A cross sectional observational study to evaluate utilization of antimicrobials in paediatric department of a tertiary care teaching hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20233899Keywords:
Antimicrobials, AWaRe classification, Paediatrics, WHO/INRUD drug prescribing indicatorsAbstract
Background: Antimicrobials play cardinal role in management of infectious disease. Paediatric age group forms significant part of developing countries and have high chances of acquiring infectious. Misuse and overuse of these antimicrobials are leading culprits in causing antimicrobials resistance. The purpose of this study was to analyse utilization of antimicrobials among paediatric department of a tertiary care teaching hospital.
Methods: A cross sectional observation study was conducted for three months in paediatric department of a tertiary care teaching hospital. The demographics and antimicrobials use details were observed daily from patients admitted to paediatric outpatient department, wards and intensive care unit to assess according to The World Health Organization-International Network of Rational Use of Drugs drug prescribing indicators and WHO antibiotics AWaRe (Access, Watch, Reserve) classification.
Results: In our study we found that mean antimicrobial use in OPD, wards and ICU was1.15±0.35, 1.12±0.33 and 2.25±1.01 respectively. Cephalosporins were most commonly prescribed in OPD (34.62%) and wards (65.26%) while piperacillin-tazobactam (29.93%) in ICU. Percent encounter with an antibiotic in OPD, Wards and ICU was 8.41%, 30.71% and 33.58% respectively. 56.69%, 81.35% and 55.80% antibiotics prescribed in OPD, Wards and ICU respectively were of Watch group. 5.66% Reserve group antibiotics were prescribed in the ICU.
Conclusions: Prescribing trends of antimicrobials is near to WHO standard but according to AWaRe classification, watch group antibiotics were prescribed more than Access group.
Metrics
References
Gopal MB, Thiyagarajan P, Venugopal V, Kumar VN. A study on antibiotic prescription among the hospitalized pediatric patients at a referral center in Puducherry, India. Int J Contemp Pediatr. 2017;4(3):700.
Mustafa ZU, Khan AH, Salman M, Syed Sulaiman SA, Godman B. Antimicrobial Utilization among Neonates and Children: A Multicenter Point Prevalence Study from Leading Children’s Hospitals in Punjab, Pakistan. Antibiotics. 2022;11(8):1056.
Antimicrobial resistance- factsheet. Available at: https://www.who.int. Accessed on 17 January 2023.
Young JC, Ju-Young S. Trends in the use of antibiotics among Korean children. Korean J Pediatr. 2019;6 2(4):113-8.
Mali NB, Deshpande SP, Tullu MS, Deshmukh CT, Gogtay NJ, Thatte UM. A Prospective Antibacterial Utilization Study in Pediatric Intensive Care Unit of a Tertiary Referral Center. Indian J Crit Care Med. 2018;22(6):422-6.
Principi N, Esposito S. Antimicrobial stewardship in paediatrics. BMC Infect Dis. 2016;16(1):23-8.
Girma S, Sisay M, Mengistu G, Amare F, Edessa D. Antimicrobial Utilization Pattern in Pediatric Patients in Tertiary Care Hospital, Eastern Ethiopia: The Need for Antimicrobial Stewardship. Hosp Pharm. 2018;53(1):44-54.
How to investigate drug use in health facilities: selected drug use indicators. Available at: https://www.who.int/publications/i/item/who-dap-93.1. Accessed on 27 May 2023.
Chautrakarn S, Anugulruengkitt S, Puthanakit T, Rattananupong T, Hiransuthikul N. Antimicrobial prescription patterns in a tertiary-care pediatric unit in Thailand. Pediatr Int. 2020;62(6):683-7.
AWaRe classification (access, watch, reserve) classification of antibiotics for evaluation and monitoring of use. Available at: https://www.who.int/ publications/i/item/2021-aware-classification. Accessed on 27 May 2023.
Mishra H, Mishra R, Mondal A. Prescription pattern of antimicrobial drugs in pediatrics outpatient department of a tertiary care teaching hospital of North India. Int J Basic Clin Pharmacol. 2014;3(2):1.
Jeeyani HN, Parikh RH, Sivanandan S, Muliya HJ, Badiyani SN, Patel MB. Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India. Int J Contemp Pediatr. 2020;8(1):35.
Uzan-Yulzari A, Turta O, Belogolovski A, Ziv O, Kunz C, Perschbacher S, et al. Neonatal antibiotic exposure impairs child growth during the first six years of life by perturbing intestinal microbial colonization. Nat Commu. 2021;12(1):443.
Mathew R, Sayyed H, Behera S, Maleki K, Pawar S. Evaluation of antibiotic prescribing pattern in pediatrics in a tertiary care hospital. Avicenna J Med. 2021;11(1):15-9.
Janowski AB, Michaels MG, Martin JP, Green MF. Piperacillin-Tazobactam Usage at a Tertiary Pediatric Hospital. Antimicrob Steward Rev. 2016;5(3):342-5.
Shulman ST, Yogev R. Treatment of pediatric infections with amikacin as first-line aminoglycoside. Am J Med. 1985;79(1A):43-50.
Abbas Q, Ul Haq A, Kumar R, Ali SA, Hussain K, Shakoor S. Evaluation of antibiotic use in Pediatric Intensive Care Unit of a developing country. Indian J Crit Care Med. 2016;20(5):291-4.
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.
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.
Sharma S, Bowman C, Alladin-Karan B, Singh N. Antibiotic prescribing patterns in the pediatric emergency department at Georgetown Public Hospital Corporation: a retrospective chart review. BMC Infect Dis. 2016;16(1):22-4.
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;24:312-9.
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 Antimicrob Resist Infect Control. 2018;7:82.