ABSTRACT
Background: Adequate importance should be given to antimicrobial chemotherapy and the antibiotics resistance issues during undergraduate training. For successful and sustained intervention, knowledge, attitudes, and practices (KAP) of antimicrobials should be done. So accordingly, this study was planned. Aim and Objective: The aim of the study was to compare KAP of antibiotic use among the 2nd year medical and dental students before and after intervention. Materials and Methods: Questionnaire-based study was done in medical and dental undergraduate students. After taking consent, responses were collected before and after intervention. Each correct response was given a score of 1 and responses were graded as satisfactory and unsatisfactory. Data collected was statistically analyzed using Microsoft Excel 2010 and results were expressed in percentage. Paired t-test was used to analyze pre and post-interventional data. Results: Significant rise in mean knowledge, attitude, practice, and overall scores after intervention in medical and dental students were observed. Satisfactory responses were significantly reduced from 73% to 63% in medical students. Casual attitude towards self-use and irregular use of antimicrobial agents (AMA) was observed which may lead to antibiotic resistance. Significant improvement in overall satisfactory responses was also observed after intervention. Conclusion: Medical and dental students showed improved knowledge about AMA use and antimicrobial resistance (AMR) after pharmacology teaching. However, predominant low scores of attitude and perception indicate the need for further educational interventions such as small group exercises, prescription audits, frequent discussion on rational pharmacotherapy, skillful communication with the patient about prescription. To reduce AMR, students should be trained about AMA use and its adherence by patients as well.
ABSTRACT
The bacteriological profile of epidural catheters was studied in 88 patients. Skin swabs before catheterization and before removal of catheter with their controls were cultured in TSB Medium. The catheter hub, the portion at the skin puncture site and at the tip were cultured in TSB Medium. The 1cm of the catheter bit just before the tip was cultured in TGB medium for anaerobes.Both, the skin controls swabs and the anaerobic culture, were negative. From the remaining, 56 positive cultures were obtained. Staphylococcus epidermidis was the predominant organism in 52% followed by staphylococcus aureus 25%. The remaining 23% was shared by Acinetobacter, Pseudomonas, Klebsiella, and E. coli. All the positive cultures from skin prior to epidural catheterization had turned sterile by 48 hours, indicating continued bactericidal action of the disinfectant. The likely source of positive skin cultures at 48 hours is hair follicles.The catheter tip culture was positive in 9 specimen, none of which resulted in the formation of epidural abscess. In 3 cases the cultures of skin puncture site and the tip were identical indicating tracking-in of the organisms.