DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20202935

Antibiotic prescribing pattern among paediatric patients attending tertiary care hospital in South India

R. P. Priyadharsini, R. Kesavan

Abstract


Background: The usage of antibiotics among paediatric age group in India is on the higher side, that more than 60% of children in the age group 0 to 4 years received antibiotics. The higher use of antibiotics results in antibiotic resistance, increased health care costs, adverse drug reaction and may complicate the treatment of infections in future. There is a continuous need to monitor the prescription of antibiotics at all health care levels to prevent antibiotic resistance.

Methods: A prospective and descriptive study was conducted in one of the pharmacies which dispenses the paediatric prescriptions in a tertiary hospital. The prescriptions used to treat infection were collected and analysed. A total of 500 prescriptions were collected and analysed.

Results: The prescriptions were analysed for the WHO prescribing indicators. The average number of drugs per prescription is 1.84 with 21% of the prescriptions containing antibiotics. The most commonly prescribed antibiotics were penicillin like amoxycillin, phenoxymethyl penicillin followed by cotrimoxazole and cephalosporin group of antibiotics. The antibiotics prescribed belonged to the access group of antibiotics. The percentage of the prescriptions with drugs form essential drugs list and prescribed with generic name is 65.8% and 67% respectively. There were no injections prescribed.

Conclusions: The antibiotic prescribing pattern and the average drugs per prescription falls with the WHO range indicating reduced use of antibiotics and absence of polypharmacy. However, the prescription of generic drugs and the drugs from the essential drug list is less.


Keywords


Paediatric, Antibiotic, Resistance, Drug utilization, WHO prescription indicators

Full Text:

PDF

References


DST research study reveals usage of antibiotics highest among children. Available at http://www. pharmabiz.com/NewsDetails.aspx?aid=119706&sid=1. Accessed on 19 February 2020.

Kids up to 4 are main victims of antibiotics over-prescription - The Hindu Business Line. Available at https://www.thehindubusinessline.com/news/kids-up-to-4-are-main-victims-of-antibiotics-over-prescrip-tion/article30118007/ece. Accessed on 28 February 2020.

WHO | Use of antibiotics in children younger than two years in eight countries: a prospective cohort study. Available at: http://www.who.int/bulletin/ volumes/95/1/16-176123/en. Accessed on 19 February 2020.

Alkaff RN, Kamigaki T, Saito M, Ariyanti F, Iriani DU, Oshitani H. Use of antibiotics for common illnesses among children aged under 5 years in a rural community in Indonesia: a cross-sectional study. Trop Med Health. 2019;47(1):45.

Zaman SB, Hussain MA, Nye R, Mehta V, Mamun KT, Hossain N. A Review on Antibiotic Resistance: Alarm Bells are Ringing. Cureus. 2017;9(6):1403.

Medernach RL, Logan LK. The Growing Threat of Antibiotic Resistance in Children. Infect Dis Clin North Am. 2018;32(1):1-17.

Laxminarayan R, Chaudhury RR. Antibiotic Resistance in India: Drivers and Opportunities for Action. PLOS Med. 2016;13(3):1001974.

Ahmad A, Patel I. Schedule H1: Is it a Solution to Curve Antimicrobial Misuse in India. Ann Med Health Sci Res. 2013;3(1):55-6.

Hazra A. Schedule H1: Hope or hype. Indian J Pharmacol. 2014;46(4):361-2.

WHO. Rational use of medicines. Available at: http://www.who.int/medicines/areas/rational_use/en. Accessed on 26 August 2019.

Core Elements of Hospital Antibiotic Stewardship Programs | Antibiotic Use | CDC; 2020. Available at: https://www.cdc.gov/antibiotic-use/core-elements/hospital/html. Accessed on 3 March 2020.

How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators - EDM Research Series No. 007: Chapter 2: Core drug use indicators: Group 1: Prescribing indicators. Available at: http://apps.who.int/medicinedocs/en/d/Js2289e/3.1.html. Accessed on 6 July 2019.

Kumar P. Assessment of antibiotic prescribing pattern in pediatric patients: A cross-sectional hospital-based survey. Available at: http://www.cjhr.org/article.asp?issn=2348-3334;

year=2017;volume=4;issue=4;spage=235;epage=237;aulast=Pradeepkumar. Accessed on 25 July 2019.

Mishra H, Mishra R, Mondal A. Prescription pattern of antimicrobial drugs in pediatrics outpatient department of a tertiary care teaching hospital of North India. Int J Basic Clin Pharmacol. 2017;3(2):385-8.

Asenso OR. A closer look at the World Health Organization’s prescribing indicators. J Pharmacol Pharmacother. 2016;7(1):51-4.

Kanish R, Gupta K, Juneja S, Bains HS, Kaushal S. Prescribing pattern and pharmaco-economics of antibiotic use in the department of pediatrics of a tertiary care medical college hospital in northern India. Ann Trop Med Public Health. 2015;8(4):101.

Concept of Essential Medicines and Rational Use in Public Health. Available at: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC2888334. Accessed on 5 March 2020.

Prescription writing: Generic or brand. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547850. Accessed on 5 March 2020.

WHO releases the 2019 aware classification antibiotics. Available at: http://www.who.int/ medicines/news/2019/WHO_releases2019AWaRe_classification_antibiotics/en. Accessed on 4 March 2020.