Trends in prescribing antibiotics for hospitalized children with respiratory tract infections in Mosul region

Abstract EN

Background : The appropriate choice of antibiotics is a complex procedure that requires clinical judgment and detailed knowledge of pharmacological and microbiological factors.

The irrational prescribing of antibacterial drugs will lead to the emergence of bacterial resistance which in turn led to the development of adverse effects ; in addition to that, the irrational use of antibiotics is cost effective.

The principles of appropriate and effective antibiotic prescribing are widely and simply outlined but practically they are difficult to implement, thus the treatment with antibiotics should be reviewed to lower the irrational use of those drugs.

Aim : To determine the extent and the rationale of antibiotic prescriptions for pediatric patients admitted with different respiratory tract infections in Mosul pediatric hospitals and to discuss the pressure on physicians and health staff to overuse of antibiotics.

Patients and Methods : A prospective observational study was conducted on 232 hospitalized pediatric patients with respiratory tract infections, those patients selected randomly from Ibn-alatheer and al-Khansaa pediatric hospitals, their age range from (0-11 years).

The antibiotic prescriptions of patients were collected over a period of 6 months and then analyzed to determine the antibiotic prescription habits of medical staff in Mosul.

Results : two hundred thirty two pediatric patients were under study, admitted with pneumonia (20 %), bronchitis (18 %), lower respiratory tract infection and asthmatic patient with chest infection (15 %) and (16 %) respectively.

About (11 %) of patients under study received antibiotics without documented reason.

(74 %) of children receive prescription of one antibiotic and the remaining (26 %) prescribed a combinations of two antibiotics.

Total of (304) antibiotic drugs were prescribed, with high prescription rate for Ampiclox (50 %) and Cefotaxime (29 %).

The off-label status of antibiotic prescription is determined for diagnosis, age, route and dose with most frequently off-label antibiotic prescription for diagnosis (different indication) which is (64 %).

Conclusion : The study demonstrated that, high percentage of antibiotic prescriptions for pediatric patients with respiratory infections is inappropriate and this mainly due to prescribing of antibiotics for conditions caused by viral infection, thus an education strategies are required for both physicians and pharmacists to diminish the effect of the problem.