Drug prescribing pattern for under-fives in a paediatric clinic in south-western Nigeria

Abstract

BACKGROUND: The audit of drug prescribing pattern in under-five children is essential in identifying the various types of non-rational prescribing such as polypharmacy and irrational use of antimicrobials. The primary objective of this study was to determine the drug prescribing pattern for children aged below five years attending the paediatric outpatient clinic of a tertiary hospital in Ado-Ekiti, South-West Nigeria. METHODS: A cross-sectional study was carried out using the medical records of patients who attended the paediatric clinic of the hospital between April 1 and October 30, 2013. The medical records of patients aged below five years were selected monthly for the period of the study using a regular interval ratio. Drug use indicators were assessed using the WHO guidelines on investigation of drug use in health care facilities. RESULTS: There were 293(55.7%) prescriptions collected from male patients and 233(44.3% from female patients with a total of 1369 prescribed drugs (2.6 ± 1.1 drugs per prescription). A total of three hundred and seventy-four (71.1%) patients had at least one antibiotic prescribed with antibiotics accounting for 28.2% of all drugs prescribed, while 13.5% of all encounters had an injection prescribed. Prescribing by generic name was done in 68.9 ± 26.5% of all prescribed medications, and 60.4% of all prescribed medications were from the latest version of the Nigerian Essential Drug List. Three hundred and twelve children (59.3%) had at least one anti-malarial drug prescribed while analgesics drugs accounted for 6.1% of all prescriptions. CONCLUSION: This study showed that over-prescription of antibiotics, significant use of injections and prescribing by generic name are real issues among Nigerian paediatric prescribers.

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

“…The need for prompt and effective treatment of malaria and infections in patients presenting in the clinic may explain this relatively low level of Proguanil prescription during the acute phase of illness. The artemisinin-based combinations (Artesunate-Amodiaquine and Artemeter-Lumefantrine) were the most commonly used antimalarial drugs in keeping with findings from other Nigerian studies17,40.…”

“…For the under-fives in this study, the mean of prescribed drugs was 4.9 much higher than 2.6 and 3.1 reported in other Nigerian studies conducted among children younger than five years of age17,26. Similar findings have also been reported in studies conducted among children in India, Oman and Italy with a mean number of prescribed drugs 2.3, 2.3 and 3.1 respectively27–29.…”

“…This difference may be due to the fact that the latter study included both paediatric and adult patients with SCD with different profiles of clinical sickling syndromes and co-morbidities. Antibiotic prescribing reported in some studies among non-SCD patients range between 28% and 33.3% and this is much higher than what is found in this study 17,31,32. This may also be due to the approach of clinicians towards management of febrile illness in children with unjustified prescription of antibiotics.…”

“…In patients with SCD, a prescription audit would give information about types of analgesics, antibiotics and anti-malarial drugs prescribed for patients. Some prescription audits have previously been conducted among children attending the children outpatient clinics of secondary and tertiary healthcare centres in Nigeria,15–17 but to the knowledge of the authors this is the first study on drug prescribing pattern among paediatric SCD patients. The main objective of this study was to assess the pattern of drug prescription in children with SCD attending a paediatric outpatients' clinic of a tertiary care centre in Ado-Ekiti, South-West Nigeria.…”

Determinants of antibiotic prescription in paediatric patients: The case of two hospitals in Maputo, Mozambique

“…A similar picture was found in Ethiopia [14] and Nigeria. [15] Possible explanations include drug availability, the presence of nonspecific infections, such as upper respiratory tract infections, empirical treatment, and prophylactic use. [17][18][19] Empirical treatment and prophylactic use seem to be an effective solution for treatment, but they are frequently associated with poor clinical responses and the selection of antibiotic-resistant bacteria.…”