ANTIBIOTIC PRESCRIBING PRACTICES IN PEDIATRIC INTENSIVE CARE UNITS: A CROSS-SECTIONAL STUDY FROM ABBOTTABAD, PAKISTAN

Abstract

The misuse of antibiotics is a global concern, with potential consequences including illness, death, and increased healthcare costs. Ensuring appropriate antibiotic use is crucial and should be integrated into pharmaceutical care plans. This study evaluated the prescribing trends of inappropriate antibiotic use among children under 12 years old in both public and private hospitals in District Abbottabad, Pakistan. The study conducted a prospective clinical assessment of antimicrobial drug utilization patterns using Patient Bedside Files (PBF) and Culture Sensitivity Test (CST) reports. Two key indicators were used to assess antibiotic prescribing: prescribed dose and indication for use. Antibiotic resistance was assessed for 25 selected antibiotics. Findings showed that in the private sector hospital, 75% of neonates, 14.5% of infants, and 10% of children in the ICU received antibiotics, but only 57% of neonates, 62% of infants, and 55.9% of children had valid indications. Additionally, 27% of neonates, 19% of infants, and 22.1% of children received under-dosed antibiotics, potentially contributing to antimicrobial resistance and increased hospitalization costs. Rational dosing was observed in only 29% of neonates, 30% of infants, and 36.8% of children. In public sector hospitals, antibiotics were administered to 65.6% of neonates, 19.4% of infants, and 15% of children, with valid indications found in 35% of neonates, 41% of infants, and 35% of children. The irrational use of antibiotics was high (over 50%) in the public sector hospital across all age groups, while in the private sector hospital, it was closer to 50%. The prescription rates of certain antibiotics exceeded 80% in both hospitals, with Amoxicillin, Penicillin, Erythromycin, and Cephalexin showing a higher resistance rate of 49.2%.