APTI ijopp - Indian Journal of Pharmacy Practice

Indian J. Pharm. Pract. 1(2), Jan-Mar, 2009APTIAbstractBoth macrolides as well as cephalosporins are widely used in the treatment of various lower respiratory tractinfections either alone or in combination. The most commonly prescribed macrolide is azithromycin, generally incombination with different cephalosporins. The objectives of the present study were to find out the differentcombinations of azithromycin and cephalosporins generally prescribed, compare their efficacy, safety (adverse drugreactions) and cost. A prospective study was conducted in the medicine ward at St. Martha's Hospital, Bangalore.The data was analyzed to interpret different parameters of the study. Efficacy was determined based upon the clinicalresponse (reduction in symptoms) and length of hospital stay. Safety was determined by assessing the occurrence ofADR and their severity. Cost of treatment was calculated by cost effective analysis. In the study period, 88 patientswere included based on the inclusion criteria. Results revealed that different combinations prescribed wereazithromycin + cefotaxime, azithromycin + ceftriaxone and azithromycin + cefuroxime. The most commonlyprescribed combination was found to be cefotaxime with azithromycin. The cefotaxime group showed statisticallysignificant difference in the reduction of clinical symptoms thereby indicating greater efficacy. 18% of the patientsexperienced ADRs which were mild in nature with none severe indicating that all the combinations were safe. Thecost effective analysis showed that combination of azithromyin and cefotaxime is most economical.Key words: Antibiotics, Organisms, Antibiotic use, PediatricsINTRODUCTIONRespiratory tract infections (RTI) are very common in the budgets. In most of the adults with LRTI, the illness iscommunity and are one of the major reasons for visiting self-limiting and its course will not be modified by1to primary care physicians . The broad diagnosis of RTI antibiotic therapy, representing viral or clinically nonincludesthe two principal sub-diagnoses of lowerrelevant bacterial diseases. However, failure to initiaterespiratory tract infection (LRTI) and upper respiratoryantibiotic therapy within four hours in cases of2tract infection (URTI) . Community-acquired lowercommunity acquired pneumonia is already associatedrespiratory tract infection is a common cause of acute6with an increased mortality. The major problem in theillness in adults. The spectrum of disease ranges frommild mucosal colonization or infection, to acutemanagement of the LRTI is the inability to determine the7bronchitis or acute exacerbation of chronic bronchitis causative micro-organism in majority of patients .(AECB) or chronic obstructive pulmonary disease There are great systematic differences in the prescription(COPD), to overwhelming parenchymal infection in of antibiotics, both overall and for LRTI, between3patients with community-acquired pneumonia (CAP) . countries and between different healthcare providers in8The term LRTI includes a wide range of diseases which the same country . The "first generation" of guidelineshave different underlying pathologies and etiologies, e.g. was mostly consensus-based, whereas those published in4, 5acute bronchitis and pneumonia . In the out-patient 2000/2001 are at least partly evidence-based. However,setting, LRTI account for the majority of all antibiotics there is still a lack of evidence in many areas of the LRTIp r e s c r i b e d , b u r d e n i n g h e a l t h c a r e d r u g field, and, in addition, interpretation of the availableIndian Journal of Pharmacy PracticeReceived on 05/02/2009 Modified on 13/03/2009Accepted on 16/03/2009 © APTI All rights reservedijoppEfficacy and Safety of Azithromycin with Various CephalosporinsUsed in Treatment of Lower Respiratory Tract Infection1 2 3Imran Ahmad Khan , Shobha Rani. R.H , Geetha Subramanyam1. Sr. DSA, Quintiles, Bangalore2. Department of Pharmacy practice, Al-Ameen college of Pharmacy, Bangalore-5600273. Dept. of Medicine, St. Martha’s Hospital, Bangalore*Address for correspondence: iamkhan@quintiles.com9evidence is variable in some cases .MATERIALS AND METHODSThe present study was conducted at medicine wards ofSt. Martha's Hospital, Bangalore which is 850 bedded53