The objective of the study was to analyze antibiotic consumption and determine bacterial resistance rates as an indicator of the rational utilization of this drug group at the urology department in the Health Centre “Studenica” Kraljevo.
Over a two-year period, the average antibiotic consumption was 104.55 DDD/100BD. Of the total financial assets used for medical treatment, the antibiotic group JO1 had a share of 49.52% in 2011 and 47.53% in 2012. Antibacterial drugs from a group of β-lactamic antibiotics were consumed most commonly, at 54.02% (2011) and 43.44% (2012). First-generation cephalosporins, quinolones and aminoglycosides were the most frequently used drug groups, while cephalexin was the antibiotic with the highest individual consumption. E. coli was the most frequently isolated bacterium in 2011, while in 2012, Klebsiella pneumoniae was the most frequently isolated bacterium. The total bacterial resistance both in 2011 and 2012 was above 50%. Gram-negative bacteria showed a higher resistance rate (2011, 59.3%; 2012, 58.9%) than Gram-positive bacteria (2011, 44.4%; 2012, 40.6%). Klebsiella pneumoniae was the bacterium with the highest resistance (75.3%) in 2011, while in 2012, there was a resistance increase in Pseudomonas aeruginosa (71.4%), especially to carbapenems. A correlation was determined between the consumption of individual antibiotics and bacterial strain resistance in 2011 (r=0.433, p=0.044) and in 2012 (r=0.478, p=0.024).
The high resistance rate shown in the bacterial strains, which was correlated with antibiotic consumption, as well as the great financial assets used for this group of drugs suggest the necessity for the rationalization of their utilization. Empirical therapy with Gram-negative bacteria should be based on carbapenems utilization, except with Pseudomonas aeruginosa, where piperacillin/tazobactam should be used.
Dejan Aleksic, Andriana Bukonjic and Srdjan Stefanovic
The aim of this study was to determine the amount of non-opioid analgesics consumed at the surgical departments of a secondary care hospital in Serbia, a developing country undergoing a socioeconomic transition that thus lacks sufficient funds to finance and invest in the healthcare system.
At the departments of gynaecology, urology, otolaryngology, general surgery and orthopaedics with traumatology at the General Hospital, Kraljevo from 2010 to 2012, six different non-opioid analgesics were used: diclofenac, ketorolac, ibuprofen, metamizole sodium, paracetamol (for per os and parenteral use), and meloxicam (for parenteral use only). Drugs in the M01 Anatomical Therapeutic Chemical classification group were consumed statistically significantly more than drugs in the N02 group (U=0.000; p<0.001). With regard to the average consumption amounts of all monitored drugs, diclofenac was consumed the most, followed by ketorolac. Meloxicam was the least used drug. There were significant differences in the average annual consumption of ibuprofen between surgical departments, but this was not the case for the other non-opioid analgesics. The differences in the average consumption between the individual drugs were significant for each year of observation.
Due to the incongruity of the results of previous studies related to non-steroidal anti-inflammatory drug consumption at different surgery wards, additional research in different geographical areas of our country is necessary to enhance the quality of prescription patterns on a national level and adjust them based on the latest scientific data and European trends.
Ivana Raković, Biljana Popovska Jovicic, Andriana Bukonjic, Sara Petrovic, Petar Canovic and Nedim Hamzagic
Pseudomembranous colitis is a frequent nosocomial infection associated with significant morbidity and mortality. Clostridium difficile infection incidence most frequently increases due to unreasonable antibiotic use and the appearance of new hypervirulent bacterial strains, which leads to prolonged hospitalization and an increase in the total cost of hospital treatment.
This is a retrospective design study conducted at Clinical Centre Kragujevac from January to December 2014. The patient data were obtained from the protocol of the Virological Laboratory and from medical documentation. All statistical analyses were performed using the computer program SPSS. The descriptive statistical data are expressed as percentage values. Continuous variables are expressed as the arithmetic mean with the standard deviation.
Clostridium difficile infection occurred more frequently with elderly patients (123 patients were over 65 years old). Out of 154 patients on antibiotic treatment, 110 patients were treated with a combination of two or more antibiotics from different pharmacological groups. The most represented antibiotics were from the cephalosporin (71.4%) and quinolone (46.3%) groups. A total of 85.8% of the patients used proton pump inhibitors and H2 blockers.
Our results describe the clinical and demographic characteristics of patients with diagnosed Clostridium difficile infection. The most prevalent characteristics (age, antibiotic therapy, PPI and H2 blocker use), which other researchers have also mentioned as risk factors, were present in our study as well.
Milos V. Nikolic, Marina Z. Mijajlovic, Dusan Lj. Tomovic, Andriana M. Bukonjic, Verica V. Jevtic, Zoran R. Ratkovic, Srecko R. Trifunovic and Gordana P. Radic
New zinc(II)-complexes with S-alkyl derivatives of thiosalicylic acid (alkyl = benzyl-(L1), methyl-(L2), ethyl-(L3), propyl-(L4), butyl-(L5)) have been synthesized and characterized by elemental microanalysis, IR spectroscopy, and 1H and 13C NMR spectroscopy. The S-alkyl derivatives of thiosalicylic acid were prepared by alkylation of thiosalicylic acid by adding alkyl halides to an alkaline water-ethanol solution, while the corresponding zinc(II)-complexes were obtained via the direct reaction of ZnCl2 with S-alkyl derivatives of thiosalicylic acid in water. Based on the microanalysis results and the IR and NMR spectra of the S-alkyl derivatives of thiosalicylic acid and the corresponding zinc(II)-complexes, we concluded that the ligands are bidentately coordinated to the zinc(II)-ion.
Marina Z. Mijajlovic, Milos V. Nikolic, Dusan Lj. Tomovic, Andriana M. Bukonjic, Aleksandar Kocovic, Verica V. Jevtic, Zoran R. Ratkovic, Olivera Klisuric, Srecko R. Trifunovic and Gordana P. Radic
New platinum(IV)-complexes with S-alkyl derivatives of thiosalicylic acid (alkyl = benzyl-(L1), methyl-(L2), ethyl-(L3), propyl-(L4), butyl-(L5)) have been synthesized and characterized by microanalysis, infrared spectroscopy, and 1H and 13C NMR spectroscopy. Th e bidentate S,O ligand precursor, the S-butyl derivative of thiosalicylic acid (S-bu-thiosal), was prepared, and its crystal structure was determined. Single crystals suitable for X-ray measurements were obtained by slow crystallization from a DMSO-water system. S-bu-thiosal crystallized in a P21/c space group of a monoclinic crystal system with a = 8.0732 (3) Å, b = 19.6769 (4) Å, c = 8.2291 (3) Å and Z = 4. S-bu-thiosal also has a coplanar geometry.
Dusan Lj. Tomovic, Andriana M. Bukonjic, Aleksandar Kocovic, Milos V. Nikolic, Marina Z. Mijajlovic, Verica V. Jevtic, Zoran R. Ratkovic, Aleksandar N. Arsenijevic, Jelena Z. Milovanovic, Bojana Stojanovic, Srecko R. Trifunovic and Gordana P. Radic
New complexes of copper(II) with S-alkenyl derivatives of thiosalicylic acid (alkenyl = propenyl-(L1), isobutenyl-(L2)) have been synthesized and characterized by microanalysis, infrared spectra, magnetic measurements, and by NMR spectra. The cytotoxic activity of two newly synthesized precursor S-alkenyl derivatives of thiosalicylic acid were tested using an MTT colorimetric technique on HCT-116 human colon carcinoma cells. The cytotoxic effect of the copper(II)- complexes were higher compared to the cytotoxicity of the corresponding ligand (for concentrations from 31.25 to 250 μM). Copper(II)-complexes showed a slightly lower cytotoxicity compared to cisplatin. Complexes of copper(II) with S-alkenyl derivatives of thiosalicylic acid (at concentrations from 250 to 1000 μM) had a cytotoxic effect on HCT-116 cells compared to cisplatin.
Boban Milovanović, Dušan Tomović, Slobodan M. Janković, Iva Grubor, Ljiljana Nikolić, Miloš Nikolić, Marina Mijajlović, Strahinja Mrvić, Ana Divjak, Andjela Milojević, Jelena Djoković, Andjelka Prokić, Andriana Bukonjić, Marija Sekulić, Vesna Matić, Djordje Vukmirović, Bojan Rakonjac, Tanja Dimitrijević, Nataša Nikolić, Dragutin Jovanović, Jelena Milovanović, Marija Ratković, Nevena Barudžić, Nenad Mladenović, Milan Milutinović, Ana Antanasković and Milena Nikolić
Fear of needles can significantly limit professional and social functioning of a person, and is highly prevalent in general population (4%).
The aim of our study was to reveal risk factors that are associated with fear of needles among healthy university students of medicine and pharmacy.
The study was of a cross-sectional type. In total, 301 students of medicine or pharmacy (82% female and 18% male) attending from 1st to 5th year of study were surveyed at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The students were surveyed using a questionnaires (scales) for assessing the fear of needless, a visual analog scale for self-assessment intensity of the fear of needless, and a general questionnaire with questions about socio-demographic characteristics of the participants. Using a score on the scales as out-come variables, multiple regressions were employed to reveal factors that may influence the fear of needles.
Average values of Blood/Injection Fear Scale, Injection Phobia Scale-Anxiety and Medical Avoidance Survey scores were 7.89 ± 9.48, 4.46 ± 5.18 and 89.95 ± 12.73, respectively. The following factors affected significantly the score of the scales: course of study, chronic disease in the family, fear of a dentist, smell of the room phobia, sound phobia, score on the Beck’s anxiety scale and fear of a situation when medical staff give an injection. The presence of chronic disease in the family was a protective factor, while the other six factors were contributing to the fear of needles.
Fear of needles is more prevalent among the students of pharmacy than among the students of medicine. It is less frequent among students with chronic disease in their family, while fear of dentist, smell of the room phobia, sound phobia, general anxiety and fear from the situation when medical staff give an injection are all factors that predispose students of medicine or pharmacy to develop fear of needles.