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BACKGROUND: Ceftazidime-avibactam (CZA) represents a novel therapeutic approach for combating infections caused by multidrug-resistant Gram-negative bacteria. With the rise of antimicrobial resistance posing a significant challenge in hospital settings, this study aims to evaluate the utilization of CZA in hospitals and its subsequent outcomes. METHODS: A retrospective study was conducted, analyzing data from medical records of patients who received CZA treatment in a large tertiary care hospital over a six-month period. Demographic information, clinical characteristics, Charlson comorbidity scale, PITT bacteremia score, microbiological data, treatment regimens, and outcomes were collected and analyzed. Descriptive statistics were used to summarize patient characteristics and outcomes. RESULTS: A total of 104 patients received ceftazidime avibactam, with a mean age of 57years. The most common indication is given as definite63.46%(66) and 36.53% (38) were received as empirical. The mean of 6days. In this 65.38%(68) patients were improved &discharged and declared patients were 34.61%(36),as shown in the table below. CONCLUSION: In conclusion, antimicrobial stewardship accepted in only 14.42%, empirical employment of ceftazidime-avibactam in hospitals faces significant drawbacks. Issues including escalating resistance, sparse clinical evidence, and economic burdens raise doubts about its utility. Prudent consideration of alternatives and continued monitoring are essential to navigate uncertainties surrounding its effectiveness in tackling multidrug-resistant infections.

BACKGROUND: Diagnosing sepsis is challenging due to its complex onset. Despite various scoring systems, diagnostic inconsistencies persist. The Surviving Sepsis Campaign (SSC) 2021 recommends the SOFA score, but it relies on lab tests often unavailable in low-resource settings. Conversely, the NEWS2 score, based on vital signs alone, presents a practical alternative. AIM: To compare the diagnostic accuracy of NEWS2 and SOFA scores in predicting sepsis in Low resource Hospitals. METHODS: This 6-month Prospective Observational study conducted in a South Indian tertiary care hospital's Emergency Department (ED) and ICUs from. Patients with signs of infection were screened for sepsis as per SSC 2021 guidelines are included. NEWS2 and SOFA scores were used to screen sepsis on admission day. Lab parameters and Vitals are collected, analyzed using SPSS for sensitivity, specificity and Area Under Receiver Operating Curve (AUROC). RESULTS: Of 568 patients with signs of infection scores were applied, 131 (23.06%) were diagnosed with sepsis and 32 (24.4%) died. NEWS2 had higher AUROC of 0.78, compared to SOFA's AUROC of 0.61. (Table 1). For predicting mortality, both scores were significant, NEWS2 ≥5 had a higher AUROC. Results in (Table 2), ROC curves in Figures 1 and 2. CONCLUSION: The NEWS2 score showed superior performance over SOFA in predicting sepsis, with higher AUROC, sensitivity, and specificity. This highlights NEWS2 as a significant tool for early sepsis detection and management in low resource hospital settings as it relies only on vital sign. Further large studies should validate its effectiveness against other early warning scores.

AIM: To examines public perceptions, attitudes and knowledge concerning antibiotics, with a particular focus on the impact of OTC accessibility and affordability. BACKGROUND: The availability of over-the-counter (OTC) medicines including antibiotics and economic disparities encourages unsupervised self-medication which may pose a threat to increase antibiotic resistance. METHOD: This cross-sectional survey utilized random sampling, stratified by demographics, to assess adults' perceptions, attitudes and understanding of antibiotics in our region. The questionnaire, covered demographics, usage patterns, resistance knowledge, OTC availability and affordability concerns. Data were gathered through face-to-face interactions and social media. RESULT: Out of 1,024 invited participants, 719 respondents were participated in the survey. Our study reveals that 225(31.2%) of daily and monthly wage earners opt to self-medication, primarily due to the high cost of consultations with 121(16.8%) of respondents citing this as their reason. Despite 195(27.1%) being satisfied with OTC medications, common issues persist such as affordability with 263(36.5%) of daily wage earners finding antibiotics too costly. Compounding the issue, 372(51.7%) do not complete their full course of antibiotics, increasing the risk of resistance. 58.5% of respondents believed that antibiotics are used to treat viral infection such as common cold and influenza. CONCLUSION: The findings of our study indicate that daily wage earners struggle to afford medications. It's important to implement the national pharmaceutical policy more effectively. Increasing the availability and accessibility of generic drugs is essential. Additionally, policies to restrict the purchase of antibiotics without prescription and to educate on their proper use are urgently needed.