Antimicrobial use at a university hospital: appropriate or misused? A qualitative study

Vlahović‐Palčevski, Vera; Francetić, Igor; Palčevski, Goran; Novak, Srđan; Abram, Maja; Bergman, Ulf

doi:10.5414/cpp45169

Cited by 19 publications

(25 citation statements)

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“…5 cillin/penicillin vs. ceftriaxone/cefotaxime) found no appreciable difference in a length of hospital stay, admission to the intensive care unit or readmission between the two groups, however, the cost of treatment in those receiving broad spectrum antibiotics was higher (17). A qualitative study on the use of antimicrobials in the medical department of a teaching hospital reported needless administration of antibiotics in about 23% of the cases while overprescribing of broad-spectrum antibiotics in situations, where a narrow-spectrum antimicrobial would have been sufficient was identified as the most common prescribing error (23).…”

Section: Discussionmentioning

confidence: 99%

Pattern of Antibiotic Usage in Children Hospitalized for Common Infectious Diseases

Shiva

Ghanaie

Shirvani

et al. 2017

Arch Pediatr Infect Dis

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Background: Antibiotic misuse is a major cause of antimicrobial resistance. Objectives: The present study aimed at determining the pattern of antibiotic usage in previously healthy children hospitalized for common infectious diseases in a tertiary care children's hospital. Methods: This study was the second part of a previous study in which inpatient charts of children hospitalized from October 2013 to September 2014 were reviewed to determine the rationality of drug use. Data from the first study were analyzed to define the antibiotic usage pattern in urinary tract infection, acute meningitis, community acquired pneumonia, fever without a localized source and acute gastro-enteritis. The data were checked independently by two pediatric infectious disease specialists to assess the appropriateness of prescribed antibiotics and in case of disagreement, rechecked by a third member. Results: Hospital charts of 140 children were reviewed; 47 had been treated for urinary tract infection, 31 for pneumonia, 25 for acute meningitis, 24 for acute gastroenteritis and 13 for fever without a localized source. One-hundred and fourteen children (81.42%) received 208 prescriptions for antibiotics (1.82 antibiotics/patient). Nineteen different antibacterial drugs and 2 antivirals (acyclovir and oseltamivir) were prescribed. Most frequently prescribed antibiotic was ceftriaxone. More than 25% of prescriptions for antibiotics were needless. In 91.6% of the prescriptions the medications had been prescribed by generic names. Dosing errors were observed in less than 7% and patients received the medication for prolonged duration, 25.6% of times. Conclusions: Nonuniformity of antibiotic usage, a high rate of needless antibiotic prescriptions, and prolonged administration found in this study call for stringent antibiotic stewardship.

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Section: Discussionmentioning

confidence: 99%

Pattern of Antibiotic Usage in Children Hospitalized for Common Infectious Diseases

Shiva

Ghanaie

Shirvani

et al. 2017

Arch Pediatr Infect Dis

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“…[18] The appropriateness of the antibacterials prescribed was assessed by the modifi ed Kunin's criteria. [7] Appropriate therapy was given in 42% of the patients only. No case could be classifi ed under criteria I, as no confi rmatory laboratory reports were conducted to confi rm the etiology.…”

Section: Discussionmentioning

confidence: 99%

“…The demographic details and information regarding diagnosis and treatment were recorded in the CRF. Modifi ed Kunin's criteria [7] were used to assess the appropriateness of the prescribed antibacterials.…”

Section: Methodsmentioning

confidence: 99%

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An analysis of the pharmacological management of respiratory tract infections in pediatric in-patients at a tertiary care teaching hospital

Iyer¹,

Patel²,

Panchal

et al. 2013

Int J Med Public Health

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“…Antibiotic treatment is necessary in only one in twenty cases of childhood diarrhoea. 9,10 Large resources are currently spent on antidiarrhoeal drugs annually, most of which are useless or harmful in pediatric patients. Therapeutic guidelines have been issued by the WHO and Indian Academic of Pediatrics (IAP), which aim at reducing the inappropriate use of antimicrobials and anti-diarrhoeal drugs in treatment of diarrhoea.…”

Section: Introductionmentioning

confidence: 99%

Pharmacoepidemiological profile and appropriateness of drug use in paediatric diarrhoea patients: a cross sectional study in western India

Chaudhari

Patel

Shah

et al. 2017

Int J Basic Clin Pharmacol

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Background: The background of the study was to analyze the prescribing pattern and appropriateness of drug treatment of diarrhoea.Methods: Total 194 pediatric patients with diarrhoea (140 admitted at tertiary care centre and 54 patients attended primary health care centre) were included and their demographic details; disease related parameters, drug treatment and adverse drug reactions were recorded. Appropriateness of drug treatment was analyzed using the WHO and Indian Academy of Pediatrics (IAP) guidelines for management of diarrhoea.Results: Most patients (27.32%) were less than 1 year of age and majority 54.64% were males. Most common presenting symptoms was diarrhoea with dehydration (100%) followed by vomiting (60%), fever (54.29%). Stool cultures were carried out only in 22.86% patients at tertiary health care centre while no investigations were carried out at PHC. Average number of drugs prescribed per patient was 8.25 ± 1.3. All the patients were given fluid replacement therapy. 94.29% and 85.19% patients were prescribed antimicrobials at tertiary centre (THC) and PHC respectively. Most common antibiotic used was cephalosporins (82%) followed by aminoglycosides (48.57%) of patients at THC while ofloxacin (82.60%) and metronidazole (17.40%) were commonly used at PHC. Analgesic/antipyretic was required in 70.71% and 85.19% of patients at THC and PHC respectively. Comparing with the WHO diarrhoea management guidelines and IAP guidelines, only 8 (14.81%) prescriptions were considered as rational. 2.85% patients developed mucocutaneous rash as ADR.Conclusions: Inappropriate prescribing for diarrhoea is highly prevalent in society. Emphasis on proper diagnosis and treatment, education and availability of locally effective guidelines may help in a better and judicious use of drugs in children.

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Antimicrobial use at a university hospital: appropriate or misused? A qualitative study

Cited by 19 publications

References 0 publications

Pattern of Antibiotic Usage in Children Hospitalized for Common Infectious Diseases

Pattern of Antibiotic Usage in Children Hospitalized for Common Infectious Diseases

An analysis of the pharmacological management of respiratory tract infections in pediatric in-patients at a tertiary care teaching hospital

Pharmacoepidemiological profile and appropriateness of drug use in paediatric diarrhoea patients: a cross sectional study in western India

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