Pattern of Antibiotic Usage in Children Hospitalized for Common Infectious Diseases

Abstract

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.

Utilization Pattern of Antibiotics and Patient Care Indicators in the Teaching Hospitals, Islamabad, Pakistan

“…With respect to individual antimicrobial, ceftriaxone shared the maximum percentage amongst all the antimicrobials in this study. The overuse of thirdgeneration cephalosporins is responsible for the emergence of extended-spectrum beta-lactamase (ESBL)-producing microorganisms [14]. Furthermore, the use of antibiotics when they are not necessary can lead to serious side effects, e.g., Clostridium difficile infection [15,16].…”

Audit of pre-operative antibiotic prophylaxis usage in elective surgical procedures in two teaching hospitals, Islamabad, Pakistan: An observational cross-sectional study

“…These agents have less activity against staphylococcal infections, high rates of resistance development, as well as an increased financial burden on the patients as compared to cefazolin [36]. Moreover, the emergence of extended-spectrum beta-lactamase (ESBL) producing microorganisms is due to the overuse of third-generation cephalosporins [37]. It is evident that, to avoid SSIs in elective surgeries, cefazolin is enough to cover the pathogens, hence there is no need for multiple antibiotic therapies [10].…”

Efficacy of Ascorbic Acid Supplementation in Relief of Symptoms Due to Febrile Upper Urinary Tract Infection in Children, a Clinical Trial and Hospital Based Study

“…This condition is treated with routine antibiotics including ceftriaxone, cefixime, and untreated UTIs lead to pyelonephritis (1)(2)(3). The symptoms of pyelonephritis include pain of back, flank or abdomen, nausea, malaise, vomiting, and, diarrhea, but fever may be the only manifestation (4,5).…”