DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20204540

Antibiotic usage rates in bacterial versus nonbacterial diseases: a new way to monitor hospital-acquired infections in children: a retrospective case analysis

Jayendra R. Gohil, Chintu C. Chaudary, Sheena D. Sivanandan

Abstract


Background: While treating children, the selection of antibiotics, when indicated, should be from the point of its effectiveness, safety, suitability, and cost. However, this flow of action does not take place in all cases. Aim of the study was to assess the antibiotic usage in admitted children and mortality.

Methods: The case records between January to July 2012 in children wards was evaluated for the use of antibiotics. Patients were grouped into; group A- ‘must use' antibiotic in all, and group B- where antibiotics are not indicated.

Results: There were 1852 admissions, including 719 Thalassemia cases. Antibiotic usage was 63% in 1133 cases after excluding thalassemia. Out of 1133 cases, 423 were in group A and 710 cases were in group B. In group B the antibiotic usage was 41%. The mortality was 6.6% and 4.8% in group A and B. Inside group B, mortality was 5.9% versus 4.0% in those administered versus not administered, antibiotics.

Conclusions: There was no increase in mortality in patients in whom antibiotics were not prescribed, and no added benefit of prescribing antibiotics was observed in nonbacterial group B disease patients. The mortality was similar in both the groups. In nonbacterial group B, the antibiotics did not offer any advantage in the reduction of mortality, but increased the cost of the treatment, and possibly the chance of development of drug resistance and adverse events. When analysing the hospital antibiotic usage, only the nonbacterial diseases should be considered to get a true picture of the inappropriate prescription of antibiotics.


Keywords


Antibiotic resistance, Bacterial, Children, Hospital-acquired infections, Inappropriate antibiotic prescribing, Nonbacterial

Full Text:

PDF

References


Sriram S, Mathew L, Devi ASM, Rajalingam B, Ramkumar K, Rajeswari R. Assessment of antibiotic use in pediatric patients at a tertiary care teaching hospital. Indian J Pharm Pract. 2008;1(1):30-6.

Pradeepkumar B, Alameri T, Narayana G, Reddy YP, Ramaiah JD. Assessment of antibiotic prescribing pattern in pediatric patients: a cross-sectional hospital-based survey. CHRISMED J Health Res. 2017;4(4):235.

Mora Y, Avila-Agüero ML, Umaña MA, Jiménez AL, París MM, Faingezicht I. Epidemiologic observations of the judicious use of antibiotics in a pediatric teaching hospital. Int J Infect Dis. 2002;6(1):74-7.

Gerber JS, Newland JG, Coffin SE, Hall M, Thurm C, Prasad PA, et al. Variability in antibiotic use at children’s hospitals. Pediatrics. 2010;126(6):1067-73.

Akande MY, Fergie JE. Antibiotic use and length of stay in children hospitalized with RSV lower respiratory tract infection (LRTI). Pediatrics. 2017;140(1):38.

Ergül AB, Gökçek I, Çelik T, Torun YA. Assessment of inappropriate antibiotic use in pediatric patients: Point-prevalence study. Turk Pediatr Ars. 2018;53(1):17-23.

Kimura Y, Fukuda H, Hayakawa K, Ide S, Ota M, Saito S, et al. Longitudinal trends of and factors associated with inappropriate antibiotic prescribing for non-bacterial ARTI in Japan: a retrospective claims database study, 2012–2017. PLoS One. 2019;14(10):e0223835.

Yoshida S, Takeuchi M, Kawakami K. Prescription of antibiotics to pre-school children 2005-2014 Japan: a retrospective claims database study. J Public Health. 2018;40(2):397-403.