7^th World Congress and Exhibition on Antibiotics and Antibiotic Resistance March 16-17, 2020 London, UK

Bedeer Sabry Bedeer Elsherbiny is a Pharmacist and Pharmacologist. He has completed his Graduation from Faculty of Pharmacy, Mansoura University, Egypt in 2003. He is a Board Certified Pharmacotherapy Specialist BCPS for Board of Pharmacy specialties USA in 2013. In 2014, he has completed his MS Master in Clinical Pharmacy from Supreme Council of Universities, Cairo, Egypt. He has more than 15 years’ research experience in Pharmacological studies and pharmacy practice. He is currently working as a clinical pharmacist in SEHA Abu Dhabi and he is a member of PTC screening and evaluation Committee in SEHA UAE. He got many awards and recognition certificates for best employee and innovation. He attended more than 40 scientific meetings such as conferences, symposia, workshops and seminars at National and International level. He has worked in several projects in SEHA UAE. He is the Member of Editorial Panel of EC Pharmacology and Toxicology Journal.

Antibiotic misuse and overuse is a common problem in ambulatory care settings. This problem will increase the rate of antibiotic resistance in both settings of ambulatory care and hospital setting. The project is a trial to implement ASP Antibiotic Stewardship Program in an ambulatory care clinic within a network of ambulatory care centers in the emirate of Abu Dhabi UAE. Applying ASP in outpatient is challenging and till now has no standards. In this project antibiotic prescription and consumption was estimated using DDD/100 patient’s visits and antibiotic prescription rate also the cost of antibiotics was estimated and all data of 2018 after implementing ASP project was compared to the data of 2017.

Mariana Lvovsky graduated from The Kaunas University Of Medicine, Lithuania. M. Pharm (2008). She has Professional Experience as Pharmacist in “Carmel” Medical Center, Haifa, Israel (2010-now), Training on ICH/GCP, Course Design, Conduct & Management of Clinical Trials Practical GCP Compliance 2012.

Background: The Unit Dose is a special department which operates as part of the pharmacy services in Carmel hospital. This unit is in charge of supervising and dispensing of antibiotics according to specific guidelines approved by infectious disease specialist. Supervised antibiotics have been designated by the medicine committee and the infectious disease specialist. Pre-authorization is needed for supervised antibiotics. The patient’s computerized file is updated accordingly. Goal: 1. Adequate use of antibiotics. 2. Standardization of aseptic preparation technique and procedure by preparing customized data form to insure standard quality preparation. 3. Reduction days of treatment and hospitalization. Providing the patients with a more accurate, accessible and safer treatment Dispensing of Antibiotics: Monitoring dosage, dose adjustment according to renal and liver function, allergies, polypharmacy combinations and the option to shift to po treatment rather than. This routine is performed on a daily basis and covers all antibiotic protocols. Computerized documentation of pharmaceutical intervention in patients file. Individual dispensing of antibiotics for 24 hours. Aseptic preparations: 1. Issuing elaborated guidelines regarding aseptic preparations Document the preparation in the Unit Dose system What can we achieve? 1. Strict monitoring of antibiotic use in hospitalized patients 2. Economic efficiency 3. Promoting high quality care 4. Computerized documentation and maintaining accessible data base 5. Regulatory improvement 240 interventions were documented by unit dose pharmacists over a period of 6 month (01.2019-06.2019). Discontinuing treatment (20%), Switch to oral administration (15%), Dose adjustment (15%), renewing the application to ID specialist (30%), and informing the medicine department that there is a need of ID specialist approval for the antibiotic order (20%).

Said Wareg E has expertise in research studies in Medical Microbiology and related subjects. One of his interests is bacterial resistance to antimicrobials especially MRSA. Currently, he is the Director of newly established Scientific and Consultancy Research Centre in Nalut University/ Libya, looking forward to building mutual and bilateral partenship cooperation with national or international institutions for the benefit of the two parties.

The evolution of resistance to antibiotics is one of the most significant problems in Modern medicine, posing serious threats to human and animal health. Multidrug-resistant organisms(MDRO,S), including MRSA, vancomycin-resistant Enterococci (VRE)and certain Gram-negative bacilli have important infection control complications. From a previous study, an agar susceptibility testing was used to test all isolates against vancomycin, chloramphenicol, gentamicin, fusidic acid, erythromycin, streptomycin, Ciprofloxacin, cefotaxime and clindamycin. MRSA was detected using cefoxitin (30µg) disc and antibiotic susceptibility pattern was determined using the Kirby and Bauer disc diffusion susceptibility testing method and confirmed for fusidic acid and vancomycin by determination of minimum inhibitory concentration. The isolated MRSA strains showed multiple drug resistance pattern as 42% for IPHA-MRSA, 34% for OPHA-MRSA and 23% for CC-MRSA. The distribution of strains of IPHA, OPHA and CC-MRSA compared with the MIC and zone size of fusidic acid showed that the highest number of isolates were distributed about the highest MIC values for IPHA-MRSA(16, 8, 4mg/L), OPH-MRSA (8, 4,2mg/L) and CC-MRSA(8,4mg/L). These results showed high multi-drug resistance for all MRSA isolated strains ( Fig.1, Fig.2, Fig.3). Interpretative zone of inhibition for fusidic acid and vancomycin was based on the British Society for Antimicrobial Chemotherapy (BSAC) (Anon-2010/2013) guidelines. Standard international interpretation criteria for zone size for fusidic acid should be addressed.

Ghazala Qamar is from Rawalpindi, Pakistan. She has completed her high school from Kuwait. She completed her medical school in Pakistan. She appeared in postgraduate entry exam in the field of pathology in November 2016 and got inducted in 4 years specialist training program in the field of haematology in January 2017. She started with the 4th year of her training and will appear in Exit exam of 4year training in February 2021.

Background: Iron deficiency is the leading cause of anemia in developing countries like Pakistan, particularly in children and females of child bearing age. This is mainly due to inappropriate dietary iron intake and increased demand of iron during pregnancy. Iron is a major component of hemoglobin and lack of this essential element results in lower hemoglobin content in red cells. Complete blood count (CBC) can provide us with a better estimate of iron deficiency. Red cell distribution width (RDW) is a significant CBC parameter and a credible marker of variation in red cell size (anisocytosis) on many routine hematology analyzers. RDW is usually elevated in IDA due to variation in size of erythrocytes while it is normal in beta thalassemia trait. Ferritin is a gold standard measure in IDA but as it is also an Acute Phase Reactant which tends to falsely elevate in various infections and inflammatory disorders. Therefore it is not of considerable significance in detection of IDA in such clinical conditions. Objective: The study aims to detect the sensitivity and specificity of RDW in iron deficiency anemia (IDA) and beta thalassemia trait (TT). In under resourced areas, tests like iron studies, Ferritin assays and Hb electrophoresis are usually not available. Hence, RDW is cost effective and a reliable parameter in detecting IDA in the absence of many other diagnostic and clinical choices. Materials & Methods: The study was conducted at Chughtai Institute of Pathology Lahore from September 2019-November 2019. It was a Cross sectional Prospective study and included 115 Patients which were divided in to two main groups i.e. Group 1 and Group 2. Group 1 included patients of IDA, both males and females ranging from 1-50 year of age. Patients with a hemoglobin <11g/dl, mean cell volume (MCV)<26fl, mean cell hemoglobin (MCH) <76 g/dl and serum ferritin <15ug were included in Group1. Group 2 included patients with beta TT having Hb A2 values of >3.5 diagnosed on Capillary Hb Electrophoresis. Results: Patients in Group 1 had a mean Hb of 7.5g/dl (SD±1.74), mean MCV of 68.9 fL (SD±16.7), mean MCH of 20.3 pg (SD±6.6) and a mean RDW of 21.4 % (SD±4.4). Patients in Group 2 had a mean Hb of 11.0 g/dl (SD±1.72), mean MCV of 60.9 fL (SD±4.9), mean MCH of 18.4 pg (SD±1.21) and a mean RDW of 16.3 % (SD±1.0). There was a significant difference in RDW of Group 1 and Group 2 (p value <0.001). In group 1, RDW had a sensitivity of 75.8%, specificity of 84.6% and negative predictive value of 61.11% and positive predictive value of 91.6%. In group 2, RDW had a sensitivity of 69.2%, specificity of 82.7% and negative predictive value of 85.7 % and positive predictive value of 64.2%. Conclusion: RDW is a reliable and useful index for the diagnosis of IDA and differentiates it from beta TT.

Kallis Sideri is from Western Sussex Hospitals, United Kingdom. His research interest is Hematology and General Surgery.

Aim: a) Identify the number of patients that required blood transfusion during laparoscopic appendicectomy in our Hospital the last 10 years. b) Is G/S really required before emergency laparoscopic procedures according to literature evidence? c) What is the quality/ cost impact of this practice as well as financial and time impact of rejected/duplicated samples? Method: 1. Identification of sample: electronic patient’s records and blood transfusion electronic database. 2. Sample size and time period: 1288 patients adults and children >5 years old that had emergency laparoscopic appendicectomy the last 10 years in Worthing Hospital. 3. Sample collection: consecutive and time sampling 4. Data analysis: Incidence of blood transfusion, no need for complex statistical analysis. Results: Only seven patients were recorded as having had blood transfusion:1) Two patients over 70 years old postoperative blood transfusion due to other co-morbidities, 2)Two no electronic record of transfusion 3)Two patients transfused other blood products such as FFP's for INR inversion and coagulation problems, 4) One patient had caecal tumour, transfused for anaemia and had later right hemicolectomy. Conclusion: Our results show that none of our patients needed intraoperative blood transfusion for vascular injury. Major haemorrhage protocol can be used when needed. We will use those data for cost improvement project.