The main aim of this study was to develop a topical drug delivery (Hydrogel) of Ketoconazole to reduce the dose of the active drug, to improve patient compliance, to avoid the side effects and increase local onset absorption and action. Ketoconazole interfare with 14-α sterol demethylase, a cytochrome P-450 enzyme essential for conversion of lanosterol to ergosterol. These turn in inhibition in synthesis of ergosterol and also enhance cellular permeability of fungus due to reduced amounts of ergosterol present in the fungal cell membrane. Methods: Topical Hydrogel formulations development of Ketoconazole was prepared by using Different-different polymers by enhancer stability and viscosity with their different concentrations. Six different formulations of Ketoconazole were prepared and evaluated parameters with respect to their colour, Spreadability, viscosity, determination of pH, drug content of formulations, in vitro drug release studies, and stability studies. Results: FT-IR study results that there were not any interaction between the drug, Polymers, and excipients. All the developed formulations of Ketoconazole show acceptable standard physical properties. The drug content and percentage yield were higher for F5 formulation among all formulation. F5 shows better drug release. Stability study of the best formulation F5 with guar gum polymer was found with best results. Conclusion: From the above observation results that this F5 formulation may be more effective topical formulation for the healing of fungal infections in the skin.

Background: Antimicrobial agents constitute a major proportion of inpatient drug utilization and healthcare expenditure in tertiary care hospitals. Inappropriate empirical prescribing contributes to increased costs and antimicrobial resistance. This study aimed to evaluate the cost-effectiveness of commonly prescribed antimicrobial agents in a tertiary care center. Methods: A prospective observational pharmacoeconomic study was conducted among 138 inpatients receiving systemic antimicrobial therapy. Clinical outcomes, drug costs, length of stay (LOS), and total hospitalization costs were recorded. Cost-effectiveness was assessed using cost per successfully treated patient. Comparative analysis was performed using Chi-square test and one-way ANOVA. Results: Empirical therapy was initiated in 66.7% of patients. Cure rates across commonly prescribed antimicrobials were comparable (p = 0.71). However, significant differences were observed in drug cost, LOS, and total hospital cost (p < 0.001). Meropenem had the highest cost per successfully treated patient (₹43,851 ± 12,006), whereas amoxicillin–clavulanate demonstrated the lowest (₹15,659 ± 4,637). Culture-guided therapy showed significantly lower drug cost (p = 0.003), reduced LOS (p = 0.01), higher cure rate (p = 0.048), and lower cost per successful treatment (p = 0.004) compared to empirical therapy. Conclusion: Culture-guided antimicrobial therapy is more cost-effective than empirical treatment. Broad-spectrum antibiotics increase hospitalization costs without significant improvement in outcomes. Incorporation of pharmacoeconomic principles into antimicrobial stewardship programs can enhance both clinical effectiveness and economic efficiency.