Niyati Trivedi

Sir Sayajirao General Hospital Medical College

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Ratinder Jhaj

All India Institute of Medical Sciences Bhopal

Nilima Kshirsagar

Indian Council of Medical Research

Harihar Dikshit

Indira Gandhi Institute of Medical Sciences

Dinesh Badyal

Christian Medical College

Bikash Medhi

Post Graduate Institute of Medical Education and Research

Janki Chauhan

Sir Sayajirao General Hospital Medical College

Suparna Chatterjee

Institute of Post Graduate Medical Education and Research

Sandhya Kamat

King Edward Memorial Hospital and Seth G.S. Medical College

Sandeep Kaushal

Christian Medical College & Hospital

Pooja Gupta

All India Institute of Medical Sciences

Cooperative Institutions

Post Graduate Institute of Medical Education and Research

Institute of Post Graduate Medical Education and Research

All India Institute of Medical Sciences Bhopal

All India Institute of Medical Sciences

Sir Sayajirao General Hospital Medical College

King Edward Memorial Hospital and Seth G.S. Medical College

Jawaharlal Institute of Post Graduate Medical Education and Research

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Indira Gandhi Institute of Medical Sciences

Institute of Medical Sciences

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Antibacterial drug utilization study in patient of sepsis due to Staphylococcus aureus

International Journal of Basic & Clinical Pharmacology (2024)

Dhruti Vaidya Niyati Trivedi KuntalKumar H. Patel

Background: Sepsis is the most common and highly fatal clinical syndrome due to infection. Gram-positive organisms as a cause of sepsis have increased in frequency over time more common than gram-negative infections. S. aureus bacteremia (SAB) is one of the most prevalent and difficult to treat infections associated with significant morbidity and mortality. Aim was to study antibacterial drug utility, sensitivity and resistance pattern of antibacterial drugs in S. aureus infective septic patient in medicine department. Methods: A prospective observational study was done in medicine department of SSG hospital, Vadodara over a period of 9 months. Results: Total 50 S. aureus were tested for their sensitivity and resistance pattern towards ten antibacterial agents in microbiology department by disc diffusion method. The antibiogram of S. aureus indicated widespread resistance antibacterial agent ranging from a minimum resistant to vancomycin (4%) to a maximum of 90% against penicillin G. Total 142 antibacterial agents were prescribed in 50 patients. Metronidazole, ceftriaxone and piptaz were the most frequently prescribed antibacterial agents with DDD/1000 patient days 2.44, 3.55 and 2.62 respectively. 30 out of 50 patients needed a change in antibacterial agents during their course of treatment either due to antibacterial agent failure or after culture sensitivity report. 60% of the patients were prescribed ≥3 antibacterial agents at any point of time during treatment. Mean DOT/LOT was 2.22±0.84. Conclusions: There is a need of antibacterial agent usage guidelines and restriction policies for the rational prescribing of antibacterial agent in critically ill patients.

10.18203/2319-2003.ijbcp20242433

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Citations (1)

Effect of oral administration of fungicide-mancozeb on thyroid gland of rat.

PubMed (1993)

Niyati Trivedi Reena Kakkar M. K. Srivastava Ambrish Mithal R. B. Raizada

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Surveillance of Health Care-associated Pseudomonas aeruginosa Infections in a Tertiary Care Teaching Hospital

QAI Journal for Healthcare Quality and Patient Safety (2023)

Yash Chauhan Niyati Trivedi

Abstract Background: Among Gram-negative microorganisms, Pseudomonas aeruginosa is the most frequent causative pathogen in health care associated infection (HAI). P . aeruginosa infections are becoming more challenging to treat due to its innate as well as capacity to fast acquiring resistance to available antimicrobial agents (AMAs). There needs to be continuous surveillance to understand the sensitivity pattern as well as the clinical profile of the infections caused by P . aeruginosa . Materials and Methods: This was a prospective, observational, study conducted in various inpatient departments of a tertiary care hospital in India. Complete clinical and epidemiological profile of the patients, from whom P. aeruginosa was isolated as a causative organism, was recorded. Such patients were followed up daily till the outcome was achieved. The sensitivity of P. aeruginosa to various AMAs was noted. Data analysis was performed using suitable statistical tests. Results: P . aeruginosa was isolated from 103 clinical specimens during the study. Almost all the patients were diagnosed with HAI. With the most common being skin and soft-tissue infections. 41.75% of P . aeruginosa were multidrug resistant, with 25.24% being carbapenem resistant. The duration of hospitalization after isolation was 19.83 ± 5.79 days. Sixty-two patients were successfully treated and discharged from the hospital. Conclusion: A high prevalence of multidrug, especially carbapenem resistance among the P. aeruginosa isolates, has been observed, compromising the ability to choose efficacious empirical regimens, use of multiple high-end AMAs, and prolongation of hospitalization. Implementation of effective preventive and control measures along with antimicrobial stewardship strategies are urgently needed.

Antimicrobial Stewardship

10.4103/qaij.qaij_6_23

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A multicentre point prevalence survey (PPS) of antimicrobial use amongst admitted patients in tertiary care centres in India

Journal of Antimicrobial Chemotherapy (2020)

Aditi Panditrao Nusrat Shafiq Suparna Chatterjee Ashish Pathak Niyati Trivedi

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.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.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.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.

Tertiary care

Prevalence

10.1093/jac/dkaa533

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Safety of hydroxychloroquine in healthcare workers for COVID-19 prophylaxis

The Indian Journal of Medical Research (2021)

NilimaA Kshirsagar Atiya Faruqui Denis Xavier SandhyaK Kamat SujithJ Chandy

Background & objectives: Hydroxychloroquine (HCQ), reported to inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in in vitro studies, has been recommended for prophylaxis of COVID-19 in healthcare workers (HCWs). The objective of this study was to assess short-term adverse events (AEs) of HCQ in HCWs. Methods: This cross-sectional study among consenting HCWs taking prophylaxis and working in hospitals with COVID-19 patients used online forms to collect details of HCWs, comorbidities, prophylactic drugs used and AEs after the first dose of HCQ. Verification of dose and AEs was done by personal contact. Multivariate logistic regression analysis was done to determine the effect of age, gender and dose of HCQ on AE. Results: Of the 1303 HCWs included, 98.4 per cent (n=1282) took HCQ and 66 per cent (n=861) took 800 mg as first day's dose. Among the 19.9 per cent (n=259) reporting AEs, 1.5 per cent (n=20) took treatment for AE, none were hospitalized and three discontinued HCQ. Gastrointestinal AEs were the most common (172, 13.2%), with less in older [odds ratio (OR) 0.56, 95% confidence interval (CI) 0.35-0.89], with more in females (OR 2.46, 95% CI 1.78-3.38) and in those taking a total dose of 800 mg on day one compared to a lower dose. Hypoglycaemia (1.1%, n=14), cardiovascular events (0.7%, n=9) and other AEs were minimal. Interpretation & conclusions: HCQ prophylaxis first dose was well tolerated among HCWs as evidenced by a low discontinuation. For adverse effects, a small number required treatment, and none required hospitalization. The study had limitations of convenience sampling and lack of laboratory and electrocardiography confirmation of AEs.

Hydroxychloroquine

2019-20 coronavirus outbreak

Pre-exposure prophylaxis

10.4103/ijmr.ijmr_2294_20

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Prescription-based cost analysis of medicines for cardiovascular risk factors at Indian Council of Medical Research-Rational Use of Medicine Centre Hospitals of India

Indian Journal of Pharmacology (2024)

Preeta Kaur Chugh Pooja Gupta Himika Wasan C D Tripathi Sujith J Chandy

Abstract OBJECTIVES: India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs. MATERIALS AND METHODS: Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range). RESULTS: Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593–3104) and for non-NLEM was INR 5343 (2964–14364). It was INR 806 (243–2132) for generic and INR 3809 (1968–14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5–22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins ( P < 0.0001). CONCLUSION: The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines.

Dyslipidemia

Defined daily dose

Brand names

10.4103/ijp.ijp_61_23

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Knowledge, attitude, and practice survey on antimicrobial use and resistance among Indian clinicians

Perspectives in Clinical Research (2021)

Suparna Chatterjee Avijit Hazra Raja Chakraverty Nusrat Shafiq Ashish Pathak

This multicentric questionnaire-based study was undertaken to address the lack of systematic background data on the knowledge, attitudes, and practices among Indian physicians related to antimicrobial use and resistance.A validated structured study questionnaire was used for capturing respondent particulars, antimicrobial prescribing habits, knowledge of antimicrobial resistance (AMR), ways of choosing and learning about antibiotics, agreement or disagreement with certain perceptions regarding antibiotics, selection of antibiotics in specific settings, and suggestions regarding rationalizing antimicrobial use in the practice setting. Summary statistical analysis of the pooled data was done.Five hundred and six respondents with a mean (standard deviation) age of 31.4 (8.71) years participated in the study. Three hundred and twenty-seven were medical and 179 surgical discipline clinicians. Overall, the theoretical knowledge about antimicrobials was satisfactory, but areas of concern were noted in the attitude and practice domains. A substantial proportion of participants failed to identify the correct choice of antibiotics in the case-based scenarios. 38.33% reported not attending a single continuing medical education on antimicrobials during the past year. Statistically significant differences were not observed in the KAP quotient scores between medical and surgical discipline respondents.Despite satisfactory background knowledge regarding the rational use of antimicrobials and AMR patterns, there are discrepancies in the physicians' prescribing attitude and thus strengthen the case for instituting specific interventions to improve antimicrobial prescribing.

10.4103/picr.picr_21_20

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Surveillance of methicillin-resistant Staphylococcus aureus infections obtained from pus sample: A comparison of community- and hospital-acquired infections

World Journal of Surgical Infection (2023)

Jainy Thakkar Prashant Shah Niyati Trivedi

Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of healthcare-associated infections. Recently, the prevalence of community-associated MRSA (CA-MRSA) is increasing affecting individuals with no known risk factors or health-care exposure, blurring the differences between the two. With changing epidemiology of an organism having a natural tendency of fast-developing resistance, MRSA infections need active ongoing surveillance, for effective implementation of appropriate treatment and preventive strategies. Patients and Methods: This was a prospective, observational study conducted in various inpatient departments of a tertiary care teaching hospital in Gujarat, India. MRSA infections were classified as community-acquired-MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA) based on the US CDC 2010 definition. Clinical and epidemiological profile as well as antibiotic sensitivity was assessed in both the groups. An unpaired t -test or Fisher’s exact test was applied to find the difference between the two groups. Results: MRSA isolation rate was 1.42% (60/4212). Ninety percentage of the isolates were multidrug-resistant (MDR), with three being vancomycin-resistant/intermediate. The total duration of hospitalization, number of antimicrobials used after isolation, and duration of therapy were higher in HA-MRSA compared to the CA-MRSA group. The treatment outcome was successful in 86.6% of patients. Conclusion: There is an increasing prevalence of CA-MRSA in the community with the majority of isolates being MDR. These data are alarming and indicate an urgent need for the implementation of strategies directed toward the effective use of appropriate antimicrobials as well as the improvement of hygiene practices in the hospital as well as the community.

Isolation

10.4103/wjsi.wjsi_10_23

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Appropriateness of antibiotic prescribing for upper respiratory tract infection in a tertiary care teaching hospital: a cross sectional study

International Journal of Basic & Clinical Pharmacology (2023)

Margi Shah Niyati Trivedi Janki Chauhan

Background: Overuse of antibiotics among the patients with upper respiratory tract infection (URTI) is a worldwide problem, leading to antimicrobial resistance. This study is aimed to evaluate the appropriateness of the antimicrobial prescribing for upper respiratory tract infections in a tertiary care teaching hospital. Methods: This was a cross-sectional, observational study. Data was collected from outdoor adult patients who were clinically diagnosed to have URTIs from General Medicine and Otorhinolaryngology Department of a tertiary care teaching hospital. The appropriateness of antibiotics used in URTI was assessed. The data was analyzed using descriptive statistics. Results: Total 100 cases, clinically diagnosed to have URTI were included in the study. Among these, common cold (46%) and acute otitis media (23%) were the most frequent encounters. 75% of the prescriptions contained at least one antibiotic. In fact, antibiotics were the most commonly prescribed agents (21.2%) followed by antihistaminic (19.8%) and NSAIDs. 57% of the antibiotics were prescribed inappropriately, either in terms of inappropriate choice (37%) or over use (20%) of antibiotic. Conclusions: Inappropriate prescription of antibiotics for otherwise self-limiting URTI cases is a common practice even in a tertiary care teaching hospital. Implementation of multifaceted approach is needed to curtail the same.

Tertiary care

Cross-sectional study

Acute Otitis Media

Common cold

10.18203/2319-2003.ijbcp20230398

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Antimicrobial activity of fresh garlic juice: An in vitro study

AYU (An International Quarterly Journal of Research in Ayurveda) (2015)

Seema Yadav Niyati Trivedi Jagat D Bhatt

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).

10.4103/0974-8520.175548

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Citations (51)