Antibiotic Prescribing Pattern in Paediatric Emergency Department at Tertiary Care Teaching Hospital in Nepal

Authors

  • Chandrajeet Kumar Yadav Assistant Professor, Department of Pharmacology Universal College of Medical Sciences, Bhairahawa
  • Ravi Bishunke Department of Pharmacy, Universal College of Medical Sciences, Bhairahawa
  • Amit Kumar Shrivastava Department of Pharmacology, Universal College of Medical Sciences, Tribhuvan University Bhairahawa, Rupandehi
  • Anjan Palikhey Department of Pharmacology, Universal College of Medical Sciences, Tribhuvan University Bhairahawa, Rupandehi
  • Lokeshwar Chaurasia Department of Pharmacology, Janaki Medical College, Tribhuvan University, ramdaiya, Janakpur

DOI:

https://doi.org/10.3126/jmcjms.v10i1.44629

Keywords:

Antibiotic prescribing pattern, Antibiotic resistance, Pediatric, WHO prescribing indicators

Abstract

Background and Objectives: The indiscriminate use of antibiotics often results in an increased incidence of adverse drug reactions (ADR), suboptimal therapy, treatment failure, polypharmacy and most importantly, the emergence of antibiotic resistance. Thus, the objective of this study was to assess the paediatric emergency department, antibiotic prescribing pattern at a tertiary care teaching hospital, Universal College of Medical Sciences (UCMS), Bhairahawa, Rupandehi, Nepal.

Material and methods: A prospective, cross-sectional, observational study was carried out on 152 paediatric patients of ages between 2 months to 12 years at the paediatric emergency department of UCMS. The data were collected by reviewing the prescription paper, and the required information was recorded using a structured data collection sheet prepared for study. The prescribing pattern was assessed through the World Health Organization (WHO) prescription indicators using the WHO Children Formulary 1993 AD.

Results: This study revealed that out of 152 patients, average number of drugs prescribed was 5.13 and antibiotic per patient was 2.10±.540. Antibiotics were prescribed at least once for 93.4% of patients. Drugs prescribed from Essential drug list (EDL) was 46.46% and that encountered with injectable was 92.1%. There was a significant difference between the patients age group and the number of drugs prescribed (χ2 = 21.553, p = 0.010). The mean duration of antibiotic treatment was 6.95±3.145. Cephalosporin’s (36.6%) followed by aminoglycosides (28.8%) were most frequently prescribed antibiotics.

Conclusion: Multiple courses of antibiotics are most frequently prescribed, which could increase antibiotic resistance in future. Continuous audits, training and new treatment protocols should be developed for prescribing and using antibiotics in paediatric patients.

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References

Sharma S, Bowman C, Alladin-Karan B, Singh NJBid. Antibiotic prescribing patterns in the paediatric emergency department at Georgetown Public Hospital Corporation: a retrospective chart review. 2016; 16(1): 1-6.

Girma S, Sisay M, Mengistu G, Amare F, Edessa DJHp. Antimicrobial utilization pattern in paediatric patients in tertiary care hospital, Eastern Ethiopia: the need for antimicrobial stewardship. 2018; 53(1): 44-54.

Al Balushi K, Al-Sawafi F, Al-Ghafri F, Al-Zakwani IJJob, pharmacy c. Drug utilization pattern in an Omani paediatric population. 2013; 4(3): 68.

Lusini G, Lapi F, Sara B, Vannacci A, Mugelli A, Kragstrup J, et al. Antibiotic prescribing in paediatric populations: a comparison between Viareggio, Italy and Funen, Denmark. 2009; 19(4): 434-38.

Shankar P, Upadhyay D, Subish P, Dubey A, Mishra PJSmj. Prescribing patterns among paediatric inpatients in a teaching hospital in western Nepal. 2006; 47(4): 261-265.

Thiruthopu NS, Mateti UV, Bairi R, Sivva D, Martha SJPiCr. Drug utilization pattern in South Indian paediatric population: A prospective study. 2014; 5(4): 178-183.

Mukherjee S, Sen S, Era N, Biswas A, Datta K, Tripathi SKJIJRMS. Antibiotic usage pattern among inpatients of a paediatric ward in a tertiary care hospital in Eastern India. 2015; 3(12): 3681-86.

Sachdeva P, Patel BJIJPBR. Drug utilization studies-scope and future perspectives. 2010; 1(1): 11-17.

Choudhury D, Bezbaruah BJJoAps. Antibiotic prescriptions pattern in paediatric in-patient department gauhati medical college and hospital, Guwahati. 2013; 3(8): 144-48.

White RJ. The early history of antibiotic discovery: empiricism ruled. Antibiotic discovery and development: Springer. 2012; 3-31.

Walsh C, Wright GJCr. Introduction: antibiotic resistance. 2005; 105(2): 391-94.

Costelloe C, Metcalfe C, Lovering A, Mant D, Hay ADJB. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. 2010; 340: 1-11.

Remesh A, Salim S, Gayathri A, Nair U, Retnavally KJAPP. Antibiotics prescribing pattern in the in-patient departments of a tertiary care hospital. 2013; 4(2): 71-76.

Oshikoya K, Chukwura H, Ojo OJP, Therapy PD. Evaluation of outpatient paediatric drug prescriptions in a teaching hospital in Nigeria for rational prescribing. 2006; 7(4): 183-88.

Impicciatore P, Choonara I, Clarkson A, Provasi D, Pandolfini C, Bonati MJBjocp. Incidence of adverse drug reactions in paediatric in/out‐patients: a systematic review and meta‐analysis of prospective studies. 2001; 52(1): 77-83.

Kanish R, Gupta K, Juneja S, Bains H, Kaushal SJAjoms. Prescribing pattern of antibiotics in the department of paediatrics in a tertiary care medical college hospital in Northern India. 2014; 5(4): 69-72.

Williams A, Mathai AS, Phillips ASJJop, sciences b. Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India. 2011; 3(4): 531-536.

Cole CP, James PB, Kargbo ATJJob, pharmacy c. An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. 2015; 6(4): 109-114.

World Health Organization, How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators. 2019.

Palikhe N. Prescribing pattern of antibiotics in paediatric hospital of Kathmandu valley. Journal of Nepal Health research council. 2004; 2: 31-6.

Umar LW, Isah A, Musa S, Umar BJAoAm. Prescribing pattern and antibiotic use for hospitalized children in a Northern Nigerian Teaching Hospital. 2018; 17(1): 26-32.

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Published

2022-04-26

How to Cite

Yadav, C. K., Bishunke, R., Shrivastava, A. K., Palikhey, A., & Chaurasia, L. (2022). Antibiotic Prescribing Pattern in Paediatric Emergency Department at Tertiary Care Teaching Hospital in Nepal. Janaki Medical College Journal of Medical Science, 10(1), 24–32. https://doi.org/10.3126/jmcjms.v10i1.44629

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Section

Research Articles