Evaluation of Antibiotics Use and its Predictors at Pediatrics Ward of Jimma Medical Center: Hospital Based Prospective Cross-sectional Study

Figures & data

Table 1 Study Participants’ Baseline Characteristics and Other Related Information at the JUMC Pediatric Ward from November 1, 2021 to April 30, 2021

Variables		Frequency	Percentage
Age	<1 month	91	22.63
	1 month–1 year (infant)	109	27.11
	1–5 years	132	32.83
	6–18 years	70	17.41
Duration of hospital stay (days)	≤7 days	107	26.62
	>7 days	285	70.89
Sex	Male	222	55.22
	Female	180	44.78
Antibiotic treatment days	≤7 days	175	43.53
	>7 days	227	56.47
Number of antibiotics prescribed	Monotherapy	481	72.33
	Dual antibiotics	115	17.3
	Three antibiotics	69	10.37
Prescriber	Medical intern	340	51.13
	Senior	64	9.6
	Resident	261	39.27
Treatment type	Empirical treatment	351	60.41
	Kinetic/definitive treatment	135	23.23
	Prophylactic treatment	95	16.35
Residence	Urban	114	28.36
	Rural	288	71.64
Weight (kg)	<4.9	63	15.67
	5–9.9	156	38.8
	10–14.9	71	17.66
	15–19.9	48	11.94
	>20	64	15.92

Table 2 Primary Infectious Conditions for which Antibiotics were Prescribed at Pediatric Ward of JUMC from November 1, 2021 to April 30, 2021 (N=485)

Disease/Disorder Type	Frequency	Percentage
Meningitis	162	33.4
Lower respiratory tract infection	137	28.24
Severe pneumonia	81	16.7
Severe acute malnutrition	77	15.86
Late onset neonatal sepsis	42	8.66
Early onset neonatal sepsis	29	5.97
Skin and soft tissue infection	22	4.53
Unknown	16	3.3
Total	485	100

Table 3 Most Commonly Prescribed Individual Antibiotics at the Pediatric Ward of JUMC from November 1, 2021 to April 30, 2021 (N=481)

Antimicrobial Agents	Frequency	Percentage
Gentamycin	116	24.11
Penicillin G	87	18.1
Ampicillin	82	17
Ceftriaxone	73	15.17
Cloxacillin	58	12.06
Chloramphenicol	53	11,02
Metronidazole	39	8.1
Amoxicillin	29	6.02
Ceftazidime	24	4.98
Azithromycin	10	2.01
Total	481	100

Table 4 Most Commonly Prescribed Combination Antibiotics at the Pediatric Ward of JUMC from November 1, 2021 to April 30, 2021 (N=184)

Antimicrobial Combinations	Frequency	Percentage
Ampicillin+gentamycin	66	43.33
Ceftriaxone+gentamycin	33	17.93
C.pencillin G+chloramphenicol	25	13.9
Ampicillin+gentamycin+metronidazole	23	12.5
Ceftriaxone+metronidazole	18	9.7
Ampicillin+gentamycin+metronidazole	13	2.85
Ceftriaxone+ampicillin	3	1.63
Ceftriaxone+gentamycin+cloxacillin	3	1.63
Total	184	100

Table 5 Route of Drug Administration Among Pediatric Patient of JUMC Pediatric Ward from November 1, 2021 to April 30, 2021 (N=665)

Route	Frequency	Percentage
Parenteral (IV, IM)	523	78.65
PO	142	21.35
Total	665	100

Table 6 Appropriateness of Dosage Regimen of Overall Antibiotics Prescribed at the Pediatric Ward of JUMC from November 1, 2021 to April 30, 2021 (N=665)

Parameters	Antibiotic Regimen	Number	Percentage
Dose	Appropriate	535	80.45
	Inappropriate	130	19.55
Frequency	Appropriate	516	77.59
	Inappropriate	149	22.41
Duration	Appropriate	540	81.2
	Inappropriate	125	18.8
Treatment	Appropriate	536	80.6
	Unnecessary antibiotic	129	19.4

Table 7 Factors Associated with Inappropriate Use of Antibiotics Using Binary Logistic Regression at the Pediatric Ward of JUMC from November 1, 2021 to April 30, 2021

Variables		Appropriateness		COR (95%CI)	P-value	AOR (95%CI)	P-value
		Yes	No
Age	<1 month	51	49	1	0.55
	1 month–1 year (infant)	61	46	0.34 (1.23–2.45)	0.76
	1–5 years	98	34	0.65 (2.43–5.23)	0.75
	6–18 years	50	20	0.54 (3.21–6.23)	0.45
Duration of hospital stay (days)	≤7 days	72	45	1	0.24	1	0.03
	>7 days	217	68	2.45 (2.32–5.34)	0.05	2.21 (2.32–7.64)
Sex	Male	153	69	0.12 (2.56–4.87	0.78
	Female	132	48	1
Antibiotic treatment days	≤7 days	127	48	1	0.23	1	0.02
	>7 days	130	97	2.23 (3.34–5.54)	0.03	2.54 4.34–6.54)
Number of antibiotics prescribed	1	332	149	1	0.084	1	0.01
	≥2	115	69	2.37 (5.32–12.65)	0.02	3.12 (6.32–13.37)
Prescriber	Medical intern	288	52	1	0.26
	Senior	44	20	0.84 (2.65–5.63)	0.45
	Resident	188	73	1.32 (4.32–7.82)	0.74	1
Treatment type	Kinetic/definitive treatment	88	47	1	0.24	1	0.34
	Empirical treatment	299	52	2.21 (3.42–6.84)	0.02	2.65 (4.23–8.87)	0.04
	Prophylactic treatment	55	40	0.91 (4.62–7.74)	0.17	3.12 (6.32–10.23)	0.08
Residence	Urban	74	40	1	0.64
	Rural	231	57	0.45 (2.32–6.73)	0.72
Weight (kg)	<4.9	42	21	1	0.84
	5–9.9	108	48	1.23 (2.76–5.63)	0.52
	10–14.9	40	31	0.93 (3.21–5.65)	0.63
	15–19.9	25	23	0.32 (2.73–6.74)	0.74
	>20	38	26	0.84 (1.74–4.54)	0.73