14 results on '"Gaya B Wijayaratne"'
Search Results
2. Outcomes among children and adults at risk of severe dengue in Sri Lanka: Opportunity for outpatient case management in countries with high disease burden.
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Champica K Bodinayake, Ajith DeS Nagahawatte, Vasantha Devasiri, Niroshana J Dahanayake, Gaya B Wijayaratne, Nayani P Weerasinghe, Madureka Premamali, Tianchen Sheng, Bradly P Nicholson, Harshanie A Ubeysekera, Ruvini Mp Kurukulasooriya, Aruna D de Silva, Truls Østbye, Christopher W Woods, and L Gayani Tillekeratne
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundHealthcare systems in dengue-endemic countries are often overburdened due to the high number of patients hospitalized according to dengue management guidelines. We systematically evaluated clinical outcomes in a large cohort of patients hospitalized with acute dengue to support triaging of patients to ambulatory versus inpatient management in the future.Methods/principal findingsFrom June 2017- December 2018, we conducted surveillance among children and adults with fever within the prior 7 days who were hospitalized at the largest tertiary-care (1,800 bed) hospital in the Southern Province, Sri Lanka. Patients who developed platelet count ≤100,000/μL (threshold for hospital admission in Sri Lanka) and who met at least two clinical criteria consistent with dengue were eligible for enrollment. We confirmed acute dengue by testing sera collected at enrollment for dengue NS1 antigen or IgM antibodies. We defined primary outcomes as per the 1997 and 2009 World Health Organization (WHO) classification criteria: dengue hemorrhagic fever (DHF; WHO 1997), dengue shock syndrome (DSS; WHO 1997), and severe dengue (WHO 2009). Overall, 1064 patients were confirmed as having acute dengue: 318 (17.4%) by NS1 rapid antigen testing and 746 (40.7%) by IgM antibody testing. Of these 1064 patients, 994 (93.4%) were adults ≥18 years and 704 (66.2%) were male. The majority (56, 80%) of children and more than half of adults (544, 54.7%) developed DHF during hospitalization, while 6 (8.6%) children and 22 (2.2%) adults developed DSS. Overall, 10 (14.3%) children and 113 (11.4%) adults developed severe dengue. A total of 2 (0.2%) patients died during hospitalization.ConclusionsOne-half of patients hospitalized with acute dengue progressed to develop DHF and a very small number developed DSS or severe dengue. Developing an algorithm for triaging patients to ambulatory versus inpatient management should be the future goal to optimize utilization of healthcare resources in dengue-endemic countries.
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- 2021
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3. A Practical Approach to Lung Ultrasound Training in Sri Lanka
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Sky Vanderburg, Iroshani Kodikara, Anna Tharakan, Tianchen Sheng, John A. Gallis, Muhunthan Sellathurai, Champica Bodinayake, Ajith Nagahawatte, Gaya B. Wijayaratne, Chris W. Woods, L. Gayani Tillekeratne, and Elisabeth D. Riviello
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General Medicine - Published
- 2023
4. Knowledge, Perceptions, and Attitudes Regarding Antibiotic Use for Lower Respiratory Tract Infections: Insights from Patients in Sri Lanka
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Champica K Bodinayake, Robert Rolfe, David T. van Melle, Truls Østbye, Vijitha De Silva, Guus ten Asbroek, Gaya B Wijayaratne, Chathuh Halloluwa, Ajith Nagahawatte, Ruvini Kurukulasooriya, Melissa H Watt, Helen L. Zhang, Yohanna W. Abeysinghe, Gayani Tillekeratne, Christopher W. Woods, Sewwandi Kanchana, Tianchen Sheng, Sky Vanderburg, and Global Health
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Adult ,Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Disease ,Medical and Health Sciences ,Young Adult ,Rare Diseases ,Antibiotic resistance ,Clinical Research ,Surveys and Questionnaires ,Tropical Medicine ,Virology ,Lower respiratory tract infection ,medicine ,Humans ,Adverse Drug Reaction Reporting Systems ,Medical prescription ,Intensive care medicine ,Respiratory Tract Infections ,Sri Lanka ,Practice ,Respiratory tract infections ,business.industry ,Health Knowledge ,Public health ,Articles ,medicine.disease ,Anti-Bacterial Agents ,Infectious Diseases ,Attitudes ,Female ,Parasitology ,Infection ,business ,Qualitative research - Abstract
Antibiotic resistance is an emerging global public health threat. One of the main drivers of this threat is the inappropriate use of antibiotics. In Sri Lanka, antibiotic consumption is increasing, but little is known locally about how patients perceive antibiotics. We conducted a qualitative study to gain a better understanding of the knowledge, perceptions, and attitudes of patients regarding antibiotics and antibiotic resistance. Semi-structured interviews involving 18 patients with lower respiratory tract infection (LRTI) admitted to a large, public tertiary care hospital in southern Sri Lanka were conducted. Interviews were analyzed to identify themes regarding the patients’ knowledge of LRTI etiology and treatment, perceptions and attitudes toward LRTI treatment, including antibiotics, and patient–physician communication. Most patients mentioned multiple care visits and the use of multiple pharmaceuticals prior to admission. Patients sought a quick resolution to their ailments and frequently visited several private physicians to obtain a satisfying answer. Self-medication was also common. Patients reused prescriptions for antibiotics, kept antibiotics for later use after prematurely stopping their course of treatment, and bought over-the-counter antibiotics. Patients’ knowledge of disease etiology and antibiotics was poor. Only a few patients were aware of antibiotic resistance. Despite the desire to receive more information regarding disease and treatment, patient–provider communication was limited and mainly confined to prescription instructions. This qualitative study performed in Sri Lanka suggests that inappropriate use of antibiotics is a multifactorial problem. To improve antibiotic use, a multifactorial approach that includes educating the public, increasing awareness among physicians, and implementing systems-level changes to restrict access to antibiotics is urgently needed.
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- 2021
5. Influenza Vaccination Implementation in Sri Lanka: A Cost-Effectiveness Analysis
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Coralei E. Neighbors, Evan R. Myers, Nayani P. Weerasinghe, Gaya B. Wijayaratne, Champica K. Bodinayake, Ajith Nagahawatte, L. Gayani Tillekeratne, and Christopher W. Woods
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Pharmacology ,Infectious Diseases ,Drug Discovery ,Immunology ,Pharmacology (medical) ,cost-effectiveness ,influenza ,vaccination ,Sri Lanka ,Markov model ,economic evaluation - Abstract
Influenza causes an estimated 3 to 5 million cases of severe illness annually, along with substantial morbidity and mortality, particularly in low- and middle-income countries (LMICs). Currently, Sri Lanka has no influenza vaccination policies and does not offer vaccination within the public healthcare sector. Therefore, we performed a cost-effectiveness analysis of influenza vaccine implementation for the Sri Lankan population. We designed a static Markov model that followed a population cohort of Sri Lankans in three age groups, 0–4, 5–64, and 65+ years, through two potential scenarios: trivalent inactivated vaccination (TIV) and no TIV across twelve-monthly cycles using a governmental perspective at the national level. We also performed probabilistic and one-way sensitivity analyses to identify influential variables and account for uncertainty. The vaccination model arm reduced influenza outcomes by 20,710 cases, 438 hospitalizations, and 20 deaths compared to no vaccination in one year. Universal vaccination became cost-effective at approximately 98.01% of Sri Lanka’s 2022 GDP per capita (incremental cost-effectiveness ratio = 874,890.55 Rs/DALY averted; 3624.84 USD/DALY averted). Results were most sensitive to the vaccine coverage in the 5–64-year-old age group, the cost of the influenza vaccine dose in the 5–64-years-old age group, vaccine effectiveness in the under-5-years-old age group, and the vaccine coverage in the under-5-years-old age group. No value for a variable within our estimated ranges resulted in ICERs above Rs. 1,300,000 (USD 5386.15) per DALY adverted. Providing influenza vaccines was considered highly cost-effective compared to no vaccines. However, large-scale national studies with improved data are needed to better inform estimates and determine the impact of vaccination implementation.
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- 2023
6. Point-prevalence survey of outpatient antibiotic prescription at a tertiary medical center in Sri Lanka: opportunities to improve prescribing practices for respiratory illnesses
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L. Gayani Tillekeratne, Champica K Bodinayake, Gaya B Wijayaratne, Ruvini Kurukulasooriya, Tianchen Sheng, Pasangi Jayatissa, Christopher W. Woods, Helen L. Zhang, D. L. Bhagya Piyasiri, and Ajith Nagahawatte
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Respiratory Tract Diseases ,030231 tropical medicine ,Respiratory tract infections ,lcsh:Infectious and parasitic diseases ,Tertiary Care Centers ,Antimicrobial Stewardship ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Ambulatory care ,Electronic prescribing ,Outpatients ,Ambulatory Care ,Prevalence ,Humans ,Medicine ,Antimicrobial stewardship ,Outpatient clinic ,lcsh:RC109-216 ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Medical prescription ,Child ,Outpatient pharmacy ,Sri Lanka ,Antibiotic stewardship ,business.industry ,Middle Aged ,Amoxicillin ,Anti-Bacterial Agents ,Cross-Sectional Studies ,Prescriptions ,Infectious Diseases ,Health Care Surveys ,Emergency medicine ,Antibiotic use ,Female ,business ,Research Article ,medicine.drug - Abstract
Background Inappropriate antibiotic use is linked to the spread of antimicrobial resistance worldwide, but there are limited systemic data on antibiotic utilization in low- and middle-income countries. The purpose of this study was to evaluate the prevalence and patterns of antibiotic prescription in an ambulatory care setting in Sri Lanka. Methods This cross-sectional survey was conducted at the Outpatient Department of a public tertiary medical center in Southern Province, Sri Lanka from February to April 2019. Among consecutive outpatients presenting for care, questionnaires were verbally administered to a systematic random sample to capture information about patient demographics, illness characteristics, and visit outcomes. Prescription data were obtained from the outpatient pharmacy’s electronic prescribing system. Results Of 409 surveyed patients, 146 (35.7%) were prescribed an antibiotic. The most frequently prescribed agents were amoxicillin (41 patients, 28.1% of antibiotic recipients) and first-generation cephalosporins (38, 26.0%). Respiratory indications were the most common reason for antibiotic use, comprising 69 (47.3%) of all antibiotic prescriptions. Antibiotics were prescribed for 66.1% of patients presenting with cough and 78.8% of those presenting with rhinorrhea or nasal congestion. Among all antibiotic recipients, 6 (4.1%) underwent diagnostic studies. Conclusions A high prevalence of antibiotic prescription was observed, in particular for treatment of respiratory conditions. These data support the need for improved antimicrobial stewardship in the Sri Lankan outpatient setting.
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- 2021
7. Additional file 1 of Point-prevalence survey of outpatient antibiotic prescription at a tertiary medical center in Sri Lanka: opportunities to improve prescribing practices for respiratory illnesses
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Zhang, Helen L., Champica Bodinayake, Gaya B. Wijayaratne, Pasangi Jayatissa, D. L. Bhagya Piyasiri, Ruvini Kurukulasooriya, Tianchen Sheng, Ajith Nagahawatte, Woods, Christopher, and L. Gayani Tillekeratne
- Abstract
Additional file 1: Supplementary file 1. OPD pre- and post-visit questionnaires. English version pre- and post-visit study questionnaires.
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- 2021
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8. The Anti-Inflammatory and Antimicrobial Potential of Selected Ethnomedicinal Plants from Sri Lanka
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Mayuri Napagoda, Lalith Jayasinghe, Jana Gerstmeier, Simona Pace, M. Mallique Qader, Sanjeeva Witharana, Sudhara De Soyza, Oliver Werz, Ajith Nagahawatte, Sybille Lorenz, Gaya B Wijayaratne, Hannah Butschek, Andreas Koeberle, and Aleš Svatoš
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microsomal prostaglandin E2 synthase ,medicine.drug_class ,Disinfectant ,Phytochemicals ,Anti-Inflammatory Agents ,Pharmaceutical Science ,Nitric Oxide ,Anti-inflammatory ,Article ,Analytical Chemistry ,lcsh:QD241-441 ,03 medical and health sciences ,Inhibitory Concentration 50 ,0302 clinical medicine ,lcsh:Organic chemistry ,Anti-Infective Agents ,Drug Discovery ,medicine ,Potency ,Humans ,Physical and Theoretical Chemistry ,Medicinal plants ,IC50 ,030304 developmental biology ,Prostaglandin-E Synthases ,Sri Lanka ,0303 health sciences ,Plants, Medicinal ,Traditional medicine ,biology ,Chemistry ,Plant Extracts ,Garcinia cambogia ,Organic Chemistry ,Antimicrobial ,Chemistry (miscellaneous) ,030220 oncology & carcinogenesis ,Arachidonate 5-lipoxygenase ,biology.protein ,5-lipoxygenase ,Molecular Medicine ,antimicrobial ,Medicine, Traditional ,disinfectant ,medicinal plants - Abstract
Traditional folk medicine in Sri Lanka is mostly based on plants and plant-derived products, however, many of these medicinal plant species are scientifically unexplored. Here, we evaluated the anti-inflammatory and antimicrobial potency of 28 different extracts prepared from seven popular medicinal plant species employed in Sri Lanka. The extracts were subjected to cell-based and cell-free assays of 5-lipoxygenase (5-LO), microsomal prostaglandin E2 synthase (mPGES)-1, and nitric oxide (NO) scavenging activity. Moreover, antibacterial and disinfectant activities were assessed. Characterization of secondary metabolites was achieved by gas chromatography coupled to mass spectrometric (GC-MS) analysis. n-Hexane- and dichloromethane-based extracts of Garcinia cambogia efficiently suppressed 5-LO activity in human neutrophils (IC50 = 0.92 and 1.39 µ, g/mL), and potently inhibited isolated human 5-LO (IC50 = 0.15 and 0.16 µ, g/mL) and mPGES-1 (IC50 = 0.29 and 0.49 µ, g/mL). Lipophilic extracts of Pothos scandens displayed potent inhibition of mPGES-1 only. A methanolic extract of Ophiorrhiza mungos caused significant NO scavenging activity. The lipophilic extracts of G. cambogia exhibited prominent antibacterial and disinfectant activities, and GC-MS analysis revealed the presence of fatty acids, sesquiterpenes and other types of secondary metabolites. Together, our results suggest the prospective utilization of G. cambogia as disinfective agent with potent anti-inflammatory properties.
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- 2020
9. Point-prevalence study of antimicrobial use in public hospitals in southern Sri Lanka identifies opportunities for improving prescribing practices
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Kristin J Nagaro, A T Sudarshana, Cherin De Silva, Ruvini Kurukulasooriya, L. Gayani Tillekeratne, Champica K Bodinayake, Christopher W. Woods, Deverick J. Anderson, Ajith Nagahawatte, Truls Østbye, Tianchen Sheng, Richard J Drew, Gaya B Wijayaratne, Hasini Ranawakaarachchi, and Thushani Dabrera
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Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Epidemiology ,Cross-sectional study ,MEDLINE ,Prevalence ,Inappropriate Prescribing ,Drug resistance ,030501 epidemiology ,Article ,03 medical and health sciences ,Antimicrobial Stewardship ,Young Adult ,Anti-Infective Agents ,Intensive care ,parasitic diseases ,medicine ,Antimicrobial stewardship ,Humans ,Young adult ,health care economics and organizations ,Sri Lanka ,business.industry ,Hospitals, Public ,Drug Resistance, Microbial ,Middle Aged ,Antimicrobial ,Hospitalization ,Infectious Diseases ,Cross-Sectional Studies ,Family medicine ,Health Care Surveys ,Female ,Guideline Adherence ,0305 other medical science ,business ,Hospital Units - Abstract
A point-prevalence study of antimicrobial use among inpatients at 5 public hospitals in Sri Lanka revealed that 54.6% were receiving antimicrobials: 43.1% in medical wards, 68.0% in surgical wards, and 97.6% in intensive care wards. Amoxicillin-clavulanate was most commonly used for major indications. Among patients receiving antimicrobials, 31.0% received potentially inappropriate therapy.
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- 2018
10. Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study
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Gaya B Wijayaratne, Bradly P. Nicholson, Joseph S. M. Peiris, Sky Vanderburg, Christopher W. Woods, Jude Jayamaha, Gregory C. Gray, Bhagya Piyasiri, Chathurangi Halloluwa, Sunethra Gunasena, Ruvini Kurukulasooriya, Sujeewa Amarasena, Ajith Nagahawatte, Vasantha Devasiri, Tianchen Sheng, L. Gayani Tillekeratne, Nayomi Danthanarayana, and Champica K Bodinayake
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Adult ,Pediatrics ,medicine.medical_specialty ,Epidemiology ,Cross-sectional study ,viruses ,Clinical Sciences ,Disease Outbreaks ,respiratory infections ,Rare Diseases ,medicine ,Humans ,Prospective Studies ,Respiratory system ,Child ,Respiratory Tract Infections ,Lung ,Sri Lanka ,Other Medical and Health Sciences ,business.industry ,Public health ,public health ,Infant ,Outbreak ,General Medicine ,medicine.disease ,Cross-Sectional Studies ,Infectious Diseases ,Emerging Infectious Diseases ,Good Health and Well Being ,Viral pneumonia ,Pneumonia & Influenza ,Public Health and Health Services ,Coinfection ,Etiology ,Medicine ,epidemiology ,Infection ,business - Abstract
ObjectivesTo determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018.DesignProspective, cross-sectional study.Setting1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka.Participants410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018.ResultsWe found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality.ConclusionsThis is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.
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- 2020
11. Lipophilic extracts of Leucas zeylanica, a multi-purpose medicinal plant in the tropics, inhibit key enzymes involved in inflammation and gout
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Oliver Werz, Hannah Butschek, Andreas Koeberle, Jana Gerstmeier, Ajith Nagahawatte, Sudhara De Soyza, Mayuri Napagoda, Lalith Jayasinghe, Gaya B Wijayaratne, Dinusha Kanatiwela, M. Mallique Qader, Aleš Svatoš, and Sybille Lorenz
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0301 basic medicine ,Xanthine Oxidase ,Antioxidant ,medicine.drug_class ,Neutrophils ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Leucas zeylanica ,medicine.disease_cause ,Gram-Positive Bacteria ,Anti-inflammatory ,Antioxidants ,Gout Suppressants ,03 medical and health sciences ,Anti-Infective Agents ,Picrates ,Microsomes ,Drug Discovery ,Gram-Negative Bacteria ,medicine ,Humans ,Lipoxygenase Inhibitors ,Candida ,Prostaglandin-E Synthases ,Sri Lanka ,Pharmacology ,Staphylococcus saprophyticus ,Arachidonate 5-Lipoxygenase ,Lamiaceae ,Plants, Medicinal ,biology ,Traditional medicine ,Chemistry ,Plant Extracts ,Biphenyl Compounds ,Ascorbic acid ,biology.organism_classification ,Antimicrobial ,030104 developmental biology ,Staphylococcus aureus ,A549 Cells ,Antibacterial activity ,Phytotherapy - Abstract
Ethnopharmacological relevance Leucas zeylanica (L.) W.T. Aiton is a popular, multi-purpose medicinal plant in Sri Lanka but the pharmacological potential and the chemical profile have not been systematically investigated to understand and rationalize the reported ethnobotanical significance. Aim of the study The present study was undertaken to scientifically validate the traditional usage of this plant for the treatment of inflammatory conditions, gout and microbial infections. Inhibition of 5-lipoxygenase (5-LO), microsomal prostaglandin E2 synthase (mPGES)−1 and xanthine oxidase (XO) by different extracts of L. zeylanica was investigated to determine the anti-inflammatory and anti-gout activity, respectively. The antibacterial and antifungal activities were also studied and the relevant constituents in the bioactive extracts were tentatively identified. Materials and methods Cell-free and/or cell-based assays were employed in order to investigate the effects of the extracts against the activity of human 5-LO, mPGES-1 and XO as well as to assess antioxidant properties. The antibacterial activity of the extracts was determined by the broth micro-dilution method against Gram positive and Gram negative bacteria including methicillin-resistant Staphylococcus aureus while the agar dilution method was employed to determine the anti-Candida activity. Gas chromatography coupled to mass spectrometric (GC-MS) analysis enabled the characterization of secondary metabolites in the extracts. Results The dichloromethane extract of L. zeylanica efficiently inhibited 5-LO activity in stimulated human neutrophils (IC50 = 5.5 µg/mL) and isolated human 5-LO and mPGES-1 (IC50 = 2.2 and 0.4 µg/mL). Potent inhibition of XO was observed by the same extract (IC50 = 47.5 μg/mL), which is the first report of XO-inhibitory activity of a Sri Lankan medicinal plant. Interestingly, significant radical scavenging activity was not observed by this extract. Only the n-hexane extract exhibited antibacterial activity against Staphylococcus aureus and Staphylococcus saprophyticus with a MIC of 250 µg/mL while the anti-Candida activity was moderate. GC-MS analysis revealed the presence of phytosterols, fatty acids, sesquiterpenes, diterpenes and several other types of secondary metabolites. Conclusions Potent inhibition of 5-LO, mPGES-1 and XO rationalizes the ethnopharmacological use of L. zeylanica as anti-inflammatory and anti-gout remedy. Interestingly, the antimicrobial activities were not prominent, despite its wide utility as an antimicrobial medication.
- Published
- 2018
12. 436. Skin and Soft-tissue Infections Are a Common Reason for Potentially Inappropriate Antimicrobial Use among Inpatients in Sri Lanka
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Tianchen Sheng, Gaya B Wijayaratne, Thushani M Dabrera, Ajith Nagahawatte, Champica K Bodinayake, Ruvini Kurukulasooriya, Kristin J Nagaro, Cherin De Silva, Hasini Ranawakaarachchi, Arambegedara Thusitha Sudarshana, Deverick J Anderson, Richard H Drew, Truls Ostbye, Chris W Woods, and L Gayani Tillekeratne
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medicine.medical_specialty ,business.industry ,Soft tissue ,Amoxicillin ,Antimicrobial ,Abstracts ,Metronidazole ,chemistry.chemical_compound ,Infectious Diseases ,Oncology ,chemistry ,Clavulanic acid ,Poster Abstracts ,medicine ,Antimicrobial stewardship ,Sri lanka ,Intensive care medicine ,business ,Extended-spectrum penicillin ,medicine.drug - Abstract
Background Skin and soft-tissue infections (SSTI) are a common reason for antimicrobial use in the outpatient and inpatient settings. Inappropriate antimicrobial use for SSTI is common. We determined the prevalence of SSTI and associated inappropriate antimicrobial use among inpatients in Sri Lanka. Methods A point-prevalence study of antimicrobial use was conducted using one-day cross-sectional surveys at five public hospitals in Southern Province, Sri Lanka from Jun-August 2017. Inpatients’ medical records were reviewed for clinical data including antimicrobials prescribed. Inappropriate antimicrobial use was identified as (1) antimicrobial use discordant with guidelines by the Sri Lanka College of Microbiologists (SLCM), and (2) redundant combinations of antimicrobials. Results Of 1,709 surveyed patients, 935 (54.7%) received antimicrobials, of whom 779 (83.3%) had a specified or inferred indication for antimicrobial use. Among patients with an indication for antimicrobial use, SSTI was the second leading indication (181 patients, 23.2%) after lower respiratory tract infection (194, 24.9%). One-third (62, 34.2%) of patients with SSTI had a history of diabetes. Commonly used antimicrobials for SSTI included amoxicillin and clavulanic acid (40.3%), extended-spectrum penicillins (24.9%), and metronidazole (22.1%). inappropriate antimicrobial use was observed in 53.0% of SSTI patients, with redundant antibiotic therapy in 35.9% and antimicrobials discordant with SLCM guidelines in 32.6%. Conclusion SSTI was a common reason for antimicrobial use among inpatients in Sri Lanka, with more than half of patients receiving potentially inappropriate antimicrobial therapy. We identified targets for future antimicrobial stewardship efforts. Disclosures All authors: No reported disclosures.
- Published
- 2019
13. 1677. Prevalence and Patterns of Outpatient Antibiotic Prescription at a Public Tertiary Medical Center in Southern Province, Sri Lanka
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Champica K Bodinayake, Pasangi Jayatissa, L. Gayani Tillekeratne, Gaya B Wijayaratne, Tianchen Sheng, Ajith Nagahawatte, Christopher W. Woods, Bhagya Piyasiri, and Helen L. Zhang
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Abstracts ,medicine.medical_specialty ,Infectious Diseases ,Oncology ,business.industry ,Family medicine ,Poster Abstracts ,medicine ,Center (algebra and category theory) ,Sri lanka ,business ,Antibiotic prescription - Abstract
Background The global emergence of antimicrobial resistance poses a major public health threat. However, there are little data regarding antimicrobial use from many low- or middle-income countries. In this study, we determined the prevalence and patterns of antibiotic prescription among outpatients at a tertiary healthcare facility in Sri Lanka. Methods The study was conducted at the Outpatient Department (OPD) of the largest public tertiary care center in Southern Province, Sri Lanka. This is a free walk-in clinic serving upwards of 1,000 patients per day. Adult and pediatric OPD patients were recruited for a cross-sectional survey in February–April 2019. Pre-visit and post-visit questionnaires were verbally administered to obtain information regarding participants’ demographics and presenting illness. The OPD pharmacy’s electronic prescribing system was queried to calculate the prevalence of antibiotic prescriptions among enrolled patients. Logistic regression was performed to identify features associated with antibiotic prescription. Results Of 408 patients surveyed, 246 (62.9%) were female and 88 (21.7%) were children Conclusion We show a high prevalence of outpatient antibiotic prescription despite limited diagnostic evaluation at a tertiary medical facility in Southern Province, Sri Lanka. Antibiotic stewardship efforts, especially targeting respiratory illness, may help improve antibiotic use in this setting. Disclosures All authors: No reported disclosures.
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- 2019
14. Point-prevalence survey of outpatient antibiotic prescription at a tertiary medical center in Sri Lanka: opportunities to improve prescribing practices for respiratory illnesses
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Helen L. Zhang, Champica Bodinayake, Gaya B. Wijayaratne, Pasangi Jayatissa, D. L. Bhagya Piyasiri, Ruvini Kurukulasooriya, Tianchen Sheng, Ajith Nagahawatte, Christopher Woods, and L. Gayani Tillekeratne
- Subjects
Antibiotic use ,Outpatients ,Antibiotic stewardship ,Respiratory tract infections ,Sri Lanka ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Inappropriate antibiotic use is linked to the spread of antimicrobial resistance worldwide, but there are limited systemic data on antibiotic utilization in low- and middle-income countries. The purpose of this study was to evaluate the prevalence and patterns of antibiotic prescription in an ambulatory care setting in Sri Lanka. Methods This cross-sectional survey was conducted at the Outpatient Department of a public tertiary medical center in Southern Province, Sri Lanka from February to April 2019. Among consecutive outpatients presenting for care, questionnaires were verbally administered to a systematic random sample to capture information about patient demographics, illness characteristics, and visit outcomes. Prescription data were obtained from the outpatient pharmacy’s electronic prescribing system. Results Of 409 surveyed patients, 146 (35.7%) were prescribed an antibiotic. The most frequently prescribed agents were amoxicillin (41 patients, 28.1% of antibiotic recipients) and first-generation cephalosporins (38, 26.0%). Respiratory indications were the most common reason for antibiotic use, comprising 69 (47.3%) of all antibiotic prescriptions. Antibiotics were prescribed for 66.1% of patients presenting with cough and 78.8% of those presenting with rhinorrhea or nasal congestion. Among all antibiotic recipients, 6 (4.1%) underwent diagnostic studies. Conclusions A high prevalence of antibiotic prescription was observed, in particular for treatment of respiratory conditions. These data support the need for improved antimicrobial stewardship in the Sri Lankan outpatient setting.
- Published
- 2021
- Full Text
- View/download PDF
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