Avinash Teli

Abstract

Inroduction: Antimicrobial agent are the biggest contribution to 20th century, which are used to prevent and cure of the infections. Over use of antimicrobials has facilitated the development of resistance. Drug utilization research help in identification of clinical use of drugs in populations and its impact on healthcare system. Aim: The aim of the study is to identify the overuse/misuse of the antibiotic usage in our intensive care unit. which helps in rationalising the antibiotic prescription and to avoid emergence of drug resistance and to improve better patient’s outcome. Material and Methods: An observational audit has been conducted in inpatient admitted in our set up and has been prescribed with restricted antimicrobials. The audit has been done for 3 months. The Audit report for 218 patients have been prescribed with Restricted antimicrobials either one or more than one. The audit report shows that Meropenem and Colistin was prescribed more often 81 and 73 respectively. Geriatric Patients have been prrscribed more with Antimicrobials than other age groups. 193 patients were on single Restricted antimicrobial therapy, 24 patients were on dual restricted antimicrobial therapy and one patient was on more than 2 Restricted antimicrobial therapy. Out of 218 Prescription having Restricted Antibiotics, 39 prescription were found irrational. Conclusion: A wide spectrum of clinical diagnoses and a variety of drugs were utilized from various antibiotic classes. Results showed that Carbapenems(Meropenem) antibiotics were extensively used in ICU. Among Colistin and Vancomycin was most commonly prescribed. Policy for rational usage of restricted antimicrobial agents in ICU should be implemented and education needs to be provided. Keywords: Restricted Antimicrobial, Antimicrobial Usage, Antibiotic, WHO Guidelines, Antimicrobial Audit, Antibiotic compliance audit, Rational antibiotic prescription, Reserve & Watch group Antimicrobial Audit, NABH Guidelines, CDC Guidelines

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Abstract

The RNA virus known as SARS-CoV-2, which causes severe acute respiratory syndrome, was discovered for the first time in Wuhan, China, in December 2019. The World Health Organization (WHO) declared the outbreak a global pandemic on March 11, 2020, as a result of the virus's subsequent spread throughout the planet. The urgent creation of safe and effective vaccines has elevated to a top priority in the global healthcare industry because of the terrible effects of the COVID-19 outbreak. The Covaxin and Covishield vaccines were administered as part of the start of the SARS-CoV-2 vaccination campaign in India on January 13, 2021. Covaxin is made up of adjuvant-inactivated viral particles, whereas Covishield is an adenovirus vector-based vaccine. The utility and effectiveness of each vaccine are significantly influenced by its formulation, adjuvants, and mode of action. Vaccine efficacy depends on various factors, including the creation of memory cells, cell-mediated immunity, and antibodies. Results from third-phase trials have shown that Covishield exhibits an effectiveness of approximately 90%, while Covaxin demonstrates an effectiveness of around 80%. Both vaccines have demonstrated satisfactory efficacy against several mutant variants of SARS-CoV-2. The effectiveness of Covishield, however, should be noted as compromised if there are significant changes in the spike (S) protein structure in future variants. In contrast, Covaxin may remain effective against such variants due to its ability to elicit multiple antibodies targeting different epitopes. The objective of this study is to evaluate and contrast Covaxin, Covishield & Sputnik v immunogenic and therapeutic efficacy. Additionally, potential vaccination challenges in the coming days will be discussed. Understanding the relative strengths and limitations of these vaccines can inform decision-making and strategies related to vaccine deployment, public health interventions, and future vaccine development efforts." Keywords: Vaccine equity, Vaccine access, COVID­19 vaccines, Covaxin, Covishield, Sputnik V, Comparative assessment, Vaccination coverage, Global health equity, Pandemic control

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Abstract

This comparative study aims to evaluate and compare the clinical management of drug-drug interactions (DDIs) in hypertensive patients with associated co-morbidities, specifically focusing on the practices in general medicine and ICU ward settings. Hypertensive patients commonly experience co-morbidities that require multiple medications, increasing the risk of DDIs and subsequent adverse events. Understanding the current evaluation and management strategies for DDIs in these patient populations is essential for optimizing patient outcomes. This research investigates the approaches employed in general medicine and ICU wards, including DDI identification, assessment, and intervention methods. By comparing these practices, the study aims to identify potential variations, challenges, and areas for improvement in DDI management across these clinical settings. The findings of this study will contribute to the development of evidence-based guidelines and recommendations for enhancing the clinical management of DDIs in hypertensive patients with co-morbidities, ultimately improving patient safety and therapeutic outcomes. Keywords: Drug- drug interactions, Hypertension, Co-morbidities, Multidisciplinary approach, General medicine, ICU, Patient Safety, Therapeutic outcomes

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