DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20170323

An observational study of antibiotic treatment in paediatric patients suffering from LRTI and Pneumonia in a tertiary care hospital

Subhradipta Bhattacharyya, Manjushree Mohanty

Abstract


Background: The observational study was conducted to evaluate the utilization of antimicrobials and sensitivity-resistance pattern in paediatric patients suffering from LRTI and Pneumonia. A prospective, non-interventional, pharmaco-vigilant study.

Methods: 97 patients suffering from LRTI and Pneumonia admitted in paediatric ward, NICU and PICU from September 2012 to February 2014 were evaluated. The research protocol was approved by Institutional Ethical Committee, KIMS. Data were collected from case sheets of patients from the ward as well as Medical Record and Data section. Data on a continuous scale was expressed as a mean along with standard deviation. Categorical data was expressed as percentage. Comparative statistical analysis was done by using student's t-test in respect of data measured on a continuous scale. All differences with P value below 0.05 were labelled as statistically significant.

Results: Among the 97 RTI cases 62 patients had pneumonia and LRTI in 35 patients. Antibiotics were found to be used in combination. Two drugs combination like, macrolide + ß-lactam (11.4%), cephalosporin + aminoglycoside (25.7%), amino-penicillin+ aminoglycoside (15.5%) and piperacillin + aminoglycoside (15%) were used in severe infection. Three drugs combination like Ceftriaxone±sul+Amikacin+anti-MRSA/carbapenem (5.1%), Macrolide (azithromycin and Clarithromycin) +Cephalosporin+Aminoglycoside (10.1%) were used in very severe infections. Significant resistance was observed against ß-lactam and Macrolides.

Conclusions: Very severe infections with bacteremia or multiorgan failure were effectively treated with administration of Macrolide, Linezolid and Carbapenem with Ceftriaxone/ Piperacillin + Amikacin.


Keywords


Antibiotic use, Combination therapy, Pneumonia

Full Text:

PDF

References


Theodore C, Sandora J Thomas. Community acquired pneumonia. Nelson Textbook of Pediatrics. Vol.2, Part XVII-XXXIII, 19th Edn; 2008.

Harrison; Principle of Internal Medicine. 18th Edition.

Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, et al. The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clinical Infectious Diseases. 2011;53:25-76.

Shah SS, Dugan MH, Bell LM, et al. Blood cultures in the emergency department evaluation of childhood pneumonia. Pediatr Infect Dis J. 2011;30:475-79.

Virkki R, Juven T, Mertsola J, et al. Radiographic follow-up of pneumonia in children. Pediatr Pulmonol. 2005;40:7-223.

Combination antibiotic therapy for communityacquired Pneumonia Jesus Caballero* and Jordi Rello Caballero and Rello Annals of Intensive Care. 2011;1:48. http://www.annalsofintensivecare.com/content/1/1/48

Goodman Gillman’s Manual of Pharmacology and Therapeutics; 12th edition. Chapter 44.

Restrepo MI, Mortensen EM, Waterer GW, Wunderink RG, Coalson JJ, Anzueto A. Impact of macrolide therapy on mortality for patients with severe sepsis due to pneumonia. Eur Respir J. 2009;33:153-9.

Rubinstein E, Kollef MH, Nathwani D. Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus Clinical Infectious Diseases. 2008;46:S378-85.

Barton-Forbes M, Hawkes M, Moore D, et al. Guidelines for the prevention and management of community associated methicillin resistant Staphylococcus aureus (CA-MRSA): a perspective for Canadian health care practitioners. Can J Infect Dis Med Microbiol. 2006;17(C):1B-24B.

Sally A, Kate G. Clinical update on Linezolid in the treatment of gram positive infections. Infection and Drug Resistance. 2012;5:87-102

Tamma PD, Cosgrove SE, Maragakisb LL. Combination Therapy for Treatment of Infections with Gram-Negative Bacteria Clinical Microbiology Reviews. 2012;25,3:450-70.

Goodman and Gilman's the Pharmacological Basis of Therapeutics by Goodman, USA; 1985.