Pattern and appropriateness of antibiotic therapy for acute respiratory tract infection among under-five children accessing care in a tertiary facility, Sokoto, Nigeria.

IF 2.3 4区 医学 Q2 PEDIATRICS
Fatima Ishaq Abubakar, Hadiza Kubra Ahmed, Omotolani Olawunmi Akintunde, Idrees Abiodun Rufai
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Abstract

Introduction: Acute respiratory tract infections (ARIs) are a major cause of antibiotic use among under-five (U5) children, often leading to inappropriate prescriptions that contribute to antimicrobial resistance, adverse drug reactions and higher healthcare costs.

Objectives: To assess the pattern and rate of antibiotic prescriptions and evaluate their appropriateness based on WHO and Paediatric Association of Nigeria guidelines for ARI treatment among U5 children at Usmanu Danfodiyo University Teaching Hospital, Sokoto METHODS: A retrospective review of medical records (case folders and prescription sheets) was conducted for U5 children diagnosed with ARI over a 10-month period at the paediatric outpatient and inpatient units, Department of Paediatrics, UDUTH. Data extracted included patient sociodemographic characteristics, ARI diagnosis based on Integrated Management of Childhood Illnesses/WHO criteria and antibiotic/medication details (class, name, route, dose, frequency, duration and regimen). Analysis was performed using SPSS V.20.0; p<0.05 was considered statistically significant.

Results: A total of 2140 drugs and 1545 antibiotics were prescribed, averaging 2.2 and 1.6 per patient, respectively. Upper respiratory tract infections accounted for 66.2% of antibiotic indications. The antibiotic prescription rate was 100.0 %, with 71.0% administered parenterally. Most prescriptions used generic names (96.5%) and were listed in the National Essential Medicines List (100%). Cephalosporins were most frequently prescribed (46.4%), followed by penicillins; fluoroquinolones were least prescribed (1.2%). Mono-antibiotic therapy was used in 53.2% of cases. Notably, 81.5% of prescriptions came from second-line therapies. Appropriate prescribing was observed for duration (93.6%), dose (66.0%), frequency (69.7%) and indication/choice (66.5%).

Conclusion: Despite encouraging adherence to appropriate antibiotic dosage regimen, the high rate of antibiotic prescription, parenteral antibiotic administration and alternative antibiotic use highlights ongoing concerns with risk of resistance, adverse effects and treatment failure. Strengthening antibiotic stewardship and adherence to first-line guidelines is crucial to optimise ARI treatment in resource-limited settings.

Abstract Image

Abstract Image

尼日利亚索科托,在三级医疗机构接受治疗的五岁以下儿童急性呼吸道感染抗生素治疗的模式和适当性。
急性呼吸道感染(ARIs)是五岁以下儿童使用抗生素的一个主要原因,往往导致处方不当,从而导致抗菌素耐药性、药物不良反应和更高的医疗费用。目的:根据世卫组织和尼日利亚儿科协会关于索科托乌斯马努丹福迪约大学教学医院U5岁儿童急性呼吸道感染治疗指南,评估抗生素处方的模式和比例,并评估其适宜性。在10个月的时间里,对UDUTH儿科门诊和住院部诊断为急性呼吸道感染的5岁以下儿童的医疗记录(病例文件夹和处方单)进行了回顾性审查。提取的数据包括患者的社会人口学特征、基于儿童疾病综合管理/世卫组织标准的ARI诊断和抗生素/药物细节(类别、名称、途径、剂量、频率、持续时间和方案)。采用SPSS V.20.0进行分析;结果:共开处方2140种药物,1545种抗生素,平均2.2种/例,1.6种/例。上呼吸道感染占抗生素指征的66.2%。抗生素处方率为100.0%,其中71.0%给药。绝大多数处方使用通用名(96.5%),被列入《国家基本药物目录》(100%)。最常见的处方是头孢菌素(46.4%),其次是青霉素类;使用氟喹诺酮类药物最少(1.2%)。53.2%的病例使用单一抗生素治疗。值得注意的是,81.5%的处方来自二线疗法。处方持续时间(93.6%)、剂量(66.0%)、频率(69.7%)和适应症/选择(66.5%)均符合处方要求。结论:尽管鼓励遵守适当的抗生素剂量方案,但抗生素处方、肠外抗生素给药和替代抗生素使用的高比例突出了持续存在的耐药性、不良反应和治疗失败风险。加强抗生素管理和遵守一线指南对于在资源有限的环境中优化急性呼吸道感染治疗至关重要。
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来源期刊
BMJ Paediatrics Open
BMJ Paediatrics Open Medicine-Pediatrics, Perinatology and Child Health
CiteScore
4.10
自引率
3.80%
发文量
124
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