Assessing antibiotic utilization among pediatric patients in Gaborone, Botswana

Area of Science:

• Pediatric infectious diseases
• Antimicrobial resistance
• Global health

Background:

• Antimicrobial resistance is a growing concern in Southern Africa.
• Pediatric data on antibiotic use and resistance patterns are limited.
• Understanding antibiotic utilization is crucial for effective antimicrobial stewardship.

Purpose of the Study:

• To describe antibiotic utilization trends in a pediatric population at a Southern African national referral center.
• To assess the appropriateness of antibiotic prescriptions in pediatric patients.
• To identify risk factors associated with inappropriate antibiotic use.

Main Methods:

• Prospective cohort study of pediatric patients (<13 years) at a tertiary care hospital in Gaborone, Botswana.
• Collection of demographic, clinical, laboratory, and microbiology data, including antibiotic use.
• Classification of antibiotic prescriptions using the World Health Organization AWaRe (Access, Watch, Restrict) Classification.

Main Results:

• Nearly half of the 299 pediatric patients received at least one antibiotic; 40% on admission.
• Only 47% of admission antibiotic prescriptions and 37% at discharge were deemed appropriate.
• A significant proportion of antibiotics prescribed were from the Watch (58%) and Access (42%) categories, with none from the Restrict category.
• Surgical patients were more likely to receive inappropriate antibiotics on admission.

Conclusions:

• The study highlights substantial rates of antibiotic consumption, with a significant portion being inappropriate.
• Areas for antimicrobial stewardship interventions include standardizing pediatric surgical care and implementing clinical pathways.
• Improving antibiotic prescribing practices is essential to combat rising antimicrobial resistance in the region.