European Journal of Molecular & Clinical Medicine

Antibiotics primarily used in treating the bacterial infections when administered unnecessarily can cause antibiotic resistance making the bacteria non responsive against antimicrobials. Analgesics that are used to relieve pain are one of the routinely used medications. Hence, the aim of this study was to check the knowledge and awareness regarding use of both antibiotics and analgesics amongst dental undergraduates. Total 324 participants from different profs and interns submitted their responses for the online questionnaire. A highly statistically significant difference was observed in the knowledge of participants for both analgesics and antibiotics. It can be concluded that the knowledge and awareness on the use of antibiotics and analgesics among dental undergraduates is low indicating lack of basic understanding of oral dose, indications and risks of both medications.

Periodontal pathogens frequently colonize oral mucosa, tongue dorsum, tonsils and other domains and may translocate from non-periodontal sites to periodontal crevices. Systemic antibiotic therapy is administered to reinforce mechanical periodontal treatment and support the host defense system in overcoming the infection by killing subgingival pathogens that remain after conventional mechanical periodontal therapy. Combination antibiotic therapy may help broaden the antimicrobial range of the therapeutic regimen beyond that attained by any single antibiotic.

We have searched the literature for evidence of the pharmacokinetics (PK) effect of rifampin. Ambroxol co-administration was proven to be beneficial in the rat model, according to reports. A half-life increase in ambroxol levels in the lung tissue, leading to higher levels of rifampin in the lungs, [5] indicating a double increase in high concentration (Cmax) and an 80% increase in high concentration (Cmax) in mice. Any developments were evaluated in terms of their ability to develop literature. Drug-resistant and drug-resistant germs can be treated. Most pre-clinical trials use complete animals. Despite the fact that lung tissue levels are measured, most clinical studies rely on less invasive procedures such as sputum or bronchoalveolar lavage. In a pre-clinical study, Wiemeyer used mice given 50 mg / kg of oral ampicillin and amoxicillin. with or without oral ambroxol at a dose of 10 mg / kg, compared with the average human dose Ampicillin and amoxicillin tissue concentration increased by 23% and 27%, respectively, with combined ambroxol treatment. However, an increase in the level of antibiotics in the lung tissue is less likely to allow the treatment of antimicrobials, and many doses of antibiotics are already effective in the clinic, so improved effects of ambroxol combination therapy are also not possible. According to at least one clinical report of each class, bromhexine and ambroxol improve the levels of a variety of antimicrobial drugs in the lungs, including beta lactam, erythromycin, rifampin, and vancomycin. Aminoglycosides, fluoroquinolones, sulfonamides, and tetracyclines did not show the same increase, however it is unclear whether this is due to bias in the negative feedback reports or lack of research on these drugs.

Background: As an alternative to surgical removal of the appendix, antibiotic medication has been suggested for the management of appendicitis. Those participants in the study who had an appendicolith were at a greater risk for complications and appendectomy than those participants who did not have an appendicolith

Background: Postoperative infection following mastoid exploration under strict aseptic conditions and antibiotic coverage postoperative cases of cortical and modified radical mastoidectomy do pose challenging infections. Aim: The present study identifies the organism and antibiotics to which they are sensitive. This measure prevents postoperative permanent disease and discharge and improves the success rate of surgery without complications. Materials and Methods: A total number of 120 patients of mastoid exploration with discharge were the subjects of present study. The study was carried out from Feb 2018 to Feb 2021. Result: Males were 72 who constituted 60% and females were 48 who constituted 40%. Emergency procedures were 85 who constituted 71% and elective procedures were 35 who constituted 29%. 48% (58) were clean surgeries and 52% (62) were clean contaminated surgeries, 109 (91%) of patients showed significant growth and 11 (9%) of patients had no growth. 50% of the patients had culture positivity and duration of surgery was greater than 2 hours. Diabetes is the most common risk factor   followed by hypertension. A total of 109 samples showed growth, 114 organisms were isolated. E. coli was the organism which was predominant followed by Staphylococcus aureus. Ampicillin showed maximum resistance followed by ceftazidime. Cefipime and Piperacillin showed least resistance to E.coli. Among 38 isolates, 12 (33%) were ESBL producers. Conclusion: The present study provides information about the incidence of commonest organism E. coli in post operative mastoid exploration to enable treatment of a patient immediately to prevent complications from re- infection.

Background: Acute respiratory tract infection (ARTI) is the most common reason for antibiotic prescription in children and adults. The present study was conducted to assess antibiotic usage in upper respiratory tract infections in children
Materials & Methods:80 children with upper respiratory tract infection of both genders were recorded. A thorough physical examination was carried out in all children. Weight in kgs and height was measured in meters. Month of ARTI and type of antibiotic prescribed was recorded
Results: Out of 80 patients, boys were 30 and girls were 50. Age group 5-7 years had 10, 7-9 years had 15, 9-11 years had 30 and 11-13 years had 25 children. The difference was significant (P< 0.05). Antibiotic prescribed in children were co-amoxiclav in 28, amoxycillin in 24, ofloxacin in 18 and cefuroxime in 10. The difference was significant (P> 0.05). The month of upper respiratory tract infections in children was January- February in 34, March- April in 12, May- July in 4, Aug- Oct in 10 and Nov- Decin 20. The difference was significant (P< 0.05).
Conclusion: The most commonly antibiotic prescribed in children were co-amoxiclav, amoxycillin, ofloxacin and cefuroxime. Common month of use was December, January and February.

Background: Postoperative infection following mastoid exploration under strict aseptic conditions and antibiotic coverage postoperative cases of cortical and modified radical mastoidectomy do pose challenging infections.
 Aim: The present study identifies the organism and antibiotics to which they are sensitive. This measure prevents postoperative permanent disease and discharge and improves the success rate of surgery without complications.
Materials and Methods: A total number of 120 patients of mastoid exploration with discharge were the subjects of present study. The study was carried out from Feb 2018 to Feb 2021.
Result: Males were 72 who constituted 60% and females were 48 who constituted 40%. Emergency procedures were 85 who constituted 71% and elective procedures were 35 who constituted 29%. 48% (58) were clean surgeries and 52% (62) were clean contaminated surgeries, 109 (91%) of patients showed significant growth and 11 (9%) of patients had no growth. 50% of the patients had culture positivity and duration of surgery was greater than 2 hours. Diabetes is the most common risk factor        followed by hypertension. A total of 109 samples showed growth, 114 organisms were isolated. E. coli was the organism which was predominant followed by Staphylococcus aureus. Ampicillin showed maximum resistance followed by ceftazidime. Cefipime and Piperacillin showed least resistance to E.coli. Among 38 isolates, 12 (33%) were ESBL producers.
Conclusion: The present study provides information about the incidence of commonest organism E. coli in post operative mastoid exploration to enable treatment of a patient immediately to prevent complications from re- infection.

Anal fissure is one of the most common anorectal conditions encountered in clinical practice. Most patients experience anal pain with defecation and minor bright red rectal bleeding, allowing a focused history to direct the evaluation.
This was a prospective, randomized, controlled clinical study conducted on 90 consecutive patients who presented to the general surgery outpatient clinic of Al - Hilla teaching Hospital Babil, between June 2019 and July 2021 were diagnosed with  anal fissure.
Although various non-surgical and surgical treatment meth­ods have been used, an ideal treatment method for acute anal fissure is still debatable. The topical antimicrobial treatment with metronidazole in addition to conventional medical treat­ments is an effective, easy-to-use, safe, fast and comfortable practice that enables further reduction of anal fissure pain and increases the healing rate.

Background: Typhoid fever is an acute systemic febrile illness caused by the bacterium
Salmonella enterica serovar Typhi. The present study was conducted to assess
prescriptions for the treatment of typhoid fever in children.
Materials & Methods: 110 patients of enteric fever of both genders were enrolled. A
thorough clinical examination was carried out. Clinical features and various antibiotics
used to treat these patients was recoded.
Results: Out of 110 patients, males were 60 and females were 50. Among culture
positive, 24 was IgM positive, 1 was widal positive and 23 were both IgM +ve, Widal
+ve. Among Culture negative, 28 were IgM positive, 10 were widal positive and 25 were
both IgM +ve, Widal +ve. The difference was significant (P< 0.05). Azithromycin was
used among 27, ofloxacin among 28 and cefixime among 55. The difference was
significant (P< 0.05).
Conclusion: Most common used antibiotics was cefiximefollowed by ofloxacin and
azithromycin.

Objective: Active chronic suppurative otitis media (CSOM) is the bacterial chronic infection
of middle ear cleft mucosa and treated with antibiotics empirically, which may cause resistance
to bacterial strains. In this study, we studied the bacteriology and susceptibility pattern in
CSOM for efficient empirical treatment especially in central India.
Methods: Clinically proven 160 patients with CSOM with otorrhea, were included in our
study. Ear discharge samples were collected with the asepsis method and bacterial culture and
antibiotics sensitivity patterns were obtained.
Results: Bacterial growth was present in 76.1% of ear samples with Staphylococcus and
Pseudomonas being most prominent. Vancomycin and Rifampicin were most effective for
staphylococcus and amoxicillin and quinolones were most resistant. Meropenem and
Piperacillin/tazobactam were the most effective antipseudomonal antibiotics. Ciprofloxacin
and Levofloxacin were least sensitive antipseudomonal quinolones.
Conclusion: Amoxicillin with quinolones were highly resistant for bacterial growth in-ear
samples so used cautiously as empirical therapy in CSOM. For effective treatment of CSOM
and prevention of resistant strain emergence, all ear samples must be sent for culture sensitivity.

Background:Surgical wound infection continues to consume a considerable portion of
health care finance. Even though the complete elimination of wound infections is not
possible, a reduction of observed wound infection rate to a minimum level could have
marked benefits in terms of both patients comfort and resources used .As many
surgeons believe that routine culture of peritoneal fluid in patients of secondary
peritonitis offer no useful information & no clinical benefits, not too many studies had
been done to support the utility of peritoneal fluid culture as a important parameter in
preventing SSI.. This study was aimed to study relevance of peritoneal fluid culture in
relation to its impact on surgical site infections and to know the most common organism
associated with peritonitis & SSI with their antibiotic sensitivity in our hospital. Also to
know if any correlation present between organism isolated from peritoneal fluid &
organism isolated from pus from wound.

INTRODUCTION: Hearing is one of the most important senses of man which provides him
with the ability to perceive the world and also helps him in communication.Chronic suppurative
otitis media (CSOM),a tremendous health predicament since time immemorial, is a chronic
inflammation of the middle ear cleft which may lead to serious sequelae and complications. The
wide spread use of antibiotics has precipitated the emergence of multiple resistant strains of
bacteria which can produce both primary and postoperative infections.
MATERIALS AND METHODS: This is a Prospective studyconducted at Department of
Microbiology,Tertiary care teaching hospitalover a period of 1 year with200 samples were
collected from patients attendingat out Patient department of ENT included in the study.After
cleaning the external ear with alcohol, ear discharge is collected aided by a Bull lamp and aural
speculum with absorbable sterile cotton swabs under strict aseptic precaution.
RESULTS: Analysis of these cases of CSOM in both sexes and age groups as shown in Table -
1: revealed that the majority of cases of CSOM were in the age 11-20yrs in both sexes .The
overall incidence of CSOM was found to be more in males 117 than in females 83 and this
predominance was noted in all the age groups.The details of anaerobic organisms isolated in
csom cases.Bacteroidsfragilis is the predominant organism followed by peptosteptococcus.All
anaerobes were 100% sensitive to Metronidazole.
CONCLUSION:Out of 200 samples 14 anaerobic organisms were isolated of which
Bacteroidesfragilis 4(28.6%) were predominant anaerobes followed by Peptostreptococcus
species 3(21.4%).This sudy is designed to have the knowledge of the pathogens and antibiotic
sensitivity pattern responsible for CSOM and choosing suitable antibiotics according to
susceptibility tests should guide the management of disease treatment and reduce the recurrence
and complications of CSOM.

Background: Appendicitis is the most common cause of acute abdominal pain,
requiring surgical intervention. The present study was conducted to assess efficacy of
postoperative antibiotics after appendectomy in non- perforated appendicitis.
Materials & Methods: 76 patients undergoing appendectomy of both genders were
divided into 2 groups of 38 each. Group I patients were not given any postoperative
antibiotics and the group II patients received a single dose of cefuroxime sodium and
metronidazole, 8 hours postoperatively. Open appendectomy was performed by the
standard operating technique through right lower quadrant incision. Parameters such
as duration of symptoms, duration of surgery and hospital stay was recorded.
Results: There were 26 males and 12 females in group I and 20 males and18 females in
group II. Duration of symptoms was 1.9 days in group I and 1.4 days in group II,
duration of surgery was 52.3 minutes in group I and 54.8 minutes in group II. The mean
hospital stay was 2.31 days in group I and 2.42 days in group II and surgical site
infections was 10 days in group I and 5 days in group II. The difference was significant
(P< 0.05).
Conclusion: Both groups were comparable in terms of surgical site infection.

Background: Pharmacovigilance relates to the activities concerning the detection,
assessment, understanding and prevention of these adverse drug reactions. The present
study was conducted to asses adverse drug reactions in known population.
Materials & Methods: 250 adverse drug reactions reported in 1 year were recorded.
The data were obtained from the ADR monitoring centre. Each ADR was assessed for
demographic data, relationship to drugs as per causality assessment, and frequency of
ADRs.
Results: Age group 20-40 years had 35 male and 30 female, 40-60 years had 40 male and
55 females and >60 years had 45 male and 45 females. ADRs were reported in oncology
in 12, dermatology in 45, ENT in 30, orthopaedics in 20, general surgery in 50, general
medicine in 43, gynaecology in 35 and psychiatry in 15 cases. Type of reaction was
nausea/ vomiting in 45%, rash in 30%, headache in 12%, abdominal pain in 4%,
diarrhoea in 5% and constipation in 4%. Common drugs leading to ADRs were
NSAIDs in 35%, antibiotics in 20%, anti- hypertensive in 8%, anti- diabetics in 12%,
anti- tubercular in 15% and CNS drugs in 10%. The difference was significant (P<
0.05).
Conclusion: Common drugs leading to ADRs were NSAIDs, antibiotics, antihypertensive,
anti- diabetics, anti- tubercular and CNS drugs.

Background: Self-medication is a common practice of using medicines without a medical supervision by the people themselves. Self-medication is likely to happen when people feel unwell, it is worse in the population with poor health seeking behavior. Therefore, it is important to assess the prevalence and factors associated with self-medication with antibiotics among the primary health care population in Madina city, Saudia Arabia. Methods: A cross sectional study was conducted from August to September 2019. The study population included two MOH primary health care centers. The population above 18 years old attended the selected primary health care centers was eligible to participate in the study. A self-filled questionnaire was used for data collection and data analyzed using the SPSS version 16 and association was tested using chi square

Background: This prospective, randomised control experiment was conducted to determine the role of single-dose antibiotic prophylaxis after hernia surgery. This research also provides evidence for determining whether stringent aseptic precautions can reduce antibiotic use.
Materials and Methods: This study included 60 patients with inguinal hernias (direct or indirect) who were admitted to the surgical ward at the Pt. B.D. Sharma Post Graduate Institute of Medical Sciences in Rohtak. Prior to admission, each patient was given a thorough screening as well as a rigorous clinical evaluation that included Haemoglobin, Bleeding time, Clotting time, Urine complete examination, Blood urea, Blood sugar, Serum electrolytes, Chest X-ray and ECG.
Results: The average age of the presenters was 45.88 years old. The majority of the patients, sixteen (26.66 percent), were between the ages of 41 and 50. The youngest patient was an 18-year-old man, while the oldest was an 80-year-old man. Males made up 98.33% (n=59) of the cases, while females made up 1.66 percent (n=1). Lichtenstein's repair was performed in forty patients (66.66%) for indirect inguinal hernias, and Lichtenstein's repair was combined with posterior wall plication in eighteen patients (30%) for direct inguinal and Pantaloons' type hernias. Indirect inguinal hernias accounted for the most occurrences (40), with two having a sliding component.
Conclusion: There is substantial evidence in the international literature to support the claim that prophylactic antibiotic treatment does not reduce the incidence of wound infection. Given the findings of this study, it is possible to conclude that the variations in infection rates are not substantial, and that prophylactic antibiotics do not reduce the rate of SSI in mesh repair of inguinal hernias, and that routine use of prophylactic antibiotics is not indicated.

Primary goal in management of open fractures is prevention of infection of bone and soft tissue by early debridement, irrigation of wound and administration of broadspectrum antibiotics with stabilization of fractures. The pattern of organisms found in open fractures is important in the selection of antibiotics for prophylaxis and empirical treatment. In this prospective study, 50 consecutive patients of all ages, both the sexes, with open fracture of grade IIIB as per Gustilo- Anderson classification were evaluated for bacterial isolates. Higher rate of infection was found in patients with farm injuries and leg was most common site. The most common gram negative and gram positive bacteria isolated were E.coli and S.aureus respectively (19.5% each). On analysis of the predebridement, post-debridement, and third culture, positive pre-debridement culture showed maximum growth of Gram-positive bacteria. However, majority of these patients were found to have growth of different organism in their post-debridement culture reports.

Background: Nimesulide is a cyclooxygenase (COX) inhibitor with a high degree of selectivity to COX-2. It is a widely used and well tolerated non steroid anti-inflammatory drug that also has analgesic and antipyretic properties. The most frequently reported side effects concern the GI tract. Pruritus and skin rash are the most common cutaneous adverse reactions. Case report: This is a case report of a 58 years old patient who came to ER with develop wheal, multiple joint pain sparing PIP/DIP joint, fever, generalized weakness, decrease oral intake afternimesulide ingestion.He also gave a history of psoriatic arthritis.He was managed with intravenous steroids, antibiotics, antihistaminic & iv analgesics Result:After 2days of medications his general condition improved, joint pain reduced, appetite improved and discharged on oral medicationsConclusion: Drug induced flare is common cutaneous drug reaction, often misdiagnosed. A detailed history taking and physical examination are the key to suspect this condition.

The rate and extent of neonatal gastrointestinal tract colonization depends on various perinatal
and neonatal factors. Colonization of gastrointestinal tract (GIT) after birth could be delayed because of
prematurity, caesarean delivery or total parental nutrition. The ill and preterm neonates in NICU acquire
intestinal flora that differ from that of healthy newborn. Objective: Hence we aim to study the factors associated
with pathological colonization of aerobic microbial flora in neonates and find pattern of pathogenic aerobic
microbial colonization of neonates. Methodology: The study was done on 94 neonates in a tertiary teaching
hospital NICU , 51 cases with pathological colonization ,43 control with normal colonization. Data collected
using Performa, Oral and rectal swabs taken Results: 68 neonates who received antibiotics 46 (90.2%) were
cases 22(51.3%) were controls. Staphylococcus aureus was predominant suggesting influence of maternal
colonization. Cases were more in babies born through LSCS and in babies whose mother had received
antibiotics Conclusion: Of all factors influencing establishment of pathological microbiota in neonatal GIT
which are interdependent , neonatal exposure to antibiotics was the most significant . Emergence of MRSA ,
ESBL are of particular concern as these are a constant threat as source of health care associated infection

Cholera is a contagious diarrheal disease which spreads through contaminated food and water. It is caused by Gram negative bacterium Vibrio cholerae of the O1 or O139 serogroup. Cholera can potentially spread as epidemic or endemic. If undiagnosed and untreated at the earlier stages, it can result in dehydration and death. Different endeavors are made for the treatment of cholera. Oral rehydration therapy (ORT), use of antimicrobials and antibiotics, probiotics and vaccinations are amongst the various alternative modes of treatment that can be used to treat cholera depending upon the severity of the disease. Also, antibiotics like tetracycline, azithromycin and doxycycline can be used synergistically for the treatment of acute infection and intense dehydration. Researchers have also advocated the use of different vaccines including oral cholera vaccine. In this review, we have provided a brief overview of the cholera disease and its pathogenesis along with different treatment strategies that can be used to treat it or reduce its symptoms.

Currently, inflammatory processes activate various systems in the body. This article reveals the etiology and pathogenesis of odontogenic inflammatory diseases of the maxillofacial region. Special attention is paid to the aggressive course of the inflammatory process with the defeat of deep cellular spaces, accompanied by pronounced endogenous intoxication. The author analyzes the importance of the use of antibiotics from the group of penicillins in the treatment of inflammatory processes of the maxillofacial region.

Phytochemicals represent traditional knowledge of compounds effective in symptomatic relief and potential healing properties. The idea has emerged from the fact that natural resources such as neem, turmeric, cloves etc. have been used to cure health problems since a really long time. Even in the current modern world, people have more preference towards natural therapeutics than modern drug formulations. Antibiotics are the drugs which are most easily prescribed unnecessarily to attain extremely rapid symptomatic relief. The practice has led to natural selection of resistant bacterial strains which are spreading at an alarming rate. The world without antibiotics is horrible to contemplate and can cause uncontrollable mortality rate in future due to resistant bacterial infections. The review elaborates importance of phytochemicals as compounds of natural origin, easy production, industrialization scope, broad spectrum antibacterial capabilities to tackle the crisis of antibiotics in the ever growing era of multi drug resistance

The aim of the present study is to assess the current trends in antibiotic prescription for various periodontal flap surgical procedures among periodontists in Chennai. Retrospective data collection was conducted from June 2019 to March 2020 on patients who visited the outpatient department of Periodontics for multitude of flap surgical procedures. The type of flap surgery done and the antibiotic regimen prescribed were recorded. The data was tabulated using excel and SPSS software version 23.0 (Statistical Package For The Social Sciences) was used for descriptive statistics.The distribution of antibiotics after flap surgical procedure among the above mentioned groups were expressed in terms of percentage. Chi square test was done to assess the association between the study variables.Based on this hospital based assessment, it was found that the most commonly prescribed antibiotic was amoxicillin 500mg, followed by a combination of amoxicillin and metronidazole for flap surgical procedures like Open flap debridement, Resective osseous surgery and regenerative osseous surgery. The least preferred antibiotics were azithromycin and doxycycline.There was statistically significant association between gender and type of antibiotic given, with a higher percentage of males receiving a combination of amoxicillin and metronidazole than females. There was no significant difference between the antibiotics prescribed for patients who underwent Resective or regenerative flap surgery. Thus Amoxicillin is the most preferred, cost-effective and less toxic drug which acts against both aerobic and anaerobic microorganisms. However care must be taken in administering antibiotics in order to avoid misuse and overuse of antibiotics.

Background
Antibiotics are the most commonly used drug group in hospitalized patients and primary health clinics as they are all over the world. Inappropriate or unnecessary use of antibiotics leads to adverse effects related with antibiotics, occurrence of resistant microorganisms, and increased therapeutic cost. With the Budgeting Application Instruction, which entered into force in 2003 for controlling antibiotic use, approval of an infectious disease specialist (IDS) was required for use of some differences in antibiotic knowledge and attitudes between parents of Medicaid-insured. It is unknown whether understanding has improved and whether previously identified differences persist.Efforts to reduce antibiotic misuse and overuse are necessary to curb additional increases in antibiotic resistance in developed and developing countries also in KSA saw increases in antibiotic use for children during the last 2 decades, no educational campaigns for patients and professionals, and introduction of new vaccines. ​
Aim of the study: To assessment of prevalence of antibiotic use for pediatric acute viral gastroenteritis attending the primary health clinics in Makah city in Saudi Arabia 2019.
Method: This is a cross-sectional study, thirty questions of children years of age who had suffered from acute gastroenteritis during the March to June, 2019 was conducted attending the primary health care centers in Makkah, Saudi Arabia. our total participants were (80).
Results:Oral antibiotics were preferred by 45.0% followed by intravenous route (30.0%), and intramuscular route in 8.75%. Antibiotics less than week were prescribed in about 43.0%. Duration from 7-14 days was recorded by 20%. Long-term antibiotics were prescribed by 3.0%. Questioning about the seasonal break out of viral gastroenteritis as stated by study individuals.
Conclusion: must be Antibiotic use based on consultation with an infectious diseases specialist decreased inappropriate antibiotic use. Acute gastroenteritis is a major source of morbidity and mortality among young children in developed and developing countries. Enter pathogenic viruses are regarded as particularly relevant causative agents.