Download PDF
CC BY-NC-ND 4.0 · Avicenna J Med 2021; 11(01): 15-19
DOI: 10.4103/ajm.ajm_73_20
Original Article

Evaluation of antibiotic prescribing pattern in pediatrics in a tertiary care hospital

Rinta Mathew
Department of Clinical Pharmacy, Bharati Hospital and Research Centre, Poona College of Pharmacy, Pune, Maharashtra, India
,
Humera Sayyed
Department of Clinical Pharmacy, Bharati Hospital and Research Centre, Poona College of Pharmacy, Pune, Maharashtra, India
,
Subhashree Behera
Department of Clinical Pharmacy, Bharati Hospital and Research Centre, Poona College of Pharmacy, Pune, Maharashtra, India
,
Keemya Maleki
Department of Clinical Pharmacy, Bharati Hospital and Research Centre, Poona College of Pharmacy, Pune, Maharashtra, India
,
Sunita Pawar
Department of Clinical Pharmacy, Bharati Hospital and Research Centre, Poona College of Pharmacy, Pune, Maharashtra, India
› Author Affiliations
Subject Editor: Financial support and sponsorship Nil.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background: The irrational use of antibiotics is a global issue and it can lead to morbidity, mortality, and increased health care costs. Hence, proper use of antibiotics is imperative and should be included in the pharmaceutical care plan. Objective: The objective of this study was to evaluate the prescribing pattern of antibiotics for children using WHO core prescribing indicators. Materials and Methods: A prospective, observational study was carried for 6 months in the pediatric department at a tertiary care hospital, Pune. The WHO prescribing indicators were used to evaluate the prescriptions, and the ideal WHO range was considered as a determining factor for rational prescription. Results: A total of 302 patients were included in the study, with a mean patient age of 4.92 ± 4 years. The average number of drugs per encounter was 6.12 (WHO standard is less than 2). The percentage of antibiotics prescribed was 26.3% with an average of 1.63 antibiotics per prescription. Of the 493 antibiotics, 85.59% were injectable which is higher than the WHO standard of 13.4–24.1%. A near-optimal value of 99.59% antibiotics was prescribed from the hospital formulary which is similar to WHO standards, and the antibiotics prescribed with generic names were 25.76%. The most common class of antibiotics prescribed were cephalosporins and penicillins. Conclusion: Polypharmacy, high injectable use, and non-adherence to generic prescription were common in our tertiary care center. Continuous audits, training, and new treatment protocols are recommended.

Keywords

Antibiotics - pediatrics - rational prescribing - prescribing pattern - WHO prescribing indicators


Publication History

Article published online:
06 August 2021

© 2021. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 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: 170
    CrossrefPubMedGoogle Scholar
  • 2 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: 44-54
    CrossrefPubMedGoogle Scholar
  • 3 Pradeepkumar 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 Res 2017; 4: 235
    CrossrefGoogle Scholar
  • 4 Kebede HK, Gesesew HA, Woldehaimanot TE, Goro KK. Antimicrobial use in paediatric patients in a teaching hospital in Ethiopia. PLoS One 2017; 12: e0173290
    CrossrefPubMedGoogle Scholar
  • 5 WHO. How to investigate drug use in health facilities: selected drug use indicators. Geneva: World Health Organization; 2010. WHO/DAP/93
    Google Scholar
  • 6 Al Balushi KA, Al-Sawafi F, Al-Ghafri F, Al-Zakwani I. Drug utilization pattern in an Omani pediatric population. J Basic Clin Pharm 2013; 4: 68-72
    CrossrefPubMedGoogle Scholar
  • 7 Lusini G, Lapi F, Sara B, Vannacci A, Mugelli A, Kragstrup J. et al. Antibiotic prescribing in paediatric populations: A comparison between Viareggio, Italy and Funen, Denmark. Eur J Public Health 2009; 19: 434-8
    CrossrefPubMedGoogle Scholar
  • 8 Shankar PR, Upadhyay DK, Subish P, Dubey AK, Mishra P. Prescribing patterns among paediatric inpatients in a teaching hospital in western Nepal. Singapore Med J 2006; 47: 261-5
    PubMedGoogle Scholar
  • 9 Thiruthopu NS, Mateti UV, Bairi R, Sivva D, Martha S. Drug utilization pattern in south Indian pediatric population: A prospective study. Perspect Clin Res 2014; 5: 178-83
    CrossrefPubMedGoogle Scholar
  • 10 Mukherjee S, Sen S, Era N, Biswas A, Datta K, Tripathi SK. Antibiotic usage pattern among inpatients of a paediatric ward in a tertiary care hospital in Eastern India. Int J Res Med Sci 2015; 3: 3681-6
    CrossrefGoogle Scholar
  • 11 Williams A, Mathai AS, Phillips AS. Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. J Pharm Bioallied Sci 2011; 3: 531-6
    CrossrefPubMedGoogle Scholar
  • 12 Cole CP, James PB, Kargbo AT. An evaluation of the prescribing patterns for under-five patients at a tertiary paediatric hospital in Sierra Leone. J Basic Clin Pharm 2015; 6: 109-14
    CrossrefPubMedGoogle Scholar
  • 13 World Health Organization. How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators. Available from: https://apps.who.int/medicinedocs/pdf/s2289e/s2289e.pdf. [Last accessed on 2019 Mar]
    Google Scholar
  • 14 Akhtar MS, Vohora D, Pillai KK, Dubey K, Roy M, Najmi A. et al. Drug prescribing practices in paediatric department of a north Indian university teaching hospital. Asian J Pharm Clin Res 2012; 5: 146-9
    Google Scholar
  • 15 Ahmed AM, Awad AI. Drug use practices at pediatric hospitals of Khartoum state, Sudan. Ann Pharmacother 2010; 44: 1986-93
    CrossrefPubMedGoogle Scholar
  • 16 Fadare J, Olatunya O, Oluwayemi O, Ogundare O. Drug prescribing pattern for under-fives in a paediatric clinic in South-Western Nigeria. Ethiop J Health Sci 2015; 25: 73-8
    CrossrefPubMedGoogle Scholar
  • 17 Dutta S, Bhattacharjee A, Devi MN. Prescription pattern of antibiotics in paediatric inpatients at a tertiary care hospital in North East India. Int J Basic Clin Pharmacol 2017; 6: 2384-7
    CrossrefGoogle Scholar
  • 18 Palikhe N. Prescribing pattern of antibiotics in pediatric hospital of Kathmandu valley. Kathmandu Univ Med J 2004; 2: 6-12
    PubMedGoogle Scholar
  • 19 Umar LW, Isah A, Musa S, Umar B. Prescribing pattern and antibiotic use for hospitalized children in a northern Nigerian teaching hospital. Ann Afr Med 2018; 17: 26-32
    CrossrefPubMedGoogle Scholar
  • 20 Atif M, Sarwar MR, Azeem M, Naz M, Amir S, Nazir K. Assessment of core drug use indicators using WHO/INRUD methodology at primary healthcare centers in Bahawalpur, Pakistan. BMC Health Serv Res 2016; 16: 684
    CrossrefPubMedGoogle Scholar
  • 21 Karande S, Sankhe P, Kulkarni M. Patterns of prescription and drug dispensing. Indian J Pediatr 2005; 72: 117-21
    CrossrefPubMedGoogle Scholar
  • 22 Nduka SO, Edebeatu C, Isidienu CP, Amorha KC. Prescribing practices for pediatric out-patients: A case study of two teaching hospitals in Nigeria. Trop J Pharma Res 2017; 16: 705-11
    CrossrefGoogle Scholar
  • 23 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
    Google Scholar
  • 24 Choudhury DK, Bezbaruah BK. Antibiotic prescriptions pattern in paediatric in-patient department Guwahati medical college and hospital, Guwahati, India. J Appl Pharm Sci 2013; 3: 144-8
    Google Scholar
  • 25 Abula T, Desta Z. Prescribing pattern of drugs in pediatric wards of three Ethiopian hospitals. Ethiop J Health Dev 1999; 13: 135-40
    Google Scholar
  • 26 Baktygul K, Marat B, Ashirali Z, Harun-Or-rashid M, Sakamoto J. An assessment of antibiotics prescribed at the secondary health-care level in the Kyrgyz Republic. Nagoya J Med Sci 2011; 73: 157-68
    PubMedGoogle Scholar
  • 27 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: 422-6
    CrossrefPubMedGoogle Scholar
  • 28 Sharif SI, Nassar AH, Al-Hamami FK, Hassanein MM, Elmi AH, Sharif RS. Trends of pediatric outpatients prescribing in Umm Al Quwain, United Arab Emirates. Pharmacol Pharm 2015; 6: 9
    CrossrefGoogle Scholar