EVALUATING PAEDIATRIC ANTIBIOTIC USE: PREVALENCE OF DRUG-DRUG INTERACTIONS AND THE NEED FOR ANTIMICROBIAL STEWARDSHIP
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Keywords
Antibiotic resistance, Paediatric infections, Drug-drug interactions, Antimicrobial stewardship, Ceftriaxone, Antibiotic prescribing patterns
Abstract
Background: Antimicrobial resistance (AMR) is a growing global health crisis, with paediatric populations particularly vulnerable to inappropriate antibiotic use. This study aimed to evaluate antibiotic prescribing patterns, the prevalence of drug-drug interactions (DDIs), and the extent of microbiological testing among paediatric inpatients.
Methods: A prospective observational study was conducted over six months in the paediatric department of Varun Arjun Medical College & Rohilkhand Hospital. A total of 150 paediatric inpatients receiving antibiotic therapy were included. Data on demographics, infection type, prescribed antibiotics, dosage forms, DDIs, and antibiotic sensitivity testing were collected and analyzed. Descriptive statistics were used to assess prescribing patterns and interactions.
Results: Among the 150 enrolled patients, males (56.00%) were more predominant than females (44.00%). The majority (55.33%) were aged 1-11 years. Respiratory tract infections (RTIs) (33.00%) were the most common indication for antibiotic therapy, followed by gastrointestinal infections (24.66%). Ceftriaxone (24.66%) was the most frequently prescribed antibiotic. Injectable formulations (91.30%) were preferred over oral formulations. A total of 26.70% subjects were found to have drug-drug interactions (DDIs). Only 6.70% of patients underwent antibiotic sensitivity testing, highlighting a gap in microbiological confirmation before antibiotic initiation.
Discussion: The findings emphasize the overuse of broad-spectrum antibiotics and the low rate of microbiological testing in paediatric patients, raising concerns about AMR. The high prevalence of DDIs underscores the need for enhanced pharmacovigilance and integration of electronic prescribing systems to monitor interactions. The lack of institutional guidelines for paediatric antibiotic use contributes to inconsistent prescribing patterns, necessitating implementing antimicrobial stewardship programs (ASPs) to optimize antibiotic selection and minimize resistance risks.
Conclusion: This study underscores the need for standardized institutional guidelines and antimicrobial stewardship programs to ensure judicious antibiotic use in paediatric inpatients. Enhancing microbiological testing, implementing electronic prescribing systems, and promoting transition from injectable to oral therapy can significantly improve antibiotic prescribing practices and reduce AMR risk.
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Dr Gaurav Mishra
Assistant Professor, Department of Paediatrics, Varun Arjun Medical College & Rohilkhand Hospital, Shahjahanpur, Uttar Pradesh, India
Dr Shweta Mishra
Assistant Professor, Department of Biochemistry, Varun Arjun Medical College & Rohilkhand Hospital, Shahjahanpur, Uttar Pradesh, India