Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20205430Keywords:
Antimicrobials, Antibiotics, Paediatric, Rational, PrescribingAbstract
Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.
Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.
Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.
Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.
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References
World Health Organization. Geneva (Switzerland): World Health Organization; 2014. Antimicrobial resistance: global report on surveillance 2014. Available at: http://www.who.int/drugresistance/ documents/surveillancereport/en/Google Scholar. Accessed on 6th October, 2020.
Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM Jr, et al. Prevalence of inappropriate antibiotic prescriptions among us ambulatory care visits, 2010-2011. JAMA. 2016;315:1864-73.
Arroll B, Kenealy T. Antibiotics for the common cold. Cochrane Database Syst Rev. 2002;(3):CD000247.
Lindbaek M. Broad-spectrum antibiotics gave no clinical benefit and more adverse effects than narrow-spectrum antibiotics in treating acute respiratory tract infections in US children. BMJ Evid Based Med. 2018;24(3):bmjebm-2018-110938.
Young June Choe, Ju-Young Shin. Trends in the use of antibiotics among Korean children. Korean J Pediatr. 2019;62(4):113-8.
Patel SV, Vergnano S. The impact of paediatric antimicrobial stewardship programmes on patient outcomes. Curr Opin Infect Dis. 2018;31:21623.
Pradeep kumar B, Alameri T, Narayana G, Reddy YP, Ramaiah JD. Assessment of antibiotic prescribing pattern in pediatric patients. A cross sectional hospital-based survey. CHRISMED J Health. 2017;4:235-7.
World Health Organization. How to investigate drug use in health facilities: selected drug use indicators. Geneva: WHO. Available from: http://www.apps.who.int/medicinedocs/pdf/se/se.pdf. Accessed on 6th October, 2020.
Pasha SS, Ahmed M, Mohinuddin MY. Rationale of antibiotic prescription in Paediatrics. 2019:1(2):2019.
Gopal MB, Thiyagarajan P, Vinayagamoorthy, Venugopal V, Kumar VN. A study of antibiotic prescription among the hospitalized pediatric patients at a referral center in Puducherry, India. Int J contem pediatr. 2017;4:700-5.
Al Ghazali MAA, Alakhali KM, Alawdi SM. Study of antibiotic prescribing pattern in pediatric patients of Thamar province, in republic of Yemen. J app pharm. 2017;9:247.
Oldak E, Rozkiewicz D, Sulik A, Pogorzelska E, Alhwish MA. Antibiotics use for acute gastroenteritis in ambulatory care of children before and after implementation of healthcare system reform in Poland. Pol Merkur Lek Organ Pol Tow Lek. 2006;20(116):155-815.
World Health Organization. Using indicators to measure country’s pharmaceutical situations: Factbook on WHO Level I and Level II monitoring indicators. Geneva: WHO. Available from: http://www.apps.who.int/medicinedocs/index/assoc/se/se.pdf. Accessed on 7th October, 2020.
Labi A, Obeng-Nkrumah N, Sunkwa-Mills G, Bediako-Bowan A, Akufo C, Stephanie B, Owusu E, Enweronu-Laryea C, Opintan JA, Kurtzhals JAL, Newman MJ. Antibiotic prescribing in Paediatric inpatients in Ghana: a multicenter point prevalence survey. BMC Pediatr. 2018;18:391.
Chaw PS, Schlinkmann KM, Raupach-Rosin H, Karch A, Pletz MW, Heubner J et al. Antibiotic use on paediatric inpatients in a teaching hospital in the Gambia, a retrospective study. BMC. Antimicrobial resistance and infection control. 2018;7:82.
Shiva F, Ghanaie R, Shirvani F, Armin S, Tabatabaei SR, Fahimzad SA et al. Pattern of antibiotic usage in children hospitalized for common infectious diseases. Arch Pediatr Infect diseases. 2018;6(1):e34474.
Sviestina I, Mozgis D. Observational study of antibiotic usage at the Children’s clinical university hospital in Riga, Latvia. Medicinia. 2018;54:74.
Emy Inumaru F, Souza e Silva A, Sa Soares A, Schuelter-Trevisol F, Marcos Fuentes L, Diaz Flores I et al. Profile and appropriate use of antibiotics among children in a general hospital in southern Brazil. Revista Paulista de Pediatria. 2019;37(1).
Croche Santander B, Campos Alonso E, Sanchez Carrion A, Marcos Fuentes L, Diaz Flores I, Vargas JC et al. Appropriateness of antibiotic prescribing in paediatric patients in a hospital emergency department. An Pediatr (Barc). 2018;88(5)259-65.
Gerber JS, Newland JG, Coffin SE, Hall M, Thurm C, Prasad PA et al. Variability of antibiotic use at Children’s hospitals throughout the United states. Pediatr. 2010;126(6):1067-73.
Baidya S, Hazra A, Datta S, Das AK. A study of antibiotic use in children admitted to pediatric medicine ward of a tertiary care hospital. Indian J Pharmacol. 2017;49(1):10-5.
World Health Organization Model List of Essential medicines, 21st list, 2019. Geneva: WHO; 2019.
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