Antibiotic Prescribing Patterns for Hospitalized children with Community-Acquired Pneumonia in a Secondary Care
Sultan Albuhairi1, Muhammad Asad Farhan2, Sami Alanazi3
1Department of Pediatrics, Allergy and Immunology Section, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia.
Insights
Antibiotic prescribing for pediatric community-acquired pneumonia (CAP) in Saudi Arabia predominantly used broad-spectrum agents, contrary to guidelines. This study highlights the need for antimicrobial stewardship to improve adherence to narrow-spectrum therapy recommendations.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
- Pharmacology
Background:
- Community-acquired pneumonia (CAP) in children typically warrants narrow-spectrum antibiotic therapy.
- Limited data exist on antibiotic prescribing patterns for pediatric CAP in Saudi Arabia.
- This study aimed to document antibiotic use in hospitalized children with CAP.
Purpose of the Study:
- To report antibiotic prescription patterns for children hospitalized with community-acquired pneumonia (CAP) in Saudi Arabia.
- To assess adherence to recommended narrow-spectrum antibiotic therapy for pediatric CAP.
- To identify factors associated with the choice of antibiotics and patient outcomes.
Main Methods:
- A prospective cross-sectional study was conducted.
- Included were 233 children aged 1 month to 13 years hospitalized with CAP.
- Data were collected from January 2019 to January 2020 at King Khalid Hospital, Majmaah, Saudi Arabia.
Main Results:
- Amoxicillin clavulanate was the most frequent antibiotic (57.9%), followed by ceftriaxone (30%) and azithromycin (20.6%).
- No patients initially received narrow-spectrum therapy.
- Younger children (1-3 months) and severe pneumonia cases received broad-spectrum cephalosporins, correlating with longer hospital stays.
Conclusions:
- The study revealed inappropriate broad-spectrum antibiotic use in pediatric CAP.
- Adherence to narrow-spectrum therapy guidelines was not observed.
- Further multicenter research and antimicrobial stewardship programs are crucial to optimize antibiotic prescribing for pediatric CAP.
Background:
Narrow-spectrum antibiotics are recommended as the first-line therapy for management of children hospitalized with community-acquired pneumonia (CAP). There are limited data evaluating the antibiotic prescription patterns for CAP in Saudi Arabia. The goal of this study to report on the antibiotic patterns in children hospitalized with CAP.
Methods:
A prospective cross-sectional study was conducted in children aged 1 month to 13 years who were hospitalized with a diagnosis of CAP at King Khalid Hospital in Majmaah, Saudi Arabia, between January 2019 and January 2020.
Results:
Data from 233 patients were collected. The majority of patients received amoxicillin clavulanate (57.9%), followed by ceftriaxone (30%), azithromycin (20.6%), cefuroxime (6%), ampicillin (2.1%), and piperacillin-tazobactam (2.1%). None of our patients were started on narrow-spectrum therapy. The younger age group (1-3 months) and patients with severe pneumonia were more likely to receive broad-spectrum cephalosporin and have a longer hospital stay (P = .000 and P = .002, respectively). However, the 4 months to 5 years age group was more likely to receive amoxicillin clavulanate (P = .001). Male gender was a significate risk factor for patients with severe pneumonia (P=.013) CONCLUSIONS: We demonstrated the inappropriate use of broad-spectrum therapy in children hospitalized with CAP. Further large multicenter studies are necessary to evaluate the patterns of antibiotic use and implement antimicrobial stewardship programs or quality-improvement projects to improve adherence to guidelines.
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