Antibiotic use among hospitalized children with lower respiratory tract infections: a multicenter, retrospective study from Punjab, Pakistan

ABSTRACT

Background

Lower respiratory tract infection (LRTI) is one of the triggering factors toward death in children below the age of five years necessitating appropriate antibiotic selection. This study aimed to evaluate antibiotic use among hospitalized children (≤5 years age) with LRTIs.

Methods

A retrospective study was conducted in seven health facilities of the central region of Punjab province of Pakistan. The medical records of hospitalized children ≤5 years diagnosed with LRTI were thoroughly evaluated to get information on demographics, clinical characteristics, and details of prescribed antibiotics. The appropriateness of antibiotics was assessed according to guidelines of the British National Formulary due to a lack of indigenous standard treatment guidelines.

Results

The medical records of 5926 children were searched with the majority (70.9%) diagnosed with community-acquired pneumonia (CAP) followed by acute bronchitis (14.1%). Ceftriaxone plus ampicillin and ceftriaxone plus ampicillin plus amikacin were prescribed to 39% and 11.7% study population, respectively. One-fourth of children were prescribed the wrong dose, and more than half were encountered with the incorrect route of antibiotic administration. Alarmingly, 90.2% of antibiotic prescriptions were inappropriate in our findings.

Conclusions

Current surveillance study revealed a worrying degree of antibiotic misuse among hospitalized LRTI children aged ≤5 years.

KEYWORDS:

• Antibiotics
• surveillance
• antimicrobial stewardship (AMS)
• children
• Punjab

Acknowledgments

We are highly thankful to the administration of the concerned hospitals for their support in the completion of this paper.

Author contribution statement

ZUM and MS made substantial contributions to the study design, data analysis, interpretation of the results, and manuscript drafting. NA and NA were involved in data collection and interpretation. KH, NT and KH revised the manuscript for important intellectual content. All authors have read and approved the final version of the manuscript.

Data availability

The datasets used during the current study are available from the corresponding author on reasonable request.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Ethical approval

The current study was conducted after the approval number from the ethics committee of The Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore (REC/DPP/FOP/2A). As we only searched, the medical records of the patients that were discharged from the hospital, therefore, the ethic committee allowed us to use this patient’s medical record after their approval.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.