Antibacterial prescription pattern and adverse drug reactions in childhood pneumonia

Abstract

Background: Antibacterial drugs play an important role in the treatment of Pneumonia-a leading cause of death globally among children. To determine the class, dosing schedule, Adverse Drug Reactions (ADRs), selection criteria and World Health Organisation (WHO) prescribing indicators of antibacterials used for pneumonia. Methods: Following the Institutional Review Board (IRB) clearance, 18 months long descriptive study was conducted among 432 paediatric patients admitted with Pneumonia in a tertiary care center. Details on antibacterial prescription with selection criteria and associated ADRs were collected. Causality, preventability and severity of ADRs were assessed. WHO prescribing indicators were calculated. Data analysed using SPSS software. Results: Aminopenicillins (61.2%)  were the major antibacterial class prescribed and the major antibacterial was Ampicillin (34.6%) with dosage regimen 32-66 mg/kg Intravenously four times daily (34.4%) with mean treatment duration 3.6±1.26 days. Major route of administration was intravenous (57%) and 99% patients received empirical treatment. The ADRs reported were Gentamicin & Ampicillin induced Hypersensitivity reactions and Vancomycin induced Redman Syndrome. WHO prescribing indicators: Average number of antibacterials per encounter 2.42, Antibacterials prescribed by generic name 96.56%, Encounters with injection 98.37%, Antibacterials from Essential Medicines List (EML) 90.9%. Conclusions: Aminopenicillins were the major antibacterial class, Ampicillin was the major antibacterial, Inj. Ampicillin 32-66 mg/kg intravenously four times daily with mean duration 3.6±1.26 days was the commonest dosage regimen prescribed. Most antibacterials were from EML, prescribed in generic name, selected empirically and administered intravenously.  Three ADRs were reported. Prescribing indicators were calculated