Antimicrobial use in paediatric patients in a teaching hospital in Ethiopia

Abstract

BackgroundAntibiotics use in in children are different from adults due to a lack of data on pharmacokinetics, pharmacodynamics, efficacy and safety of drugs, different physiological spectrum, pediatrics populations being vulnerable to the majority of the illnesses, and the adverse effect of their irrational use is more serious. However, antibiotic use is not explored much in a paediatric population. The current study focused on antibiotic use among pediatric population using data from a tertiary hospital in Ethiopia.MethodsA retrospective cross-sectional study collated data from 614 pediatrics patients admitted in pediatrics ward at Jimma University Teaching Hospital, Southwest Ethiopia. Descriptive analyses were performed to describe the type and pattern of antibiotics. The number of prescriptions per a patient was also compared with the WHO standard. Data analysis was carried out using SPSS version 20 for mackintosh.ResultsAntimicrobials were prescribed for 407(86.4%) patients of which 85.9% were in the form of injectables. A total of 1241 (90%) medicines were administered parenterally followed by oral 110 (8%). The maximum number of medicines per prescription was eight for all types of drugs in general, and five for antimicrobials in particular. All antimicrobials were prescribed empirically without any microbiological evidence. Pneumonia, sepsis and meningitis were the main reasons for antimicrobial use in the ward. Out of the total of 812 antibiotics prescribed; Penicillin G crystalline was the most (20%) frequently prescribed, followed by gentamicin (19%) and ampicillin (16).ConclusionsMajority of the prescribed antibiotics were antimicrobials, and was in the form of injectables. Antimicrobials were over prescribed and the number of drugs per prescription was also far from WHO recommendation. Strict prescribing standard guidelines and treatment habits should be developed in the country, to prevent antimicrobial resistance.

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

“…In this study, it was also found that most of the patients were males. This is in concordance with the studies that were done in Guyana, India, Sierra Leone, Ethiopia, Cameroon [5,[22][23][24][25]. This similarity in findings suggests that male children are more likely to get infections than female children.…”

“…This is even though most bacteria are resistant against penicillins [36]. These findings are in agreement with what was found in studies that were done in Ethiopia, Cameroon, Nigeria, and Iraq [24,29,36,37]. These similarities in the findings could be due to the availability of these drugs in these various hospitals and hence their use.…”

Antibiotic Prescribing Pattern in Paediatrics Outpatient in a Tertiary Care Hospital

“…In a study done in Ethiopia, it has been reported that penicillin G crystalline was the most (20%) frequently prescribed, followed by gentamicin (19%) and ampicillin, whereas in the present study cefpodoxime followed by azithromycin and amoxicillin-clavulanic acid were the commonest. 5 In another study done in the west, the most frequently used antibiotics were cephalosporins (43.7% of treated children), followed by macrolides, a combination of penicillins plus a beta lactamase inhibitors and broadspectrum penicillins (40.1%, 29.8% and 29.4%, respectively). Cephalosporins were frequently prescribed in the youngest children and macrolides were mostly prescribed in children >6 years of age.…”

The knowledge, attitude and practice of health practitioners towards antibiotic prescribing and resistance in developing countries—A systematic review

“…Participants viewed antibiotic resistance to a lesser extent as a problem in their practice and in their health facilities, when compared to nationally, globally or generally. This could be explained by the limited awareness of the local antibiotic resistance patterns in their respective health facilities, either due to the limited use of microbiology laboratory to guide antibiotic therapy 30,31 or due to other factors such as limited microbiology services or lack of trust on the provided results. 26 A study from developed countries also showed similar findings, as health practitioners reported having a limited knowledge of the local resistance patterns and viewed antibiotic resistance to be less of a problem locally than nationally.…”