@article {117, title = {Comparative Evaluation of Antimicrobial and Anticonvulsant Induced Cases of Steven Johnson Syndrome and Toxic Epidermal Necrolysis}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {March 2014}, pages = {1-6}, type = {Research Article}, chapter = {1}, abstract = {

Background: Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) constitute a spectrum of severe, potentially life threatening, mucocutaneous adverse drug reactions. Antimicrobial agents and anticonvulsants are the most commonly implicated drugs. This study was aimed to compare and analyse the differences in the incubation peri-od, clinical presentation and outcome in patients of SJS/TEN caused by the antimicrobials and anticonvulsants. Materials and Methods: Patients of SJS, TEN and SJS/TEN overlap admitted in the dermatology ward of our hospi-tal, in whom an antimicrobial agent or an anticonvulsant were found to be probable causative agent by Naranjo score were assigned to Group A and B respectively. Inpatient records of the selected patients were studied to compare the differences. Results: Total of forty patients (twenty each of Group A and B) were included in the study. Fluoroquinolones followed by chloroquine were the most commonly implicated antimicrobials. The anticonvulsants most commonly implicated were phenytoin followed by carbamazepine. Incubation period in the antimicrobial group was significantly shorter [Group A (7.32 {\textpm} 5.4 days) vs Group B (28.58 {\textpm} 19.35 days)] with p value \< 0.001. The duration of stay, in the derma-tology ward, was significantly longer (p value\< 0.05) in the cases of TEN caused by antimicrobials (20.1 {\textpm} 7.49 days) as compared to those caused by anticonvulsants (14.5 {\textpm} 5.36 days). Three patients in Group A and one patient in Group B expired. Conclusion: A shorter incubation period and a higher morbidity and mortality were seen in the antimicrobial induced cases as compared to the anticonvulsant group.

}, keywords = {Anticonvulsants, Antimicrobials, Steven Johnson syndrome, Toxic epidermal necrolysis}, author = {Surabhi Dayal and Brahmita Monga and V. K. Jain and Kamal Aggarwal and Anuradha} } @article {152, title = {Trends in Prescribing Antimicrobials in an ENT Outpatient Department of a Tertiary Care Hospital for Upper Respiratory Tract Infections}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {April 2012}, pages = {15-18}, type = {Research Article}, chapter = {15}, abstract = {

Background: The drug utilization study identifies the problems that arise from drug usage in healthcare delivery system and highlights the current approaches to the rational use of drugs. Objective: To study the trends in prescribing antimicrobials in an ENT outpatient department (OPD) of a tertiary care hospital for upper respiratory tract infections (URTI). Materials and method: An observational study was conducted in the OPD of ENT at Bapuji Hospital, Davangere, Karnataka, India from May to July 2011. Prescriptions of all patients were collected; relevant information entered in a preformed proforma and analyzed using the drug utilization 90\% [(DU-90\%)] method. The results were presented in percentages and analyzed using DU-90\% method. Result: A total of 300 prescriptions were analyzed. The common cases for which antimicrobials prescribed were infections like pharyngitis, acute suppurative otitis media (ASOM), chronic suppurative otitis media (CSOM), tonsillitis, laryngitis. It was noted that 142 patients (47.33\%) received amoxicillin alone, 52 patients (17.33\%) received combination of amoxicillin and clavulanic acid, 43 patients (14.33\%) received cefixime, 40 patients (13.33\%) received cefuroxime and 23 patients (7.66\%) received azithromycin, levofloxacin and other antimicrobials. Conclusion: The present study showed that among the various antimicrobials used, only four antimicrobials figured in DU-90\% segment which were amoxicillin, combination of amoxicillin and clavulanic acid and cephalosporins like cefixime and cefuroxime. Though azithromycin and levofloxacin are also frequently used drugs in upper respiratory tract infections, in this study they did not figure in the DU-90\% segment.

}, keywords = {Antimicrobials, DU-90\%, ENT, Upper Respiratory Tract Infection}, author = {K.Ramachandra and Narendranath Sanji and H.S. Somashekar3 and Abhishek Acharya and Keerthi Sagar J and Susheela Somappa Halemani} }