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Empirical antimicrobial use is common in hospitalized infants and may contribute to antimicrobial resistance in low- and middle-income countries. In this observational birth cohort study nested in a randomized controlled trial in Dhaka, Bangladesh, inpatient antimicrobial prescription data were extracted from serious adverse event forms completed for hospitalizations of infants (0-12 months of age). The primary outcome was the proportion of inpatient admissions where systemic antimicrobials were prescribed. Infant and hospitalization-related factors associated with antimicrobial prescriptions were determined. Among 1254 infants, there were 448 admissions to 32 facilities from 2014 to 2016. Antimicrobials were prescribed in 73% of admissions with a mean antimicrobial exposure rate of 0.25 antimicrobials per day of admission [95% confidence intervals (95% CIs): 0.24-0.27]. The most common antibiotics were aminoglycosides (29%), penicillins (26%) and third-generation cephalosporins (25%). In all, 58% of antibiotics were classified as 'access', 38% 'watch' and 1% 'reserve' using the World Health Organization (WHO) Essential Medicines List classification. WHO-recommended antimicrobial regimens were used in 68% of neonatal sepsis and 9% of lower respiratory tract infection (LRTI) admissions. 'Watch' antimicrobials were used in 26% of neonatal sepsis and 76% of LRTI admissions. Compared with private facilities, antimicrobial prescription rates were lower at government [rate ratio (RR) 0.71; 95% CI: 0.61-0.83] and charitable facilities (RR 0.39; 95% CI: 0.28-0.53), after adjustment for household wealth index and parental education. Younger infant age, older maternal age and longer admission were associated with higher prescription rates. These findings highlight the need for paediatric antimicrobial stewardship programs in Bangladesh., (© The Author(s) [2020]. Published by Oxford University Press.)

Graphene manganese ferrite (MnFe 2 O 4 -G) composite was prepared by a solvothermal process. The as-prepared graphene manganese ferrite composite was tested for the adsorption of lead (Pb(II)) and cadmium (Cd(II)) ions by analytical methods under diverse experimental parameters. With respect to contact time measurements, the adsorption of Pb and Cd ions increased and reached equilibrium within 120 and 180 min at 37 °C with a maximum adsorption at pH 5 and 7 respectively. The Langmuir model correlates to the experimental data showing an adsorption capacity of 100 for Pb(II) and 76.90 mg g −1 for Cd(II) ions. Thermodynamic studies revealed that the adsorption of Pb and Cd ions onto MnFe 2 O 4 -G was spontaneous, exothermic and feasible in the range of 27–47 °C. Cytotoxicity behavior of graphene against bacterial cell membrane is well known. To better understand its antimicrobial mechanism, the antibacterial activity of graphene and MnFe 2 O 4 -G nanocomposite was compared. Under similar concentration and incubation conditions, nanocomposite MnFe 2 O 4 -G dispersion showed the highest antibacterial activity of 82%, as compared to graphene showing 37% cell loss. Results showed that the prepared composite possess good adsorption efficiency and thus could be considered as an excellent material for removal of toxic heavy metal ions as explained by adsorption isotherm. Hence MnFe 2 O 4 -G can be used as an adsorbent as well as an antimicrobial agent. [ABSTRACT FROM AUTHOR]