Publications (26) View all
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Article: Comparative evaluation of griseofulvin, terbinafine and fluconazole in the treatment of tinea capitis.
Chander Grover, Pooja Arora, Vikas Manchanda[show abstract] [hide abstract]
ABSTRACT: Tinea capitis (TC) is a common childhood fungal infection which, if untreated, can cause long-term scarring. A number of antifungal drugs with proven efficacy are available for the treatment of TC. However, varying dosage schedules, changes in epidemiology, and rising drug resistance are factors that hamper treatment in some cases. A prospective, non-blinded, cross-sectional study of three commonly used drugs (terbinafine, griseofulvin, and fluconazole) was undertaken in children aged ≤12 years, presenting to a pediatric superspecialty hospital. The comparative efficacies of these three drugs were evaluated. A total of 75 patients (25 in each treatment group) who completed the designated treatment protocol were included in the final analysis. Of these, 60% had non-inflammatory TC and 56% had an ectothrix pattern on hair microscopy. Trichophyton violaceum was the most commonly isolated fungus. Cure rates of 96%, 88%, and 84% were achieved with griseofulvin, terbinafine, and fluconazole, respectively. Overall, seven patients required prolonged therapy. No side effects to therapy were seen. Griseofulvin remains the drug of choice in the treatment of TC. Terbinafine was the second best agent and offered the advantage of a shorter course of therapy. Fluconazole had comparatively low cure rates but was easier to administer than the other two medications.International journal of dermatology 04/2012; 51(4):455-8. · 1.18 Impact Factor -
Article: TRICHOPHYTON TONSURANS INDUCED RECURRENT ONYCHOMADESIS IN A VERY YOUNG INFANT.
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ABSTRACT: Onychomadesis, or nail shedding, is rarely seen in children and can be due to stress, systemic illnesses, trauma, and drug therapy or may be idiopathic. Fungal infection of the nail is only rarely reported as a cause of onychomadesis. We present here a case of Trichophyton tonsurans-induced onychomycosis and resultant onychomadesis in a 9-month-old boy with onset of lesions at 2 weeks of life.Pediatric Dermatology 02/2012; · 1.07 Impact Factor -
Article: Intravenous colistin administration in neonates.
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ABSTRACT: Nosocomial infection due to multidrug-resistant Gram-negative pathogens in intensive care units is a challenge for clinicians and microbiologists, and has led to resurgence of parenteral colistin use in the last decade. Safety and efficacy data regarding intravenous colistin (colistimethate) use in neonates is sparse. We present our experience of efficacy and safety of colistimethate in the treatment of sepsis in critically sick term and preterm neonates. The records of the neonates who received colistimethate in a neonatal intensive care unit of a tertiary care center from January 2009 to December 2009 were reviewed. Eighteen critically sick neonates (10 term and 8 preterm) received 21 courses of colistimethate (dose ranging from 50,000 to 75,000 IU/kg/d) for treatment of pneumonia, blood stream infections, meningitis, and empyema thoracis. The isolated pathogens in decreasing order of frequency were Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonos aeruginosa, and Enterobacter. Mean duration of colistimethate was 13.1 days/course (range: 5-21 days). At least one other antibiotic was coadministered in all courses. A favorable clinical outcome occurred in 16 of 21 (76%) courses, 5 patients died due to severe sepsis with multiple organ dysfunction. Microbiologic clearance was documented in 17 courses. Increase in serum creatinine by > 0.5 mg/dL above baseline in 2 babies was associated with the presence of multiple organ dysfunction syndrome in both and coadministration of netilmicin in one. Colistimethate intravenous administration appears to be safe and efficacious for multidrug-resistant Gram-negative infections in neonates, including preterm and extremely low birth weight neonates.The Pediatric Infectious Disease Journal 03/2011; 30(3):218-21. · 3.58 Impact Factor -
Article: Multidrug resistant Acinetobacter
Vikas Manchanda, Sinha Sanchaita, N Singh[show abstract] [hide abstract]
ABSTRACT: Emergence and spread of Acinetobacter species, resistant to most of the available antimicrobial agents, is an area of great concern. It is now being frequently associated with healthcare associated infections. Literature was searched at PUBMED, Google Scholar, and Cochrane Library, using the terms ′Acinetobacter Resistance, multidrug resistant (MDR), Antimicrobial Therapy, Outbreak, Colistin, Tigecycline, AmpC enzymes, and carbapenemases in various combinations. The terms such as MDR, Extensively Drug Resistant (XDR), and Pan Drug Resistant (PDR) have been used in published literature with varied definitions, leading to confusion in the correlation of data from various studies. In this review various mechanisms of resistance in the Acinetobacter species have been discussed. The review also probes upon the current therapeutic options, including combination therapies available to treat infections due to resistant Acinetobacter species in adults as well as children. There is an urgent need to enforce infection control measures and antimicrobial stewardship programs to prevent the further spread of these resistant Acinetobacter species and to delay the emergence of increased resistance in the bacteria.Journal of Global Infectious Diseases. 01/2010; -
Article: Salmonella enteritidis bacteremia in at win pair.
Devendra Mishra, Vikas ManchandaThe Indian Journal of Pediatrics 05/2008; 75(4):407. · 0.52 Impact Factor