Identification of Drug-Related Problems on Beta Lactam Antibiotics Used for Pediatric at a Secondary-Care Hospital in Cimahi

Abstract

WHO estimated that >50% of medicines are used inappropriately. One that posess highest risk due to inappropriate use is beta-lactam antibiotic, espescially in pediatric patient since the organ function in pediatric patient has not fully developed as in adult yet. This cross-sectional study was performed to identify drug-related problems (DRPs) occurred during beta-lactam therapy in pediatric hospitalized in a secondary-care hospital in Cimahi. A predetermined medication-use criteria based on the current literatures was created as an assessment standard tools. Furthermore, identification of DRPs based on PCNE v6.2 classification was carried out concurrently (January-March 2015) to 351 patients. As many as 458 DRPs were found including 22 cases inappropriate drugs (category C1.1), 127 cases no indication for drug (C1.2), 42 cases inappropriate combination of drugs, or drugs and food (C1.4), 1 case of too many drugs prescibed for indication (C1.6), 137 cases drug dose too low (C3.1), 89 cases drug dose too high (C3.2), 39 cases duration of treatment too short (C4.1), and 1 case of duration of treatment too long (C4.2). The potential DRPs was estimated to be occured for approximately 1-2 DRPs per patient.Keywords: drug-related problems; beta-lactam antibiotic; pediatric; pharmaceutical care

Drug-related problems (DRPs) on antibiotic therapy in pediatric patients: a review

“…Underdose is more common than overdose. Zazuli et al 17 reported that the highest incidence of DRP is a mismatch of therapeutic doses where 30% of patients with diarrhea received doses of antibiotics that are smaller than those that should be recommended for therapy. A study concerning the use of antibiotics in pediatric patients in District General Hospital, Semarang reported that among 28% of patients experiencing DRPs in the form of underdose.…”

“…21 Whereas a study in in a Secondary Care Hospital in Cimahi, West Java reported that the antibiotic therapy without indication is 27.73%. 17 Majority antibiotics were empirically prescribed without microbial culture and antibiotic sensitivity test. The antibiotics were prescribed mostly for fever or symptoms associated with the upper respiratory tract infections which commonly caused by viral infections.…”

“…Furthermore, amoxicillin, ampicillin, ampicillin-sulbactam, cefixime, cefotaxime, ceftazidime, ceftriaxone were prescribed for noninfectious diagnosis such as perinatal asphyxia, asthma, cerebral palsy, colic, dehydration, thalassemia, suspected epilepsy, unspecified febrile. 17 Adherence Adherence is the patient unable or unwilling to take medication decisions as instructed. 1 Antibiotic adherence is an important issue in pediatric infection management.…”