Antibiotic Prescribing Patterns in Paediatric Patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

Abstract

The use of antimicrobial agents has become a routine practice for the treatment of paediatric illnesses. The uncontrolled use of antibiotics has caused a rise in antimicrobial resistance. This study aimed to assess the antibiotic prescribing patterns in paediatric patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia. This was a cross-sectional study conducted between April 2019 to July 2019. The study population included both in-patients and outpatients aged between one month and eighteen years whose medical files were reviewed. A sample size of 357 medical files was conveniently sampled. Statistical Package for Social Sciences version 21.0 was used for data analysis. A chi-square test was used to assess the association between categorical variables. A p<0.05 was considered to be statistically significant at 95% confidence level. The majority of the medical files 230 (64.4%) were for paediatrics in the age group of 1 month to 5 years. Antibiotic prescribing was found to be 78.7%. The study revealed that 119 (33.3%) of patients required antibiotics and were on antibiotic treatment while 46 (12.9%) did not require antibiotics but were on antibiotic treatment. The most common diseases 147 (41.2%) were those affecting the respiratory system. The most commonly prescribed antibiotics were penicillins 154 (54.8%), followed by cephalosporins 88 (31.3%). The association between age, white blood cell count status, and system of illness with antibiotic use were statistically significant (χ 2 =15.083, p=0.001; χ 2 = 6.571, p=0.037 and χ 2 =27.717, p<0.0001). The study also found that the frequency of antibiotic use was high among paediatric patients as per the World Health Organization's prescribing indicators. The most commonly prescribed antibiotics to paediatric patients were penicillins.

Novel chromosomal insertions of ISEcp1-blaCTX-M-15 and diverse antimicrobial resistance genes in Zambian clinical isolates of Enterobacter cloacae and Escherichia coli

“…In Zambia, policies promoting the judicious use of antimicrobials are hardly adhered to and most drugs can be accessed without a prescription [ 63 ]. Moreover, a study conducted at the UTH reported a 53.7% antibiotic prescription rate [ 64 ], clearly surpassing the 30% rate recommended by the WHO [ 65 ]. Most serious bacterial infections among UTH inpatients are treated with third-generation cephalosporins (e.g., cefotaxime) [ 66 ], while quinolones (e.g., ciprofloxacin) are commonly used for outpatient infections [ 64 ].…”

“…Moreover, a study conducted at the UTH reported a 53.7% antibiotic prescription rate [ 64 ], clearly surpassing the 30% rate recommended by the WHO [ 65 ]. Most serious bacterial infections among UTH inpatients are treated with third-generation cephalosporins (e.g., cefotaxime) [ 66 ], while quinolones (e.g., ciprofloxacin) are commonly used for outpatient infections [ 64 ]. Our results show that nearly 90% of cefotaxime-resistant strains were also resistant to quinolones.…”

Formulary Management Activities and Practice Implications Among Public Sector Hospital Pharmaceutical and Therapeutics Committees in a South African Province

“…( Jenkings and Barber, 2004 ) found in the UK that formulary decisions were based on a cluster of factors including the clinical benefits and the degree of certainty, with local knowledge also used in the UK ( Martin et al., 2003 ; Jenkings and Barber, 2004 ). This is very different to the situation in some other sub-Saharan African countries where there is very variable PTC activities even among tertiary hospitals; however, this is not universal ( Directorate of Pharmacy Services, 2012 ; Office of Director of Pharmaceutical Services (ODPS) Ministry of Health Ghana, 2015 ; Ashigbie et al., 2016 ; Mudenda et al., 2016 ; Fadare et al., 2018b ; Anand Paramadhas et al., 2019 ).…”

Assessment of private health sector prescribing patterns and adherence to prescription format using World Health Organization core drug use indicators in Addis Ababa, Ethiopia

“…Similarly, according to the studies from other parts of the country, drug per prescription amounts 1.9, 2.34, 2.2, and 2.13 in southern, eastern, northern, and southwest regions of Ethiopia, respectively [ 5 , 22 – 24 ]. The higher number of drugs per encounter were also reported across public and private healthcare facilities in Asian and sub-Saharan African (SSA) countries such as Vietnam (3.85), India (3.7), Pakistan (4.1), Saudi Arabia (2.36), and South Africa (3.7), Sudan (2.3), Zambia (2.5), Sierra Leone (3.8), Nigeria (3.5) [ 4 , 25 – 31 ]. Furthermore, a study in Tanzania indicated private healthcare facilities are prescribing more drugs per encounter than public healthcare facilities [ 32 ].…”

“…Furthermore, the percentage of antibiotic prescription of the current study was higher than studies from Sudan (63%), Zambia (53.7%), Uganda (53%), Swaziland (54%), and Jordan (61%). [ 31 , 43 ].…”