Antibiotic Prescription Pattern, Appropriateness, and Associated Factors in Patients Admitted to Pediatric Wards of Tibebe Ghion Specialized Hospital, Bahir Dar, North West Ethiopia

Figures & data

Table 1 Socio-Demographic Characteristics of Pediatric Patients in TGSH Pediatric Wards, from September 1st, 2020 to August 31st, 2021 GC (n=279)

Socio-Demographic Characteristics	Frequency	Percent
Sex
Male	176	63.1
Female	103	36.9
Residence
Urban	92	33.0
Rural	187	67.0
Age
< 1 month (neonates)	90	31.9
1 month to 1 year (infants)	91	32.6
1–3 years (toddlers)	48	17.2
3–5 years (preschool children)	8	2.9
5–10 years (school children)	25	9.0
10–14 years (adolescents)	18	6.5
Weight (kg)
<5	134	48.0
5–9.99	81	29.0
10–14.99	33	11.8
15–19.99	7	2.5
20–24.99	10	3.6
≥25	14	5.0

Table 2 Common Conditions for Which Antibiotics Were Prescribed for Pediatric Patients in TGSH Pediatric Wards, from September 1st, 2020 to August 31st, 2021 GC

Diagnosis Made for Antibiotic Use	Frequency	Percent
Pneumonia	47	16.8
EONS	39	14.0
Meningitis	21	7.5
Intussusception	14	5.0
Trauma	14	5.0
VLOS	14	5.0
Appendicitis	13	4.7
SAM	12	4.3
Abscess	11	3.9
SAM + AGE	11	3.9
HAI	11	3.9
LONS	10	3.6
SAM+SCAP	10	3.6
AGE	9	3.2
BO	8	2.9
Sepsis of GI onset	8	2.9
Meningitis + aspiration pneumonia	5	1.8
LONS + aspiration pneumonia	4	1.4
UTI	4	1.4
Congenital syphilis	3	1.1
Pertussis	3	1.1
HSD	2	0.7
Otitis media	2	0.7
Others	4	1.6

Abbreviations: BO, bowel obstruction; EONS, early-onset neonatal sepsis; VLOS, very late onset sepsis; SAM, Severe Acute malnutration; AGE, acute gastro entraitis; LONS, late onset neonatal sepsis; SCAP, severe community aquired neumonia; GI, gastrointestinal; HAI, hospital-acquired infection; HSD, Hirschsprung disease; UTI, urinary tract infection.

Table 3 Frequency and Percentage of Combination and Single Antibiotics Prescribed to Pediatric Patients in TGSH Pediatric Wards, from September 1st, 2020 to August 31st, 2021 GC

Names of Combination Antibiotics Prescribed	Frequency	Percent
Ceftriaxone + metronidazole	53	23.5
Ampicillin + gentamycin	49	21.7
Ampicillin + ceftriaxone	24	10.6
Ceftriaxone + vancomycin	16	7.1
Ampicillin + ceftriaxone + metronidazole	15	6.6
Ampicillin + gentamycin + ceftriaxone	6	2.7
Ceftriaxone + cephalexine	5	2.2
Ampicillin + ceftazidime	4	1.8
Ampicillin + ceftriaxone + gentamycin	3	1.3
Ampicillin + ceftriaxone + gentamycin	3	1.3
Ampicillin + gentamycin + metronidazole	3	1.3
Ciprofloxacin + vancomycin + metronidazole	3	1.3
Metronidazole + vancomycin	3	1.3
Others	39	17.3
Ceftriaxone	45	84.9
Amoxicillin	4	7.6
Crystalline penicillin	2	3.8
Ampicillin	1	1.9
Cloxacillin	1	1.9

Table 4 Potential Drug–Drug Interactions Between Some Concomitantly Prescribed Drugs at TGSH, Bahir Dar, Ethiopia, from September 1st, 2020 to August 31st, 2021 GC

Drug Combination	Frequency	Potential Interaction
Gentamycin + furosemide	10	Increased nephrotoxicity and ototoxicity adverse effects
Vancomycin + gentamicin	4	Increased nephrotoxicity and ototoxicity with aminoglycosides
Vancomycin + furosemide	10	Increased nephrotoxicity and ototoxicity with furosemide
Bacteriostatic + bactericidal	17	Bacteriostatics decrease the effect of bactericidal activity

Note: Interactions between bacteriostatic and bactericidal drugs include the combination use of pencillins and fluoroquinolones/macrolides, cephalosporins and fluoroquinolones/macrolides, glycopeptide (vancomycin) and fluoroquinolones/macrolides.

Table 5 Bivariate and Multivariate Analysis of Factors Associated with Inappropriate Use of Antibiotics Among Pediatric Patients Admitted to Pediatric Wards of TGSH, Bahir Dar, Ethiopia, from September 1st, 2020 to August 31st, 2021 GC

Variables	Category	Antibiotic Prescription Appropriateness		Odds Ratio
		Yes, N (%)	No, N (%)	COR (95% CI)	AOR (95% CI)
Residence	Urban	50 (54.3)	42 (45.7)	0.614 (0.372–1.016)	0.574 (0.333–0.989)*
	Rural	78 (41.7)	109 (58.3)
Age	<1 month	32 (11.5)	57 (20.4)	4.412 (1.443–13.489)*	4.933 (1.577–15.428)*
	1 month to 1 year	37 (13.3)	54 (19.4)	3.795 (1.247–11.549)*	3.18 (1.166–11.225)*
	1–3 years	26 (9.3)	22 (7.9)	2.200 (0.678–7.141)	1.917 (0.575–6.392)
	3–5 years	5 (1.8)	3 (1.1)	1.560 (0.267–9.106)	1.871 (0.282–12.421)
	5–10 years	15 (5.4)	10 (3.6)	1.733 (0.470–6.394)	2.038 (0.520–7.984)
	10–14 years	13 (4.7)	5 (1.8)
Comorbidity	Yes	73 (26.2)	104 (37.3)	1.629 (0.997–2.661)	0.134 (0.650–1.981)
	No	55 (19.7)	47 (16.8)
Type of treatment	Empiric	108 (43.5)	140 (56.5)	2.881 (1.261–6.578)	1.694 (0.666–4.312)
	Definitive	1 (50.0)	1 (50.0)	2.222 (0.125–39.638)	0.289 (0.10–8.368)
	Prophylactic	20 (69.0)	9 (31.0)
Parental negligence	Yes	3 (1.1)	20 (7.2)	6.462 (1.874–22.284)*	6.978 (1.872–20.017)*
	No	125 (44.8)	131 (47.0)

Note: *P-value less than that taken to indicate statistically significance.