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Introduction: Antimicrobial drug resistance is a fast emerging problem worldwide. It is a consequence of the use, particularly of the misuse of drugs. In most of the developing countries, antibiotics can be purchased without prescriptions, even when the practice is not legal. Presently, in India, Schedule H, under the Drug and Cosmetics Act and Rules, provides a list of over 536 drugs which include Antimicrobial Agents [AMAs], which are required to be sold on the prescription of a registered medical practitioner. Objectives: To evaluate the Over the Counter (OTC) sales of antimicrobial agents in allopathic pharmacies [community] within the city corporation limits. To describe the degree of difficulty which is faced in obtaining antibiotics without a prescription. To find out as to what advice, if any, was given by the pharmacists with regards to the administration of the medicines which had been sold. Methods: Three diseases were simulated by two medical students who presented as patients in randomly selected pharmacies at an Urban location. They then requested the pharmacists for medications for their illnesses. AMAs were requested for, if they were not issued at the first instance. Results and Discussion: Nearly 50% of the pharmacists declined to issue AMAs. Amoxicillin was the most common of the AMAs which were dispensed by the pharmacists. The duration and the frequency of the treatment which was advised by the pharmacists were mostly wrong. Conclusion: This study showed that the practice of dispensing AMAs without prescriptions was widely prevalent among the dispensaries which were located even in urban areas. Not only were the AMAs dispensed, but also they were dispensed without taking any history of hypersensitivity. What makes the practice worse is that the duration and the frequency of administration of these drugs are wrongly advised more often than not. [ABSTRACT FROM AUTHOR]

Aim: Staphylococcus aureus is one of the leading causes of nosocomial infections and is known for its ability to develop resistance to antibiotics. The drug susceptibility pattern of Methicillin Sensitive S. aureus (MSSA) and Methicillin Resistant S. aureus (MRSA) may vary. Aims and Objectives: This study was carried out to determine and compare the drug susceptibility patterns in nosocomial MSSA and MRSA. Material and Methods: The study was conducted between September 2009 and August 2011. Standard conventional methods were used for the isolation and identification of S. aureus. MRSA was identified by the cefoxitin (30 μg) disk method. Antibiotic susceptibility test was done using Kirby- Bauer disk diffusion method and the interpretation of the results was done using CLSI guidelines. Results: Out of 685 strains of S. aureus studied, 173(25.25%) were MRSA and 512 (74.25%) were MSSA. Out of 173 MRSA strains, 114(65.89%) were isolated from pus, 22(12.71%) from vaginal swab, 18(10.40%) from central catheter tip and the remaining from other specimens. All isolates were susceptible to vancomycin and least number of isolates were susceptible to penicillin. MRSA displayed significantly higher resistance to other antibiotics. 45.7% of MRSA strains were resistant to clindamycin, 64.7% to ciprofloxacin, 87.3% to cotrimoxazole, 54.3% to erythromycin, 17.3% to gentamicin, 16.8% to netilmycin, and 58.38% to tetracycline. Inducible clindamycin resistance was detected in 37 (21.38%) strains of MRSA. Conclusion: Nosocomial infections caused by MRSA is a significant problem. MRSA and MSSA differ with their susceptibility to antibiotics. All MRSA isolates in our hospitals were susceptible to vancomycin. Proper selection of the antibiotics based on antibiotic susceptibility test results is needed for effective treatment and prevention of emergence of resistance in MRSA and MSSA. [ABSTRACT FROM AUTHOR]