Prescribing pattern of antibiotics in paediatric hospital of Kathmandu valley

Area of Science:

• Pediatric pharmacology
• Infectious disease management
• Antimicrobial stewardship

Background:

• Antibiotics are frequently prescribed in pediatrics, raising concerns about rising healthcare costs, inconsistent prescribing, and antibiotic resistance.
• Effective antibiotic policies require a thorough understanding of current prescribing practices.
• Monitoring antibiotic use is crucial for public health and patient safety.

Purpose of the Study:

• To investigate and analyze antibiotic prescribing patterns in hospitalized pediatric patients.
• To identify trends in antibiotic use across different age groups and diagnoses.
• To provide data for the development of targeted antibiotic stewardship strategies.

Main Methods:

• A prospective follow-up study was conducted over one and a half months (November-December 2003).
• Data were collected from a cohort of 121 pediatric inpatients.
• Prescribing practices, including drug and antibiotic counts per patient, specimen cultures, and route of administration, were analyzed.

Main Results:

• Patients received an average of 5.01 drugs and 2.41 antibiotics, with over 98% receiving at least two drugs.
• Cultures for pathogen identification were obtained in only 19.8% of cases with infectious diseases.
• Infants under 1 year received antibiotics more frequently (40%) than older children (31% for 1-5 years, 29% for 5-12 years; P<0.001). Parenteral administration accounted for 75% of antibiotics, with cephalosporins and penicillins being most common.

Conclusions:

• Infants under one year are at a higher risk for receiving multiple antibiotic courses, correlating with increased antibiotic resistance.
• Current prescribing practices indicate a need for improved diagnostic workups, with cultures obtained in a minority of cases.
• Interventions to control antibiotic use should prioritize younger children, particularly infants, to mitigate resistance development.