Chitosan Loaded Mucoadhesive Microspheres of Gliclazide - Journal

There are enormous logical differences in the prescription of
antibiotics for LRTI, between countries and between different
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healthcare providers in the same country. The "first
generation" of guidelines was mostly consensus-based,
whereas those published in 2000/2001 are partly evidencebased.
However, there is still lack of evidence in many areas of
the LRTI, also interpretation of the available evidence is
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variable.
MATERIALS AND METHODS
Study Location
The present study was conducted at medicine wards of St.
Martha's Hospital, Bangalore which is a tertiary care teaching
hospital providing specialized health care services. Ethical
clearance was obtained from the Institutional review board of
St. Martha's Hospital, and an Informed consent was taken
from the patients before initiating the study. The study was
conducted for a period of 8 months.
Study Population
All adult and geriatric hospitalized patients of medicine
department who were diagnosed with lower respiratory tract
infection being prescribed with a combination of
azithromycin and cephalosporin during the study period and
who were willing to participate in the study were included. A
total of 88 patients were enrolled. Out patients,
Pregnant/lactating patients, Pediatric patients, Non
consenting patients were categorized under exclusion group.
Study Design
Imran Ahmad Khan et al./ Assessment of Various Combination of Drugs Used In Treatment of Lower Respiratory Tract Infection
It was a prospective study where in the data was collected from
the case sheets of inpatients diagnosed with LRTI. A detailed
description of demographic details, Presenting complaints,
Past History, Personal History, Family History, Drug history,
Laboratory parameters was taken. Patient follow up was
carried out until discharge.
Efficacy was determined based upon the clinical response i.e.
reduction in the symptoms such as sputum production, cough,
wheezing, dyspnea, fever, discolored sputum and length of
hospital stay. The patients were monitored throughout till
discharge and the symptoms were noted at a regular interval
of every three days. The patients were also monitored for any
adverse drug reactions during the treatment.
Cost of treatment was calculated by “Cost Effective Analysis”.
It is an economic evaluation method of pharmacoeconomics
where cost is measured in monetary terms and consequences
are measured in non-monetary units. Cost effective analysis is
used when there is single measurable dimension of
effectiveness for both treatments. This method is used when it
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is necessary to measure both cost and clinical outcomes of
drugs.
The cost effective ratio for each treatment option is calculated.
This ratio is total cost of the drug divided by the number of
units of output (benefit). In this case, the output is reduction in
the symptoms on the seventh day of the treatment. Preferred
drug is the one with lower cost per unit of output or health
improvement. The difference in the reduction of symptoms in
different treatment groups was statistically analyzed by Chi-
square test.
RESULTS
After appropriate scrutiny 88 patients met the inclusion
criteria and were enrolled after taking informed consent.
Demographic details, diagnosis, co-morbidities and habits are
depicted in (Table 1). Different LRTI's were diagnosed of
which pneumonia was the form of illness in 40% of patients
making it highest among others.
The various laboratory parameters evaluated were, White
Blood Corpuscles (WBC), Erythrocyte Sedimentation Rate
(ESR), Platelet count, Partial Pressure of Oxygen and Carbon
dioxide (PaO2, PaCO2), Bicarbonates (HCO3) and Oxygen
Saturation (SaO2). 84% of the patients got admitted with the
complaint of cough and 83% with the complaint of excessive
sputum production. Other complaints included, wheezing,
dyspnea, myalgia, nausea, fever and discolored sputum.
The combinations of macrolide and cephalosporin therapy
prescribed to the patients according to the diagnosis for the
treatment of their relevant conditions are positioned in (Table
2).
The length of hospital stay of patients ranged from 1 to 12
days and minimum stay was observed in azithromycin +
ceftriaxone combination, whereas patients on combination of
azithromycin + cefuroxime experienced maximum hospital
stay.
Further evaluation of each symptom was done individually to
assess the severity. The results are presented in (Table 3) and
Table 1: Demographic details of the study subjects
Demographic Details n* %
Males 52 59
Females 36 41
Age (50yrs-59yrs) 29 33
Co-Morbidities (Hypertension) 44 50
Smoking 52 59
Alcohol 26 29.5
Tobacco
n*- No of patients
30 34
RJPS, Jul - Sep, 2011/ Vol 1/ Issue 2