A clinical audit to evaluate antibiotic prescribing practice in pediatric patients admitted for enteric fever....

Area of Science:

• Infectious Diseases
• Pharmacology
• Public Health

Background:

• Enteric fever, caused by Salmonella, presents a significant global health challenge, particularly in pediatric populations.
• Increasing antimicrobial resistance necessitates careful evaluation of current antibiotic prescribing practices.
• The implementation of an Antibiotic Stewardship Program (ASP) is vital for optimizing antibiotic use in hospitals.

Purpose of the Study:

• To assess antibiotic prescribing patterns for pediatric enteric fever.
• To determine the need for an Antibiotic Stewardship Program (ASP) in a tertiary care hospital.
• To compare prescribing practices with established clinical guidelines.

Main Methods:

• A prospective audit was conducted over one year in a pediatric ward.
• Blood cultures and clinical data (antibiotic choice, dosage, outcome) were collected and analyzed.
• Statistical analysis was performed using SPSS and compared against treatment guidelines.

Main Results:

• Of 157 suspected enteric fever cases, 137 were Salmonella-positive.
• Ceftriaxone monotherapy was the most common empirical treatment (70%); 20% received combination therapy.
• High rates of resistance were found: 7 non-resistant, 15 multi-drug resistant, and 115 extensively drug-resistant typhoid cases. Nearly 46% were discharged earlier after empirical therapy adjustment based on susceptibility.

Conclusions:

• Antibiotic prescribing for pediatric enteric fever frequently deviates from recommended guidelines.
• Extensive drug resistance is a major concern, impacting treatment efficacy.
• The findings underscore the urgent need for an Antibiotic Stewardship Program (ASP) and review of current recommendations due to evolving resistance patterns.