A prospective study of antimicrobial drug utilization in infective diseases in pediatrics at Navodaya Medical College Hospital of Raichur, Karnataka, India

Abstract

Background: There is increased concern regarding the inappropriate use of antimicrobials resulting in emergence of resistant strains, unnecessary adverse effects and poor therapeutic outcome. This present study has been taken up with a view to analyze the use of various antimicrobial agents alone and/or in combination to combat diseases of infective origin in a proposed manner.Methods: This was a prospective study carried out for a period of 1 year from January 2011 to December 2011. The prescriptions of all eligible patients were reviewed on daily basis and all the relevant data were retrieved to assess the utilization pattern of antimicrobials and also their safety and potential interactions.Results: A total of 500 patients were selected randomly who satisfied the inclusion criteria. Of the total selected patients with infectious diseases, 493 patients (98.6%) received one or more antimicrobials. Use of antimicrobials was high in the age group of ‘6 months to 3 years’, ‘rural patients’ constituted 62% and were mostly from ‘Lower Socio-economic status’ (46%). Respiratory diseases constituted 38% of the patients. Fever was the notable symptom in 68.4%. Cephalosporins (48.6%) were the most frequently prescribed class of antimicrobials. Combination of ‘Parenteral therapy followed by oral therapy’ was the preferred route in 92%, and a combination of two antimicrobials was seen in 34.4%. Majority of the patients (81%) were discharged on advice and most of the patients (37.6%) had duration of stay of 7-9 days. 25.8% reported ‘Adverse Drug Reactions’ including predictable and unpredictable reactions.Conclusions: Antimicrobial prescribing is common in pediatric infectious diseases. As inappropriate usage of systemic antimicrobials was observed, it is essential that appropriate guidelines on the use of systemic antimicrobials are implanted to ensure rational prescribing of antimicrobials.