Antimicrobial resistance (AMR) is a global concern, especially in low- and middle-income countries, threatening food production, healthcare, and life expectancy. Antimicrobial stewardship (AMS) programs can optimize antibiotic use, improve patient outcomes, lower AMR, and save healthcare costs. This observational-retrospective study in Dhi Qar Governorate aimed to assess antimicrobial prescribing patterns in Al-Nasiriya public hospitals. Dhi Qar Health Directorate comprises ten hospitals, and only one hospital was excluded from the study. The study used data from antibiotic stewardship committees, including antibiogram, antibiotic, and meropenem surveys, hospital pharmacies’ medical files, and the directorate statistics from 1/1/2023 to 1/10/2023. The number of patients undergoing antibiotic screening was 6090. Most patients (43.34%) were in the 18–49 years age range. Most cases of antibiotics' clinical indication were surgical procedures (41.82%), with cesarean sections being the most common (16.15%), followed by medical treatment (37.25%), with respiratory conditions (21.34%) being the most common. Most patients (99.72%) received empirical rather than targeted treatment, parenteral rather than oral treatment (98.93% were given parenteral antibiotics); more than half of patients (52.84%) were prescribed a combination of two or more antibiotics. Most cases (95.43%) in antibiotic screening were continued on the same dose without reviewing the antibiotic prescription after 48–72 hours. The treatment resulted in 87.75% healing, 53.57% discharge with antibiotic discontinuation, and a 1.21% death rate among patients. Metronidazole, ceftriaxone, meropenem, amoxicillin, and cefotaxime were the most frequently prescribed antibiotics. The data from hospital pharmacies’ medical files showed the consumption of 14 types of antibiotics within the WHO's Watch group and 18 within the Access group. The most antibiogram-isolated bacteria were E. coli (19.06%), Staphylococcus non-aureus spp. (18.74%), Staphylococcus aureus (11.26%), Klebsiella pneumonia (10.15%), and Pseudomonas aeruginosa (7.88%). The antibiogram showed resistance to many antibiotics, and there was a significant difference in resistance distribution among the Access, Watch, and Reserve groups (P value = 0.024). Antibiotic practice showed empirical treatment with broad-spectrum antibiotics (most of which are in the WHO Watch group), limited culture and sensitivity testing, and limited antibiogram use, making monitoring antibiotic resistance hard.
ABSTRACT
The multi-drug resistant efflux pump is a glycoprotein pump whose function is to push foreign substances. The efflux pump is found in humans, animals. It also has wide-ranging properties in bacteria and fungi. They are found in all species of bacteria, and efflux pump genes can be found in bacterial chromosomes or mobile genetic elements, such as plasmids. The most sensitive function that leads to a global problem is its resistance to antibiotics in bacterial cells, which increases the ability to bacteria from becoming strong virulence factors that most or all antibiotics cannot kill. It also has othe
... Show MoreThis work includes the synthesis and identification of ligand {3-((4-acetylphenyl)amino)-5,5-dimethylcyclohex2-en-1-one} (HL* ) by the treatment of 5,5-dimethylcyclohexane-1,3-dione with 4-aminoacetophenone under reflux. The ligand (HL* ) was identified via FTIR, Mass spectrum, elemental analysis (C.H.N.), 1H and 13C-NMR spectra, UV-Vis spectroscopy, TGA and melting point. The complexes were synthesized from ligand (HL* ) mixed with 3-aminophenol (A) and metal ion M(II), where M(II) = (Mn, Co, Ni, Cu, Zn and Cd) at alkaline medium to produce complexes of general formula [M(L* )(A)] with (1:1:1) molar ratio. These complexes were detected via FT-IR spectra, UV-Vis spectroscopy as well as elemental analysis (A.A) and melting point, conductivit
... Show MoreThis work includes the synthesis and identification of ligand {3-((4-acetylphenyl)amino)-5,5-dimethylcyclohex2-en-1-one} (HL* ) by the treatment of 5,5-dimethylcyclohexane-1,3-dione with 4-aminoacetophenone under reflux. The ligand (HL* ) was identified via FTIR, Mass spectrum, elemental analysis (C.H.N.), 1H and 13C-NMR spectra, UV-Vis spectroscopy, TGA and melting point. The complexes were synthesized from ligand (HL* ) mixed with 3-aminophenol (A) and metal ion M(II), where M(II) = (Mn, Co, Ni, Cu, Zn and Cd) at alkaline medium to produce complexes of general formula [M(L* )(A)] with (1:1:1) molar ratio. These complexes were detected via FT-IR spectra, UV-Vis spectroscopy as well as elemental analysis (A.A) and melting point, conductivit
... Show MoreThat the child in the early years of his life learns a lot of experiences that help him
grow properly, and if the availability of the child family atmosphere full of love and affection
and trust he was able to grow healthy growth and is in accordance with itself and with the
community in which they live, and stop method of the child in the expression of fear on the
nature of situation and on the theme of fear and the reaction of those around the child as well
as the vague positions that can not a child from its interpretation raises his fear, and its lead in
life are the kindergarten of the growing concerns him, causing his social concern, therefore,
targeted current research to identify patterns of parental care(mot
This study focuses on the biodegradation of oxymatrine insecticide by some soil fungi isolated from four agriculture stations. The results showed that the highest degradation rate 94.66% was recorded by Ulocladium sp. at 10 days and A. niger recorded the lowest degradation rate 45.86%, while at 20 days Ulocladium sp. also showed the highest degradation rate 94.98% and the lowest degradation rate reached to 82.49% with A.niger. The mix (Exerohilum sp.+Ulocladium sp.) recorded the highest degradation rate of oxymatrine insecticide 90.22%, 88.51%, 85.34% at 4, 8 and 12 ppm.The use of mixed isolates enhanced the biodegradation process. There is no study of oxymatrine biodegradation
... Show MoreThe use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 from Al-
... Show MoreThe use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro
... Show MoreBackground:Parkinson’disease(PD) is a neurodegenerative disorder of the central nervous system characterized by resting tremor, bradykinesia, cogwheel rigidity, and impairment of postural reflexes; the frequency of PD increases with aging.Clinically Parkinson's disease characterized by two groups of symptoms: motor and non-motor symptoms.Non-motor symptoms can be categorized as autonomic, cognitive/psychiatric (may include depression, dementia, anxiety, hallucinations), sensory and rapid eye movements (REM) sleep behavior disorder (RBD).
Objectives:The objectives of this study are to find out the frequency of the non-motor symptoms of idiopathic Parkinson disease in a group of patients in Baghd
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