Antibiotic consumption among hospitalized neonates and children in Punjab province, Pakistan

ABSTRACT

Background

Periodic surveillance of antibiotic consumption in the form of point prevalence studies is a quick and robust methodology to evaluate prescribing trends in hospitals. The current study was undertaken to document antibiotic consumption among neonates and children from hospitals in Pakistan.

Methods

This large multicenter study using the World Health Organization standardized methodology and AWaRe (Access, Watch, and Reserve) classification examined antibiotic consumption for suspected bacterial infection among neonates and children admitted hospitals in Punjab, Pakistan.

Results

A total of 708 beds of children wards of the 16 health facilities were examined. Almost all (97%) hospitalized children were prescribed antibiotics on the day of the assessment with 2.6 antibiotics per patient. The three most common indications were respiratory tract infections (31.58%), sepsis (26.52%), and prophylaxis for medical problems (10.30%). The three most frequently prescribed antibiotics were ceftriaxone (24.2%), amikacin (23.2%), and ampicillin (16.7%). Almost half of the antibiotics were prescribed from the ‘Access’ (49.5%) and ‘Watch’ (45.5%) categories under the AWaRe classification. However, no antimicrobial was prescribed from the ‘Reserved’ category.

Conclusions

Our findings indicate that empirical antimicrobials use among hospitalized children is highly prevalent in Pakistan. The utilization of ‘Watch’ category of antimicrobials is frequent, stressing immediate action.

KEYWORDS:

• Antimicrobials
• antibiotics
• children
• empirical use
• pakistan
• point prevalence
• prescribing
• surveillance

Author contribution statement

ZUM and MS made substantial contributions to the study design, data collection, data analysis, interpretation of the results, and manuscript drafting. MY, HAM, MK, MI, MBR, were involved in data collection and interpretation. BG, KH and SSH revised the manuscript for important intellectual content including English language. All authors have read and approved the final version of the manuscript.

Acknowledgments

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

Declaration of interests

No potential conflict of interest was reported by the author(s).

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/34. 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.

Data availability

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

Supplental material

Supplental material can be accessed here

Additional information

Funding

This paper was not funded.