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Paediatric prescribing in Karachi
S Q Nizami1, I A Khan, Z A Bhutta
1Department of Paediatrics, The Aga Khan University, Karachi.
Insights
This study observed drug prescribing for common childhood illnesses in general practices and pediatric clinics. Results indicate significant overuse of antibacterials, particularly by general practitioners.
Area of Science:
- Pediatric pharmacology
- General practice drug utilization
- Childhood infectious diseases
Background:
- Drug prescribing patterns for common childhood ailments require assessment to identify potential overuse.
- Understanding variations in prescribing between general practitioners (GPs) and pediatricians is crucial for optimizing pediatric care.
Purpose of the Study:
- To evaluate the extent of drug overuse in pediatric primary care.
- To compare drug prescribing practices for common childhood illnesses between GPs and pediatricians.
Main Methods:
- Observational study of 2433 encounters involving children under five with GPs and pediatricians.
- Data collection on presenting complaints, prescribed medications (antibacterials, analgesics, antipyretics, antiemetics, antidiarrhoeals), and encounter duration.
- Analysis of prescribing trends, focusing on antibacterial use and specific drug classes.
Main Results:
- Antibacterial agents were prescribed in 49% of encounters, with ampicillin and cotrimoxazole being most common.
- General practitioners prescribed antibacterials more frequently than pediatricians.
- Antidiarrhoeals were prescribed in 41% of encounters for children with diarrhea; antiemetics in 8%.
Conclusions:
- Significant overuse of antibacterials in pediatric primary care settings was observed.
- Prescribing practices for common childhood illnesses differ between GPs and pediatricians, warranting further investigation into appropriate drug utilization.
- Shorter encounter times with GPs may correlate with higher antibacterial prescription rates.
Abstract:
To assess amount of drug overuse we studied drug prescribing for common childhood problems by 65 general practitioners (GPs) and 29 paediatricians. A total of 2433 encounters between GPs or paediatricians and children under five years of age were observed. The presenting complaints were fever in 18%, cough in 9%, both fever and cough in 21%, vomiting in 20% and diarrhoea in 41% of encounters. Antibacterials were prescribed in 49% of encounters, analgesics and antipyretics in 29%, antiemetics in 8% and injectables in 15%. Antidiarrhoeals were prescribed in 41% encounters with children reported to have diarrhoea. Ampicillin and cotrimoxazole were the two common antibacterials prescribed by both GPs and paediatricians. Antibacterials were prescribed in significantly larger number of encounters with GPs than in those with paediatricians. Mean encounter time of patients with GPs was 3.4+/-2.7 minutes and with paediatricians 9.7+/-4.1 minutes.