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Antibiotic misuse in children by the primary care physicians--an Indian experience
S Basu1, M Chatterjee, P Kumar Chandra
1Department of Pediatrics, North Bengal Medical College & Hospital Sushrutnagar, Darjeeling, India. drsriparnabasu@rediffmail.com
Insights
Antibiotic misuse is common in pediatric outpatient departments, with over-prescribing and improper selection being frequent errors. Parental demand and healthcare system factors contribute to this irrational antibiotic use.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Pharmacology
Background:
- Antibiotic misuse is a significant global health concern, contributing to antimicrobial resistance.
- Pediatric outpatient departments (OPDs) are key settings where antibiotic prescribing patterns can be evaluated.
- Understanding the drivers of antibiotic misuse is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate the extent of antibiotic misuse in a pediatric OPD at a teaching hospital.
- To identify the primary reasons contributing to inappropriate antibiotic prescribing in this setting.
Main Methods:
- A 6-month prospective study involving new pediatric cases treated with antibiotics.
- Data collection included parental consent, documentation of antibiotic usage errors, and questionnaires for medical officers and parents/guardians.
- Statistical analysis was performed using SPSS 10.
Main Results:
- Antibiotics were prescribed to 84.9% of new patients, with documented misuse in 36.8% of cases.
- Common errors included lack of indication (35.3%), improper drug selection (17.9%), and incorrect dosage (7.7%).
- Medical officers cited parental demand, patient overload, free medicine supply, and uncertain follow-ups as reasons for overuse. Parents lacked knowledge about antibiotics and desired quick relief.
Conclusions:
- Antibiotic misuse, particularly over-prescribing and improper selection, is prevalent in this region.
- Factors such as poor socioeconomic status, patient overcrowding in OPDs, and parental expectations significantly contribute to irrational antibiotic use.
Objective:
To determine the misuse of antibiotics in the Pediatric outpatients department' (OPD) of a busy teaching hospital and to ascertain the probable reasons behind it.
Methods:
Over a 6 months period, new cases primarily treated with antibiotics by Medical Officers (first contact physicians in Peadiatric Medicine and Surgery OPD) were recruited in the study after obtaining written consent from the parents. Various errors of antibiotic usage were noted. All Medical Officers were asked to fill up a preformed questionnaire and the parents/guardians were interviewed on their ideas about antibiotics. Data were analyzed by the statistical software SPSS 10.
Results:
Antibiotics were prescribed in 2427 (84.9%) new patients. Misuse of antibiotics was documented in 36.8% patients (no indication in 35.3%, improper selection in 17.9% and incorrect dosage in 7.7%). All medical officers were aware that they overuse antibiotics. The various reasons sited were demand of the parents, reluctance to counsel due to patient overload, free supply of medicines from OPD and sympathetic grounds as follow up visits were uncertain. Majority of the parents/attendants belonged to poor socioeconomic status and did not have any idea regarding antibiotics. All parents wanted quick relief without hospitalization and only 2.3% were willing to revisit the OPD for the same illness. Both medical officers and parents felt that base line investigations were unnecessary.
Conclusion:
Antibiotic misuse is quite common in this part of the world. Irrational use was mostly seen in over-prescribing and improper selection of antibiotic. Poor socio-economic status and overcrowding of patients in OPD were the main responsible factors.
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