We are one of the leading pharma companies in Ahmedabad specializing in antibiotics, including Lincoln Pharmaceuticals Ltd., Concord Biotech, and Aviva Pharmatech. We manufacture a wide range of antibiotic formulations catering to domestic and international markets. Their contributions have strengthened Ahmedabad’s position as a key hub for pharmaceutical innovation in India.

Antibiotic Stewardship and PED Pneumonia

Antimicrobial resistance (AMR) threatens public health in hospitals worldwide. [1] Antibiotic stewardship aims to improve patient outcomes by reducing inappropriate antibiotic prescriptions and minimizing selection of resistant bacteria.

A nurse in each hospital collects data from the patients’ medical records on antibiotic use before and during COVID-19. These data are analysed using the WHO AWaRe framework.

Antibiotics for Infections

In addition to their direct antibacterial effect, antibiotics have many indirect effects on bacteria that enhance host clearance and optimize the immune response. This is a critical aspect of how they work against infection, and it’s why it is so important to limit the use of antibiotics by promoting responsible prescribing and practicing good infection control.

Infection-causing bacteria possess numerous self-defense mechanisms that contribute to resistance against antibiotics. These include bacterial plasmids, transposons, integrons and bacteriophages, as well as ribosomal RNA methylation (rRNA methyltransferases), which reduces the binding of the antibiotic to the 23S rRNA target of the bacterial ribosome. The spread of resistance genes between bacterial strains is also facilitated by horizontal gene transfer, and widespread antibiotic use exerts strong selection pressure on the bacterial population to evolve resistant strains.

Bacteria also employ efflux pumps to extrude antibiotics from their cells, which allows them to survive exposure to high concentrations of drugs. These pumps are present in gram-positive bacteria, as well as in eukaryotic cells including human beings. The efflux pumps of gram-negative bacteria are more complex and rely on a dual membrane structure, requiring them to form tripartite systems to extrude antibiotics across both the inner and outer cell walls.

Researchers are developing novel strategies to combat antibiotic resistance and improve treatment outcomes for patients with challenging infections. These strategies utilize cutting-edge technologies that combine pharmacology, bacteriology, molecular biology and recombinant genetics to understand how antibiotics work against disease and how they can be effectively combined.

Antibiotics for Pneumonia

Pneumonia is a common cause for consultation and antibiotic prescription in paediatrics, but inappropriate prescribing is a significant contributor to the emergence of multidrug-resistant bacteria. This study aims to assess the frequency and changes over time of non-compliance with antibiotic prescription guidelines in children admitted to paediatric emergency departments (PED) for CAP.

Outpatient CAP prescriptions were analyzed using data from the Merative health care information system. Overall, broad-spectrum antibiotics were used to treat otherwise healthy CAP patients (35%; not recommended) and in patients with comorbidities (44%; recommended). Ten-day antibiotic durations were the most common. Broad-spectrum use decreased over time but varied across subgroups. The most commonly prescribed antibiotics were amoxicillin/clavulanic acid and azithromycin, with good guideline adherence.

In multivariable analyses, non-adherence to the pneumonia guidelines was associated with patient age and comorbidity status. In addition, the choice of antibiotic and the length of the course was influenced by provider specialty. Interestingly, the proportion of antibiotic prescriptions ordered by nurses and physician assistants was consistently lower than that by physicians.

The study is limited to non-elderly, privately insured adults and the results cannot be extrapolated to other populations. In general, there is a need for better tools to diagnose infection and to distinguish viral from bacterial infections. In particular, simple biomarker tests like procalcitonin and viral rapid tests should be considered for children with suspected pneumonia to avoid unnecessary antibiotic use.

Antibiotics for Urinary Tract Infections

A variety of antibiotics are used for urinary tract infections, including the b-lactams (penicillins and cephalosporins), glycopeptides (vancomycin), and aminoglycosides. The use of these drugs depends on the severity of the infection and the patient’s clinical condition. The effectiveness of these drugs in treating infections caused by bacteria is related to their ability to inhibit the growth of the bacterial cell wall.

The study collected the data of antibiotic purchases from the provincial centralized procurement system in Gansu Province between 2012 and 2020, analysed the antibiotic consumption and use preferences in different levels of health care institutions, and calculated twelve relevant quality indicators for comparison with ESAC monitoring results. The results show that antibiotic consumption has declined since 2014 in the entire province, but this decline is more obvious in public hospitals than in PHCs. Therefore, implementing intervention policies to control antibiotic use should be focused on PHCs.

The study also shows that the use of antibiotics for immunocompromised patients, such as cancer patients with febrile neutropenia, should be strictly controlled. The authors believe that this can be achieved by establishing a joint task force with the provincial oncology hospital to carry out stewardship activities and educate physicians and pharmacists on antimicrobial use. It is also necessary to increase the number of laboratory tests available for oncology patients, and reduce the turnaround time for blood culture results.

Antibiotics for Other Infections

Antibiotics work by inhibiting growth of bacteria. However, some bacteria can develop resistance to antibiotics. These resistant bacteria become “hospital germs” and can lead to a number of infections including pneumonia, MRSA and the Neisseria bacteria that cause gonorrhea.

Physicians are concerned that the growing problem of antibiotic resistance will reduce their ability to treat infections caused by these organisms. This concern has led to increased interest in reducing unnecessary antibiotic use. One way to do this is to educate physicians and health care providers about the dangers of overusing antibiotics and the need for prudent prescribing based on current evidence.

Several national and international initiatives are under way to increase antibiotic research, development, and marketing. These efforts include incentives to encourage companies to develop new antibiotics, incentives for doctors to prescribe less often, and education about how to best use antibiotics.

The need for new antibiotics is urgent because many infectious diseases have become resistant to the drugs available today. It is estimated that about 400,000 people die of resistant infections each year in the United States alone. This is an unacceptable burden.