Abstract

PRESCRIBING PATTERN OF ANTIBIOTICS IN PEDIATRIC HOSPITAL IN NEPAL

Sweta Shrestha and Sangita Shakya*

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Abstract

Background: Infancy and childhood is a period of rapid growth and development. The various organs, body system and enzymes that handles the drugs develops at different rates. The immune systems are not fully matured. So, infants and children are among the most vulnerable population to contract various infectious diseases. Excessive and inappropriate use of antibiotics causes increase incidence of ADRs, emergence of resistant microorganisms and associated infections, long hospitalization period, polypharmacy. So, the main objective is to study the prescribing practice of antibiotic in paediatric IPD. Methodology: A hospital based cross sectional, prospective and study was conducted at In-patient department of Ishan Children and Women’s Hospital for a period of 3 months in 390 pediatric Inpatients aged upto 12 years to whom at least one antibiotic was prescribed. Results: In this study, 390 Paediatric Inpatients were enrolled. Out of them, 69% were male and 31% were female. Most of them were belonging to age less than 1 year. The most common disease was Pneumonia (30%). Among 390 patients, only 165 cases i.e. (42.30%) were sent for culture test to identify pathogenic organisms. Only 13 specimens showed positive culture results, among them isolated organisms were Staphylococcus aureus, Streptococcus spp., Acinetobacter spp. and E.coli. An antibiotics prescribed per patient was found to be 2.03 . In this study most of the hospitalized In-patients received one antibiotics i.e. 40.16 %. The total number of antibiotics administered parenterally were 94.96%. Beta-lactam (51.94%) was the most frequently prescribed group of antibiotics, among them Cephalosporin (40%) were frequently prescribed followed by Aminoglycosides. Conclusion: Pneumonia was the most common disease among paediatric patient, age group less than 1 year. Beta- Lactam was the most commonly used antibiotics. Among them, Cefotaxime was the most frequently prescribed antibiotic in Pneumonia. The maximum percentage of patient were male.The percentage of encounter with an antibiotics was very higher. On the other hand, there was less trend to prescribe drug by generic name. Empirical therapy was higher in this study.Among culture positive specimens, the isolated organisms were Staphylococcus aureus, Streptococcus spp., Acinetobacter spp. and E.coli. Staphylococcus aureus.The most common ADR was fever seen due to Cefotaxime.

Keywords: Pediatrics, Antibiotic, In-patients, Prescribing pattern.