Prescribing pattern of antibiotics in paediatric hospital of Kathmandu valley.

Abstract

INTRODUCTION Antibiotics are among the most commonly prescribed drugs in paediatrics. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use is of growing concern and strict antibiotic policies should be warranted. Before such policies can be implemented, detailed knowledge of antibiotic prescribing practice is important. OBJECTIVE The main objective is to study the prescribing practice of antibiotic in hospital in-patient. METHODS A prospective follow up study of one and half month's duration was undertaken during November- December of 2003. A total number of 121 patients were taken for the study. RESULTS The average number of drugs per patient was 5.01+/-1.36 and antibiotics per patient was 2.41+/-1.02. More than 98% of the patients were exposed to, at least, two drugs. Among 121 patients clinically diagnosed with infectious diseases and treated with antibiotics, specimens were taken for culture in only 24 cases i.e. (19.8%) to identify pathogenic organisms. Only 13 specimens showed positive culture results. Infants less than 1 year received antibiotics more frequently than 1-5 and 5-12 years (40, 31 and 29%, P<0.001, P=0.000). Seventy-five percentage of the total antibiotics were administered parentrally. Cephalosporin was the top most frequently prescribed antibiotics followed by penicillin group. Significant difference was found between age group of patient and disease encountered (chi2 = 42.95, P=0.000). CONCLUSION The fact that children below 1 year or infants are at special risk of receiving multiple courses of antibiotics, together with the knowledge that antibiotic resistance develops in this setting; suggest that strategies to control antibiotic use should focus on these patients' populations.

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