Retrospective assessment of irrational use of antibiotics to children attending in Mekelle general hospital (original) (raw)
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Outpatient prescribing and antibiotic use for children in a tertiary hospital
Sahel Medical Journal, 2020
Background: Rational prescribing is essential to prevent medication errors, antibiotic resistance, and treatment failure. Assessment of prescribing practices helps monitor the utilization of medicines. Objectives: The aim of this study was to evaluate the prescribing pattern and utilization of antibiotics for children attending outpatient units. Materials and Methods: This was a descriptive, retrospective study of outpatient pediatric prescriptions received at the pharmacy of a Nigerian teaching hospital, using the World Health Organization (WHO) core prescribing indicators and Index of Rational Drug Prescribing (IRDP). Prescription information for a 2-year period was collected on a standardized prescribing form. Computer data entry was made into Microsoft Excel 2010 spreadsheet. Data analysis was done using SPSS Version 20(IBM, Corp., Armonk, NY, USA). Results were compared with the WHO core prescribing indicators and presented as means, frequencies, proportions, contingency tables, and charts comparing with published standards. Results: There were 3445 eligible prescriptions, with mean child age of 3.2 (±2.9) years. An average of 2.4 (±1.6) drugs were prescribed per encounter, with 48.2% written in generic names. Prescriptions containing oral antibiotics and antibiotic injections constituted 50.2% and 41.2%, respectively. Medicines prescribed were available in the essential medicines list in 95.5% of cases. The IRDP was 2.98 against the ideal of 5. Majority (71.3%) of antibiotic-containing prescriptions had one antibiotic prescribed while β-lactam penicillins and cephalosporins were the most prescribed, with ampicillin/cloxacillin being the most common combination. Conclusion: Irrational prescribing and inappropriate antibiotic use were prevalent in this tertiary hospital. Similar studies are needed to describe the trends in all Nigerian tertiary hospitals, along with retraining on rational prescribing.
“Assessment of Prescription of Antibiotics in Pediatrics”
Indian Research Journal of Pharmacy and Science, 2016
BACKGROUND:Antibiotics are strong and effective medicines, used to treat various bacterial infections. Antibiotics are among the most commonly prescribed drugs in paediatrics. Overuse and inappropriate use of antibiotics has led to antibiotic resistance and treatment failure. OBJECTIVES: To assess the prescription of antibiotics in paediatrics of a Tertiary Care Teaching Hospital. STUDY DESIGN:A retrospective study was done in a paediatric department in Mandya district hospital. Ethical clearance was obtained. The patient data was collected by using well designed patient data collection form and their prescription were recorded and analysed. RESULT: A total of 100 cases of various infections are examined among that 55% male and 45% female. Accompanying major age group having infections is 1-3 years i.e. 35%. Out of 100 prescriptions ,Cephalosporins are the major class of antibiotics used about 40% followed by Aminoglycosides, Penicillins, Macrolide, Quinolones, Cotrimoxazole and Nitroimidazoles respectively. Amikacin is the most commonly used individual antibiotic i.e. 26%. CONCLUSION:The present study concludes that prescription pattern of antibiotic in paediatrics was rational. Children of age toddlers (1-3 years) are more prone to various infections. Cephalosporins are the major classes of antibiotics used. Amikacin is most commonly used individual antibiotic.
Asian Journal of Pharmaceutical and Clinical Research, 2019
Objective: Our objective of the study was to evaluate the prescribing patterns of drugs with cost analysis in pediatric inpatients at tertiary care hospital. Methods: It is an observational prospective study carried out in pediatric inpatients with a sample of 180 patients based on age, inclusion, and exclusion criteria for period of 3 months. The patient’s data were collected using patient case record form and analysis of the data was done. Results: Of 180 patients data were collected, the results show that majority of gender admitted in the hospital were male children 94 (52%) and many are from age group of early childhood (2–5 years) 67 (37%). Respiratory tract infections are diagnosis most commonly analyzed and off overall 236 prescribed antibiotics cephalosporins 86 (43%) and combination of amoxicillin + clavulanic acid 25 (71%) is the class of antibiotics prescribed higher than other class of drugs. Parental 173 (73%) route of administration was observed to be followed more th...
Antibiotics are the key drugs for treatment of infections and are among the most commonly prescribed drugs in Pediatrics department. 1 Their indiscriminate use increases the risk of bacterial drug resistance and thus has prompted the need to use antibiotics judiciously in pediatric practice. 2 Studies reported that 50% to 85% of children receive antibiotics in developed and developing countries. 3 Rational antibiotic prescription is very important to avoid multiple drug resistance, treatment failure, noncompliance and increase in cost of treatment. 4 Irrational prescribing is a global problem. The rationality of prescribing pattern is of utmost importance because bad prescribing habits including misuse, overuse and underuse of medicines can lead to unsafe treatment, exacerbation of the disease, health hazards, and economic burden on the patients and wastage of resources. Examples of irrational use of medicines include: poly-pharmacy, inadequate dosage, and use of antimicrobials even for non-bacterial infections, excessive use of injections when oral forms are available and inappropriate, self-medication and noncompliance to dosing regimes. 5
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: The misuse and overuse of antibiotics contribute to the development of antimicrobial residence. Official data in EU/ EEA in 2017 in the hospital sector suggested that the consumption is lowest in the Netherlands, with 1 DDD per 1,000 inhabitants/day in comparison with Finland, with 2.8 DDD/TID. AIM: The aim of this study was to analyze data on the scope and structure of the antibiotic prescription in pediatric patients at University Children’s Hospital for period of 3 months in 2018 and 2019. MATERIALS AND METHODS: The data for antibiotic consumption were obtained from a hospital pharmacy, which are ordinated to hospitalized patients. RESULTS: The total amount of utilized antibacterial drugs with ATC code J01 for first quarter in 2018 is 33.65 DDD/100BD in comparison to the first quarter of 2019 when it declined to 32.09 DDD/100BD. The most consummated antibiotics in the first trimester of both years were the group of cephalosporins, especially the 3rd- and 4th-generatio...
Use of antibiotics in children- a Danish nationwide drug utilization study
Background We aimed to describe the use of systemic antibiotics among children in Denmark. Methods National data on drug use in Denmark were extracted from the Danish National Prescription Database. We used prescription data for all children in Denmark aged 0-11 years from January 1, 2000 to December 31, 2012. Results We obtained data on 5,884,301 prescriptions for systemic antibiotics issued to 1,206,107 children. The most used single substances were phenoxymethylpenicillin (45%), amoxicillin (34%) and erythromycin (6%). The highest incidence rate of antibiotic treatment episodes was observed among children under two years of age at 827 per 1,000 children in 2012. Incidence rates were relatively stable throughout the study period. One-year prevalences in 2012 were 485, 363 and 190 per 1,000 children among children aged 0-1, 2-4 and 5-11, respectively. A gradual shift from narrow-spectrum penicillin V to the broader-spectrum amoxicillin was found among children below the age of 5 years. The use of macrolides decreased slightly, especially among those aged 0-1 years. Minor regional differences were noted, with a somewhat higher use in the Capital Region. Skewness in use was most notable among those aged 0-1 years. There was little evidence of heavy users. Conclusion Prescribing rate of antibiotic to children in Denmark remained stable at a high level from 2000 to 2012. An increase in the use of broad-spectrum beta-lactam penicillin was noted, but otherwise the prescribing pattern adhered well to National guidelines with respect to choice of antibiotics.
International Journal of Pharmacy and Pharmaceutical Sciences, 2021
Methods: A prospective six-month observational study was conducted in the pediatric department. The history of the patients was collected from the case sheets and the patient demographic details were also collected. The details of antibiotics prescribed and the other therapy applied to the patients were collected in terms of dosage, duration, and route of administration. The antibiotic consumption was assessed based on qualitative and quantitative indicators which assess the appropriateness of antibiotic use, and the dosage of antibiotics prescribed, respectively. Regarding the qualitative evaluation of antibiotic consumption, the World Health Organization (WHO) guideline was considered to appraise compliance with indication and dosing. Results: Distribution of drug prescription indicators showed that the average number of drugs per encounter was 3.7, which is more than the standards suggested by WHO and should be reduced as much as possible to mitigate polypharmacy and its consequences. 93.45% of encounters existed leastwise with one or more antibiotics, which was higher than the WHO standards. Almost 56.08% of drugs were prescribed considering their generic name, which was very much lower than the ideal percentage recommended by WHO. Conclusion: The percentage of encounters with one or more antibiotics was very higher than the WHO standard percentage, which indicates the irrationality of antibiotic prescribing. To minimize the irrationality of prescriptions and their inappropriateness, effective interventions and compliance with antibiotic prescribing guidelines are required.
Pattern of Antibiotic Usage in Children Hospitalized for Common Infectious Diseases
Archives of Pediatric Infectious Diseases, 2017
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.
Irrational Prescribing of Antibiotics in Pediatric Outpatients: A Need for Change
Journal of Pediatric Sciences (ISSN:1309-1247), 2014
Background and Aims: Antibiotics play a major role in the treatment of infectious diseases and are among the drugs most commonly prescribed for children. Respiratory tract infections in pediatric patients are a common cause of antibiotic prescribing which increases morbidity, mortality, patient cost and the likelihood for emergence of antibiotics-resistant microorganisms. This study was undertaken to determine the proportion of common respiratory tract infections and to generate data on the extent of rational/irrational prescribing of antibiotics in patients attending the pediatric out-patient department. Material and Methods: retrospective study carried out during one year (January to December, 2013) in the pediatric out-patient department of the Clinical Center in Tetovo. Patients of either sex at age group between 1 week and 14 years who attended the pediatric out-patient department and were prescribed antibiotics for respiratory tract infections were included in the study. The data was compared against national guideline-based medicine, major antibiotic guidelines recommended by World Health Organization (WHO) and American Academy of Pediatrics (AAP), and cross-referenced against Cochrane studies. Results: Children aged >1 -≤3 years received 49.6% of antibiotics. The most common prescribed antibiotics were penicillins (62.2%), followed by cephalosporins (32.5%). Sore throat (61.5%) was identified as the most common diagnosis. There was a significant relationship (r=0.234, p< 0.05) between diagnosis and antibiotic prescribing. Ninety two percent of pediatric patients with common cold, laryngitis, viral sore throat, acute otitis media and bronchitis were prescribed antibiotics irrationally, that represents a major deviation from the recommendations from the guidelines. High levels (90%) of antibiotic irrational prescribing were revealed in pediatric outpatients diagnosed with pneumonia. Conclusion: This study reinforces the need to implement strategies that promote rational use of antibiotics in respiratory tract infections in children and close monitoring of antibacterial use at national, regional and local level.
Prescription of antibiotics among paediatric outpatients at Teaching Hospital-Jaffna
Jaffna medical journal, 2019
Aim of the study was to evaluate prescription of antibiotics among paediatric outpatients at Teaching Hospital-Jaffna. It was a cross sectional descriptive study carried out among the paediatric outpatients in July and August 2014. A data extraction form was developed based on WHO data collection forms and was used to collect the data. Nine drug use indicators which include modified core and complementary WHO drug use indicators and indicators developed by the investigators were used to evaluate antibiotic prescription. Descriptive statistics were used for data analysis. Out of 1181 prescriptions of paediatric outpatients, 825 (69.9%) had antibiotics. Average number of antibiotics per prescription was 0.7. Percentage of antibiotics prescribed by generic name, from essential medicine list and for common conditions were 97%, 100% and 91.4% respectively. Percentage of prescriptions with the documentation of reason for prescribing an antibiotic was 97%. Only 3.4% antibiotic prescriptions were complete. Percentage of drug cost spent on antibiotics was 33.2% and average antibiotic cost per encounter was 54.34 Sri Lankan rupees. The most frequently prescribed antibiotic group was penicillins (53.3%). The most common indication for antibiotics was respiratory tract infection (70.3%). Majority of the antibiotics (74%) were prescribed in paediatric dosage form. Good prescribing practice was observed for prescribing in generic name, prescribing the antibiotic from essential medicines list, prescribing for common conditions, documentation of reason for prescribing and prescription of paediatric dosage forms. The completeness of antibiotic prescriptions was poor and needs special attention to improve. The drug use indicators are useful tools to evaluate the antibiotic prescriptions in a setting as well as among different settings.