TIME KILL CURVE FOR EVALUATION OF RELATIVE EFFICACY OF ANTIBIOTICS IN SURGICAL WOUND INFECTIONS and DIABETIC FOOT ULCER

2016-10-16T02-20-53Z
Source: Indo American Journal of Pharmaceutical Research
Thakur Sajan Singh*, Mrs. Richa Saxena, Dr. Indu Kapur, Sai Krishna Paritala, Pravallika Rapolu, Mounica Bondalapati.
Background: A surgical site infection or SSI, is an infection of a wound developed from surgery which may affect either closed wounds or wounds that were left open to heal whereas, diabetic foot ulcers are caused by neuropathic (nerve) and vascular (blood vessel) complications of the disease. Treatment of wound site infections needs a multidimensional approach, includes the right choice of antibiotic, the cleanliness of wound site, choice of topical agent, rate of bacterial killing, plasma drug concentration(PDC) at site of infection and in diabetic cases glycemic control. Antibiotic therapy plays the most important role in management of wound site infections; the choice is made by performing culture sensitivity. The killing effect of an antimicrobial agent can be expressed as the rate of killing a fixed concentration of drug under controlled conditions. The resulting graphic depiction is known as "Time kill curve". Objectives: To determine 3log phase decrease between growth control and antibiotic serial dilutions and selecting drug of choice and also to compare 100 fold decrease between growth control and antibiotic plus add on therapy and further establishing time kill curve, by plotting CFU on Y-axis and time on X-axis. Method: Its an Observational and Comparative study carried out for 6 months, designed to study different antibiotics effect on 35 patients at different concentrations. Results: Viable colonies from those dilutions containing 5-50CFU were counted. The colony counts were multiplied with dilution factor to obtain CFU per milliliter. The results were tabulated as CFU per milliliter (y-axis) vs time (x-axis) on semi-log paper (CFU per milliliter can be converted to log10values).The antimicrobial agent concentration that showed 3log10CFU/ml fold decrease when compared with the growth control was determined. The time when the 3log10CFU/ml fold decrease occurred when compared with the growth control was determined. Conclusions: According to Time-Kill Curve we can conclude that Amoxicillin+Clavulanic acid is effective on Escherichia coli, Amikacin is effective on Pseudomonas aeruginosa, Ampicillin + Ciprofloxacin is effective on Staphylococcus aureus, Ampicillin + Sulbactam is effective on Klebsiella pneumonia. Time-Kill Curve method may be employed to establish the log phase difference in killing effect by the desired groups of antibiotics and therefore the Antibiotic that shows the highest log phase difference can be the selected as drug of choice to treat the condition.


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