An assessment of the index of rational drug prescribing for severe acute respiratory infections among hospitalised children in Northern Nigeria: a retrospective study

Figures & data

Table 1. Demographic and clinical characteristics of the patients.

Variable	Frequency	Percentage
Age in years
<1	148	57.1
1–5	99	38.2
6–10	11	4.2
>10	1	0.4
Sex
Male	147	56.8
Female	112	43.2
Mean weight (SD)	8.2 ± 3.4
Diagnosis
Bronchopneumonia	145	56.0
Lobar pneumonia	5	1.9
Bronchiolitis	9	3.5
Viral croup	3	1.2
Tonsillitis	13	5.0
Pharyngitis	13	5.0
Pharyngotonsillitis	23	8.9
Unspecified ARI	48	18.5

SD: standard deviation; ARI: acute respiratory infection.

Table 2. The core prescribing indicators for the treatment of SARI among the patients.

Prescribing indicator	Value for the hospital	Reference value
Average number of medicines per encounter, (mean ± SD)	3.9 ± 1.1	1.6–1.8
Number of medicines prescribed by generic name, n (%)	942 (82.1)	100.0
Encounter with an antibiotics prescribed, n (%)	292 (99.7)	20.0–25.4
Encounter with an injection prescribed, n (%)	291 (99.3)	10.1–17.0
Percentage of medicines prescribed from EMLc, n (%)	907 (79.0)	100.0

SD: standard deviation; EMLc: essential medicine list for children. Reference values were based on WHO-core prescribing indicators [19].

Table 3. The calculated indices of rational drug prescribing for SARI patients along with the ideal standards.

Prescribing indicators	Obtained index	Optimal index	Comment
Non-polypharmacy	0.35	1	Fair
Generic prescribing	0.82	1	Good
Rational antibiotic prescribing	0.3	1	Poor
Rational injection prescribing	0.1	1	Poor
Essential drug index	0.79	1	Good
Total	2.36	5	Poor

Table 4. Antibiotic use among children hospitalized patients with severe acute respiratory infections.

Variable	Frequency	Percentage
Prevalence of antibiotic prescription	292	99.7
Number of antibiotics per prescription
0	1	0.3
1	115	39.2
2	171	58.4
3	6	2.1
Classes of antibiotics prescribed (n = 475)
Cephalosporins	190	40
Aminoglycosides	162	34.1
Penicillins	102	21.5
Macrolides	12	2.6
Quinolones	3	0.6
Chloramphenicols	3	0.6
Nitroimidazole	2	0.4
Sulphonamides	1	0.2
Antibiotics prescribed (n = 475)
Gentamicin	162	34.1
Cefuroxime	102	21.5
Ceftriaxone	87	18.3
Amoxicillin-clavulanic acid	82	17.3
Amoxicillin	14	3.0
Erythromycin	9	1.9
Azithromycin	3	0.6
Chloramphenicol	3	0.6
Crystalline-penicillin	3	0.6
Ampicillin-sulbactam	3	0.6
Ciprofloxacin	2	0.4
Metronidazole	2	0.4
Ceftazidime	1	0.2
Co-trimoxazole	1	0.2
Levofloxacin	1	0.2

Table 5. Antibiotic combinations prescribed among hospitalized pediatric patients with severe acute respiratory infections.

Antibiotic combinations prescribed	Frequency (n = 177)	(%)
Dual antibiotic combinations
Cefuroxime + gentamicin	87	49.1
Amoxicillin-clavulanic acid + gentamicin	43	24.3
Ceftriaxone + gentamicin	20	11.3
Amoxicillin + gentamicin	8	4.5
Amoxicillin + ceftriaxone	4	2.2
Erythromycin + gentamicin	3	1.6
Azithromycin + gentamicin	2	1.1
Crystalline-penicillin + chloramphenicol	2	1.1
Metronidazole + erythromycin	1	0.6
Levofloxacin + erythromycin	1	0.6
Triple antibiotic combinations
Erythromycin + gentamicin + cefuroxime	2	1.2
Erythromycin + gentamicin + ceftriaxone	1	0.6
Azithromycin + gentamicin + cefuroxime	1	0.6
Azithromycin + crystalline-penicillin + ceftriaxone	1	0.6
Co-trimoxazole + gentamicin + ceftriaxone	1	0.6

World Health Organization. Promoting rational use of medicines: core components. Geneva: World Health Organization; 2002.

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Data availability statement

All data generated or analyzed during this study are included in this published article.