The Profile of Antibiotic Prescriptions in Pediatric Outpatients: A Retrospective Observational Study

Abstract

Background. Antimicrobial therapy is a common practice in pediatrics.
 Aim. The main objective was to determine and characterize the profile of antibiotic prescriptions in pediatric outpatients.
 Methods. This was a retrospective observational study performed in two pharmacies in Lviv (October 2021). 113 written doctor’s prescriptions for outpatient children were collected.
 Results. Antibiotics were administered for 44.2% (95%CI 34.9%–53.9%) of patients. The main reasons for antibiotic prescriptions were acute tonsillitis (30.0%) and acute upper respiratory tract infections (26.0%). Macrolides, cephalosporins, penicillins, and sulfonamides with trimethoprim presented 40.0%, 36.0%, 20.0%, and 4.0% of antibiotic prescriptions, respectively. Antimicrobials from the Access group accounted for 26.0% of antibiotic prescriptions (instead of at least 60.0%, WHO) and antibiotics from the Watch group constituted 74.0% (instead of a maximum of 40.0%, WHO). Antibiotics were prescribed to 61.9% of outpatients with acute upper respiratory tract infections, 93.7% of patients with acute tonsillitis, and 45.5% – with otitis media instead of recommended 0-20% (ESAC-Net). The first-line antibiotics were used in 23.1% of cases of acute upper respiratory infections, 26.7% of cases of acute tonsillitis, and 40.0% of otitis media, which is below the acceptable range (80–100%, ESAC-Net). In total, 22 antibiotic-associated drug-related problems (DRPs) were found in 34.0% of written doctor’s prescriptions with antimicrobials. The most common were: (1) excessive length of therapy (36.4%) and (2) potential drug-drug interactions (31.8%).
 Conclusions. The rate of antibiotic prescriptions for children is high and associated with different DRPs. The majority of antibiotic prescription quality indicators are outside the recommended ranges. Thus, effective interventions and campaigns to improve antibiotic therapy in children are needed.