Evaluation of carbapenem antimicrobial stewardship program at a tertiary care hospital: A prospective interventional study.

This study aimed to determine physicians' acceptance rate of the Antimicrobial Stewardship Program ASP interventions in critically ill patients and to compare the clinical outcomes between accepted and rejected ASP groups. The study included patients on carbapenem therapy who were advised ASP interventions between 18-75 years of age and admitted in ICU/HDU from December 2020 to May 2021 at Liaquat National Hospital Karachi. Based on acceptance by the primary physician, data is divided into two groups. Outcomes were observed based on clinical improvement within seven days, 30-day mortality and readmission rates. Among 134 non-adherent prescriptions, Carbapenem ASP interventions were accepted in 117 (87.3%) patients. The accepted interventions improved clinical outcomes for most patients within seven days, 99 (84.6%). An insignificant association in death between the accepted versus rejected group within 30 days (p=1.000) was observed. On the other hand, a significant association in readmission was seen between both groups within 30 days (p=0.036). This study concluded that carbapenem prescriptions guided by the 'Antimicrobial stewardship program' are widely accepted in Pakistan and have improved clinical outcomes within 30 days of intervention.

Cytomegalovirus infection in pregnant women and its association with bad obstetric outcomes in Northern India.

BACKGROUND: Cytomegalovirus (CMV) infection during pregnancy is far more complex than other infections, due to ability of the virus to be frequently reactivated during the child bearing age and may vertically transmitted to the developing fetus in spite of maternal immunity. Therefore, in the current study we determined the prevalence of CMV infection in pregnant women and tried to identify the role of maternal CMV infection in adverse pregnancy outcomes in Northern India. In this case-control study, 517 pregnant women, out of them 200 in case group and 317 in the control group. The overall 31.72% (164/517) cases were found with active CMV infection. CMV positivity (p=0.026) was significantly associated with bad obstetric history (75/200, 37.50%) compared to normal pregnancy (89/317, 28.07%). CMV infection was predominantly observed in age group 21-25 years. CMV positivity have been found to be significantly higher in women from rural area as compare to those from urban area (p=0.028). However, no significant difference has been observed in case of occupation, income, and haemoglobin level.