Evaluation of Antimicrobial Use and Adverse Drug Reactions in the Children Admitted to Paediatric Intensive Care Unit of Tertiary Care Hospital of Eastern India: A Prospective Observational Study
Background: Inappropriate antimicrobial use is a matter of increasing concern but suitable antibiotics prescribing practice means using effective, safe, and affordable antibiotics for precise duration. The present study was evaluated to know the use of antibiotics in relation to diagnosis and adverse drug reactions (ADRs) in the pediatric intensive care unit (PICU) of a tertiary hospital of eastern India.
Methods: In present study, 200 children of either sex, up to 12 years age, who admitted in PICU, were studied within a period of 18 months. Baseline demographic and clinical features, hospital stay duration, antimicrobials received, dosing, indications, and details of ADRs were recorded. Every patient was followed up till discharge or death.
Results: Data of total 200 children of PICU admissions, majority were boys (65.0%) and from rural (73.0%) background. Median age was 21 months (interquartile range [IQR] 6-72 months). Approximately similar numbers hailed from nuclear and joint families. Mothers were illiterate in 27.0% and fathers in 24.0% cases. 20.50% children died and the rest were discharged. All studied children of about 100.0% received antibiotics and 96.5% received combination or multiple (two or more) antibiotics. ADRs of at least “possible” causality, were noted in 0.57% instances.
Conclusion: Use of multiple antimicrobials per prescription and heavy reliance on parenteral route merits further exploration. Antimicrobials are mostly used empirically in absence of policy. These findings will hopefully be useful in future for planning long-term and more extensive drug utilization studies in the hospital and in promotion of rational prescribing and drug use. Finally, the baseline data can serve in situation analysis for local antibiotic prescribing guidelines.
Copyright (c) 2020 Dr.Kaushick Mishra
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