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Analysis of Antimicrobial Drugs Usage Pattern and it's Cost Analysis in the Pediatric Department of a Tertiary Care
R Shrestha1, P Koju2, S Silwal2
1Department of Pharmacology, Pharmacovigillance Unit, Research and Development Division, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Insights
Antimicrobial use in children is high, with Penicillin being the most prescribed. Cephalosporins incurred the highest drug costs, highlighting the economic impact of antimicrobial prescribing in pediatric care.
Area of Science:
- Pediatric Pharmacology
- Infectious Disease Management
- Health Economics
Background:
- Antimicrobial agents are extensively used globally, with significant prescription rates in pediatric populations (50-85%).
- Inappropriate antimicrobial use contributes to antimicrobial resistance and imposes a substantial economic burden on healthcare systems.
- Children are particularly susceptible to various acute and chronic diseases, necessitating careful antimicrobial stewardship.
Purpose of the Study:
- To conduct a comprehensive analysis of antimicrobial drug usage patterns within a pediatric department.
- To evaluate the associated costs of antimicrobial drug utilization in a tertiary care hospital setting.
- To identify trends in antimicrobial prescribing and expenditure in pediatric patients.
Main Methods:
- A retrospective hospital-based study was conducted involving pediatric patients (1-18 years) admitted between January 2018 and December 2019.
- Data on antimicrobial prescriptions and costs were collected from electronic medical records.
- Descriptive statistical analysis was performed using Microsoft Excel to summarize usage and expenditure data.
Main Results:
- Respiratory tract infections (39.6%) were the most common indication for antimicrobial prescriptions, followed by sepsis (19.75%) and enteric fever (11.94%).
- Penicillins were the most frequently prescribed antimicrobial class (1238 instances), while Cephalosporins represented the highest expenditure (NRs. 530,988.6).
- Total antimicrobial expenditure in the pediatric department reached approximately NRs. 1,619,121.11 during the study period.
Conclusions:
- Penicillin-based antimicrobials were the most commonly prescribed drugs in the pediatric department.
- Cephalosporins incurred the highest drug expenditure, followed by Penicillins, indicating a significant cost associated with these drug classes.
- The findings underscore the need for optimized antimicrobial stewardship programs in pediatric settings to manage resistance and control healthcare costs.
Abstract:
Background Antimicrobials agents are the most widely and often imprudently used therapeutic drugs globally. The pediatric population comprises 20-25% of the total world population, and various acute and chronic diseases are prone to this group. It is also estimated that 50% to 85% of children are prescribed with antimicrobials in developed and developing countries. The misuse of antimicrobials not only contributes not only to the development of antimicrobial resistance but also results in economic burden on the health care system. Objective To analyze the antimicrobial usage and its cost analysis in the Pediatric department of a tertiary care hospital at sub-urban area. Method A hospital based retrospective study was conducted among patient (aged 1 to 18 years) admitted in pediatric ward and intensive care unit for at least 24 hours and dispensed at least one antimicrobial drug from January 2018 to December 2019. Data were collected from electronic medical record using a structured data collection form. The data was entered and analyzed using Microsoft Excel. A descriptive analysis was presented as mean ± (standard deviation) for the continuous variables and frequencies and proportions for categorical variables. Result Among the 1,281 patients, the antimicrobials were prescribed mostly in the respiratory tract infection (39.6%), followed by sepsis (19.75%), enteric fever (11.94%), seizure (10.07%), urinary tract infection (4.29%). Penicillins (1238 times) were highly prescribed followed by Cephalosporin (733 times), Nitro-imidazole (292 times), Aminoglycosides (180 times) and Fluoroquinolones (144 times). During study period in the Pediatric Department, approximately NRs. 1,619,121.11 was spent in the antimicrobial drugs and the highest expenditure was found to be in the Cephalosporin group of antimicrobials (NRs. 530,988.6), followed by Penicillin group of drug (NRs. 3,81,842.2). Conclusion The study concludes that the Penicillin groups of drugs were the most commonly prescribed drug and the highest cost was found to be in Cephalosporin group drugs followed by Penicillin group of drugs.
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