Evaluation of prescription pattern of antimicrobials in the treatment of respiratory tract infections in pediatric patients attending a tertiary care hospital

Authors

  • Tejal C. Patel Department of Pharmacology, HBT Medical College and Dr. RN Cooper Municipality General Hospital, Juhu, Mumbai, Maharashtra, India
  • Simran A. Sapra Department of Pharmacology, HBT Medical College and Dr. RN Cooper Municipality General Hospital, Juhu, Mumbai, Maharashtra, India
  • Kiran A. Bhave Department of Pharmacology, HBT Medical College and Dr. RN Cooper Municipality General Hospital, Juhu, Mumbai, Maharashtra, India
  • Prasad R. Pandit Department of Pharmacology, HBT Medical College and Dr. RN Cooper Municipality General Hospital, Juhu, Mumbai, Maharashtra, India
  • Anupama V. Mauskar Department of Paediatrics, HBT Medical College and Dr. RN Cooper Municipality General Hospital, Juhu, Mumbai, Maharashtra, India
  • Mohit Kumar Singh Department of Pharmacology, HBT Medical College and Dr. RN Cooper Municipality General Hospital, Juhu, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20230392

Keywords:

Upper respiratory tract infections, Antibiotics, Lower respiratory tract infections, Antimicrobial, Infectious diseases

Abstract

Background: Irrational use of antimicrobials is a complex and multifactorial problem in developing countries. Prescriptions not adhering to the treatment guidelines, self-medication, inappropriate use of drugs by patients can inadvertently lead to development of antimicrobial resistance. An observational study was designed to evaluate antimicrobial use in pediatric population with respiratory tract infections and its adherence to national treatment guidelines.

Methods: This was a cross sectional observational study initiated after taking institutional ethics committee permission. The prescriptions of children diagnosed with upper respiratory tract infections and lower respiratory tract infections (LRTI) were screened. Their demographic profile and details of drugs prescribed were recorded.

Results: Out of 230 pediatric prescriptions,155 (67%) were from outpatient department and 75 (33%) from those admitted in ward. Total 145 children were diagnosed with URTI whereas 85 had LRTI. In this study, 60 children with URTI received combination of amoxicillin and clavulanic acid (Co-amoxiclav) whereas 66 children with LRTI received Co-amoxiclav,18 ceftriaxone (N=18), 6 vancomycin (N=6) and 18 were prescribed oseltamivir (N=18), either alone or in combination. Other drugs prescribed included, paracetamol for fever and cough syrups. Out of 195 drugs prescribed by brand names, 138 (70.8%) were antimicrobials. Fixed dose combination amoxicillin and clavulanic acid, paracetamol and cough syrups were available from hospital pharmacy. None of the prescriptions had polypharmacy.

Conclusions: URTI was treated using single antimicrobial whereas LRTI was treated with more than one antimicrobials or combination of antimicrobial and antiviral agent. The prescriptions were in accordance with the national treatment guidelines.

References

van den Anker J, Reed MD, Allegaert K, Kearns GL. Developmental Changes in Pharmacokinetics and Pharmacodynamics. J Clin Pharmacol. 2018;58(10):S10-25.

Al-Ghazali MAA, Alakhali KM, Alawdi SM. Study of antibiotics prescribing pattern in paediatric patients of thamar province, in republic of Yemen. J Appl Pharm. 2017;9:247.

Rogawski A. Use of antibiotics in children younger than two years in eight countries: a prospective cohort study. Bull World Health Organization. 2017;95:49-61.

Van Boeckel TP. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14:742-50.

Infections. Available at: https://main.icmr.nic.in/ sites/default/files/upload_documents/AMR_Annual_Report_2021.pdf Accessed on 1 December 2022.

Youngster I. Antibiotic use in children–a cross-national analysis of 6 countries. J Pediatr. 2017;182:239-44.

Baidya S, Hazra A, Datta S, Das AK. A study of antimicrobial use in children admitted to pediatric medicine ward of a tertiary care hospital. Indian J Pharmacol. 2017;49:10‑5.

Antimicrobial. Available at: www.icmr.nic.in/ guidelines/treatment%20guidelines%20for%20antimicrobial.pdf. Accessed on 1 December 2022.

Ayukekbong JA, M Ntemgwa M, Atabe AN. The threat of antimicrobial resistance in developing countries: causes and control strategies. Antimicrob Resist Infect Control. 2017;6:47.

Kokani VR, Pandit PR, Bhave KA. Antimicrobial prescribing pattern in the treatment of acute respiratory tract infections in children in a tertiary care hospital. Int J Basic Clin Pharmacol. 2016;5(5):1770-4.

Malpani AK, Waggi M, Rajbhandari A, Kumar GA, Nikitha R, Chakravarthy AK. Study on prescribing pattern of antibiotics in a pediatric out-patient department in a tertiary care teaching and non-teaching hospital. Indian J Pharm Pract. 2016;9(4):253-9.

Pramil T, Rajiv A, Gaurav G. Prescription practice in patients of upper respiratory tract infection at a pediatric outpatient clinic in Punjab. Indian J Pharm Pract. 2014;7(2):26-32.

Mahapatra S, Tripathy S, Balaji C, Rani RJ, Sekar P. Prescribing pattern of antimicrobial agents in pediatrics department of a teaching hospital. Int J Basic Clin Pharmacol. 2015;4(4):753-6.

Deshmukh SN, Mahajan MM. A study of prescription pattern of antibiotics in paediatric in-patients at a tertiary care hospital in central India. Int J Pharm Res. 2016;6:286-90.

Majhi B, Panda A, Barma SK. Antibiotic prescribing pattern in paediatrics outpatient in a tertiary care hospital. J Evid Based Med. 2017;4:3048-51.

Adhikary J. A study on prescribing pattern of drugs in lower respiratory tract infection among children aged less than 12 years. Int J Adv Sci Eng Technol. 2017;5(3):49-51.

Mohan S, Dharamraj K, Dindial R, Mathur D, Parmasad V, et al. Physician behaviour for antimicrobial prescribing for pediatric URTI: A survey in general practice in Trinidad, West Indies. Ann Clin Microbiol Antimicrobi. 2004;3(11):1-8.

Gajbhiye VP, Kale RS, Vilhekar KY, Bahekar SE. Drug utilization study on antimicrobials use in lower respiratory tract infection in pediatric intensive care unit of rural tertiary care hospital. J Med Soc. 2016;30(3):146.

Joseph N, Bharathi DR, Sreenivasa B, Nataraj GR, George N, Safdar M. Prescribing pattern of drugs in upper respiratory tract infections in pediatric out patients. Int J Contemp Pediatr. 2016;3(3):1006-8.

Naik HG, Khanwelkar CC, Kolur A, Desai R, Gidamudi S. Drug utilization study on antibiotics use in lower respiratory tract infection. National J Med Res. 2013;3(4):324-7.

Prajapati V, Bhatt JD. Study of prescribing pattern of antimicrobial agents in the pediatric wards at tertiary teaching care hospital, Gujarat. Indian J Pharm Sci Res. 2012;3:2348‐55.

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Published

2023-02-22

How to Cite

Patel, T. C., Sapra, S. A., Bhave, K. A., Pandit, P. R., Mauskar, A. V., & Singh, M. K. (2023). Evaluation of prescription pattern of antimicrobials in the treatment of respiratory tract infections in pediatric patients attending a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 12(2), 227–231. https://doi.org/10.18203/2319-2003.ijbcp20230392

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Original Research Articles