Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

Background: Enteric fever is a major public health problem in developing countries like India. It affects all age groups but young children are at highest risk. Timely management with appropriate antimicrobial therapy can reduce both morbidity and mortality. In recent years, the emergence of antimicrobial resistance is a significant challenge. Therefore, this study was undertaken to study antibiotic sensitivity pattern of the Salmonella isolates. Aims and Objectives: The aims of this study were to estimate the prevalence of resistance to commonly used antibiotics in the Salmonella isolates. Materials and Methods: Children between 6 months and 14 years of age admitted for fever and whose blood culture was positive for Salmonella Typhi or Salmonella Paratyphi A, B, or C were included in the study over a period of 2 years (August 2018–July 2020). Results: There were 155 patients of enteric fever whose blood culture results were positive for S. Typhi/S. Paratyphi who were included in the study. Out of the 155 culture positive cases, S. Typhi was isolated in 135 (87.1%), S. Paratyphi A in 16 (10.3%) and S. Paratyphi B in 4 (2.6%) cases. All the 135 isolates of S. Typhi were sensitive to cephalosporins. High rate of sensitivity was noted for the first-line drugs – amoxicillin, ampicillin, and trimethoprim-sulfamethoxazole. All 16 isolates of S. Paratyphi A were sensitive to cephalosporins. All the isolates of S. Paratyphi B tested were sensitive to cephalosporins, azithromycin, nalidixic acid, and trimethoprim-sulfamethoxazole. Conclusion: At present, there is low prevalence of resistance to first-line drugs and third-generation cephalosporins and high resistance to fluoroquinolones, nalidixic acid, and azithromycin as noted in this region. Rational antibiotic selection should be based on sensitivity pattern to prevent emergence of resistant strains.

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.

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