Treatment Patterns, Cough Formulations, and Antibiotics Usage for Pediatric Acute Cough in India: A Real-World Study
Surinder Kumar Jindal1, Agam Vora2, Harshad Malve3
1Jindal Chest Clinics, Chandigarh, India.
Insights
Pediatric acute cough management in India shows high antibiotic prescription rates for both productive and nonproductive coughs. This study highlights varied prescription patterns and the need for guideline adherence in pediatric cough treatment.
Area of Science:
- Pediatrics
- Pharmacology
- Public Health
Background:
- Pediatric acute cough presents diagnostic and management challenges.
- Cough is a frequent pediatric symptom with diverse prescription practices.
- Evaluating prescription patterns for acute cough in Indian children is crucial.
Purpose of the Study:
- To assess prescription patterns for acute cough in the Indian pediatric population.
- To analyze treatment strategies, formulation rationality, and antibiotic use.
- To identify potential gaps in clinical practice for pediatric cough management.
Main Methods:
- Retrospective analysis of electronic medical records.
- Inclusion of pediatric patients presenting with cough from 2017 to 2023.
- Evaluation of prescription data for acute cough treatments.
Main Results:
- High antibiotic prescription rates observed for both productive (61.11%) and nonproductive (54.93%) coughs.
- Combination therapies (antitussives, antihistamines, bronchodilators) were widely used.
- Azithromycin and cefpodoxime were frequently prescribed antibiotics; dextromethorphan and levocloperastine common monotherapies.
Conclusions:
- Overprescription of antibiotics and varied treatment approaches indicate potential clinical practice gaps.
- Need for improved prescription monitoring and education on pediatric cough management.
- Emphasis on adherence to clinical guidelines for effective pediatric acute cough treatment is essential.
Background:
Managing pediatric acute cough poses a unique challenge due to its wide range of causes, from self-limiting viral infections to more serious bacterial conditions. Cough is a common symptom in pediatric practice, often leading to varied prescription practices. This study aimed to evaluate prescription patterns for acute cough in the Indian pediatric population.
Methods:
The electronic medical records data of pediatric patients presenting with cough from 2017 to 2023 was studied to understand the treatment patterns, rationality of formulations, and antibiotic prescription for acute cough.
Results:
The findings of the study revealed a high rate of antibiotic prescriptions for both productive (61.11%) and nonproductive coughs (54.93%). Combination therapies, particularly those containing antitussives (productive cough 15.81%, nonproductive cough 37.10%), antihistamines (productive cough 3.46%, nonproductive cough 5.49%), and beta-agonists/bronchodilators (productive cough 14.73%, nonproductive cough 5.45%), were widely prescribed. Among the antitussive combinations, chlorpheniramine + dextromethorphan + phenylephrine was widely prescribed for productive as well as nonproductive cough, respectively (9.2%, 20.22%). Azithromycin (nonproductive cough: 19.92% and productive cough: 19.55%) and cefpodoxime were frequently prescribed antibiotics. Dextromethorphan and levocloperastine were the commonly recommended monotherapy. Frequent prescription of antitussive combinations for productive cough was observed in the study. The cough medications were prescribed mostly for a duration of 3-5 days.
Conclusion:
Overprescription of antibiotics and diverse management approaches, using mono- and combination therapies, across different types of pediatric acute cough highlight potential gaps in clinical practice and perhaps understanding. The results underscore the need for improved prescription monitoring, education across the specialties on cough categorization and effective management of pediatric acute cough and adherence to clinical guidelines.
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