Evaluation of antibiotic prescriptions and use in under-five children in Ibadan, SouthWestern Nigeria

Abstract

BackgroundIrrational antibiotic prescriptions for children is a global concern requiring periodic evaluation and monitoring.ObjectivesTo assess appropriateness of antibiotic prescribing for under-five children, as well as evaluating mothers' usage of antibiotics for their under-five and reason(s) for use.MethodCross-sectional review of out-patient case-notes of under-five using principles of antibiotic prescribing and a questionnaire-guided interaction with under-five mothers.ResultsNearly all (445;98.9%) antibiotic prescriptions were based on signs and symptoms indicative of bacterial infection. Only 3(0.7%) had the initial antibiotic regimen modified. Nine (2.0%) had documented evidence of sensitivity test requested before antibiotic prescribing. Presence of infection or need for antibiotic therapy was established in 190(42.2%). Majority (324;72.0%) of mothers had administered antibiotics to their under-five. Of these, 157(48.5%) were prescribed by physicians and 79(24.4%) were self-recommended. Educational status of mothers significantly influenced antibiotic usage.ConclusionAntibiotic prescriptions for under-fives was largely based on symptoms indicative of bacterial infections, thereby corroborating the widespread empirical antibiotic prescribing. Considerable number of mothers engaged in self-recommendation of antibiotics for their under-fives. Thus, there is a need for continuous enlightenment of prescribers and mothers on rational use of antibiotics, while microbiological confirmation of clinical diagnosis is encouraged for evidence-based antibiotic prescribing.

Antibiotic Prescribing Patterns in Paediatric Patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

“…The studies in the following countries also found antibiotic prescribing to be high; in India by Majhi The most common antibiotic class that were prescribed were penicillins followed by cephalosporins. This is even though most bacteria are resistant against penicillins [36]. These findings are in agreement with what was found in studies that were done in Ethiopia, Cameroon, Nigeria, and Iraq [24,29,36,37].…”

“…This is even though most bacteria are resistant against penicillins [36]. These findings are in agreement with what was found in studies that were done in Ethiopia, Cameroon, Nigeria, and Iraq [24,29,36,37]. These similarities in the findings could be due to the availability of these drugs in these various hospitals and hence their use.…”

“…In this study, it was found that age, White Blood Cell (WBC) count status and system of illness were significantly associated with the use of antibiotics as shown in Table 3. Similar to these findings, studies that were done in India and Nigeria also found that these factors are associated with the use of antibiotics [18,36]. The age of paediatric patients was a factor that could influence the use of antibiotics.…”

Use of antibacterials in the management of symptoms of acute respiratory tract infections among children under five years in Gulu, northern Uganda: Prevalence and determinants

“…However, the inadequate enforcement of regulation of access to antibacterials especially in the private sector coupled with nonfunctional microbiology laboratories in most health facilities could be responsible for the high antibacterial use in children with symptoms of ARIs observed in this study. The high antibacterial resistance selection pressure created by high antibacterial use is a potential driver of resistance emergence and spread (20), further diminishing the already limited choices of antibacterial therapy for infectious diseases especially in LMICs (10). The high prevalence of antibacterial use reported in this study is similar to reports of previous studies done in LMICs [3,[7][8][9][20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”

La resistencia a los antibióticos: un problema muy serio

“…Muchas de las prescripciones de antibióticos se realizan en forma empírica, superando en diversos estudios un 50% de los casos [17,18] . Adicionalmente, se debe considerar que cerca de una tercera parte a la mitad de las prescripciones de antibióticos son por infecciones del tracto respiratorio; y siendo la mayor parte de estas infecciones de origen viral, está demostrado que los antibióticos no afectan la duración, los síntomas y la intensidad de la enfermedad.…”