by 45 publications

References 13 publications

Antibiotic prescribing patterns and knowledge of antibiotic resistance amongst the doctors working at public health facilities of a state in northern India: A cross sectional study

Antibiotic prescribing patterns and knowledge of antibiotic resistance amongst the doctors working at public health facilities of a state in northern India: A cross sectional study

Antibiotic stewardship initiative in a Medicine unit of a tertiary care teaching hospital in India: A pilot study

Unilateral Axillary Lymphadenitis Caused by Pseudomonas Aeruginosa- A Rare Case Report

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