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Evaluation of Prescriptions Containing Antibiotics in Pediatrics, Suffering from Respiratory Tract Infections at Selected Hospitals of Jamshoro and Hyderabad, Pakistan
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A3656 - Evaluation of Prescriptions Containing Antibiotics in Pediatrics, Suffering from Respiratory Tract Infections at Selected Hospitals of Jamshoro and Hyderabad, Pakistan
Author Block: Y. Qureshi1, A. Dayo1, M. Ghoto2, J. Jamali1, F. Panhwar3, S. Rajput1, T. Khan4; 1Pharmaceutics, Pharmacy, Jamshoro, Pakistan, 2Pharmacy Practice, Pharmacy, Jamshoro, Pakistan, 3Pharmacology, Pharmacy, Jamshoro, Pakistan, 4Pharmaceutics, Pharmacy, jamshoro, Pakistan.
Abstract:
Respiratory tract infections (RTIs) refers to various infectious diseases affecting the respiratory tract. These infections can be caused by bacteria, a virus or even fungi. Children represent a large number of population worldwide and comprises of 28% of total world’s population. WHO explain that monitoring the safety of medicine use in children is of prime importance since only limited data is generated through clinical trials as the medicine is available in market for adult, it can be used in children as off-label drug which has been the common practice for decades. Therefore it is not surprising that pediatric patients are at three times higher risk rate for medication error then adults.
The FDA has approved many drugs for adult use that have been tested on adults but not for children. It is also one of the challenging issue in our society that non-medical qualified people, pharmacy keepers are not able to judge the proper use of medicine like dose in the children.
Objectives: To evaluate the frequency of different antibiotics prescribed, to assess the most frequently prescribed antibiotic, to identify the medication errors in prescriptions on the basis of recommended guidelines, to identify the type of antibiotic which is changed due to ineffectiveness. The study also focused to identify the medication errors in prescriptions on the basis of WHO and FDA guidelines.
Material and method: A prospective observational study was performed and prescriptions were collected by random sampling technique from pediatric ward of the hospitals of Jamshoro and Hyderabad. Data was collected from patient’s medication record file and recorded on pre-designed questionnaire and were evaluated for objectives on the basis of authenticated drug references.
Results: From total of 824 patients, 42% were female and 58% were male. Patients with lower respiratory infections were 64.1% and upper respiratory tract infection were 35.1%. Most affected age group is newborn with 29.9% out of total. 31.19% were patients of pneumonia. Most prescribed drug is ceftriaxone with 44.67% and most prescribed combination is cefotaxime and gentamycin. The combination of cefotaxime and gentamycin is greatly changed to cefotaxime and vancomycin. In pneumonia 75.58% of the cases were deviating from the standard line of therapy. In cold and cough antibiotics were prescribed which is against WHO guidelines. 59.7% cases of bronchiolitis were deviating from guidelines.
Conclusion: Results show that significant number of pediatric patients were having prescriptions, deviating from FDA and WHO.
Author Block: Y. Qureshi1, A. Dayo1, M. Ghoto2, J. Jamali1, F. Panhwar3, S. Rajput1, T. Khan4; 1Pharmaceutics, Pharmacy, Jamshoro, Pakistan, 2Pharmacy Practice, Pharmacy, Jamshoro, Pakistan, 3Pharmacology, Pharmacy, Jamshoro, Pakistan, 4Pharmaceutics, Pharmacy, jamshoro, Pakistan.
Abstract:
Respiratory tract infections (RTIs) refers to various infectious diseases affecting the respiratory tract. These infections can be caused by bacteria, a virus or even fungi. Children represent a large number of population worldwide and comprises of 28% of total world’s population. WHO explain that monitoring the safety of medicine use in children is of prime importance since only limited data is generated through clinical trials as the medicine is available in market for adult, it can be used in children as off-label drug which has been the common practice for decades. Therefore it is not surprising that pediatric patients are at three times higher risk rate for medication error then adults.
The FDA has approved many drugs for adult use that have been tested on adults but not for children. It is also one of the challenging issue in our society that non-medical qualified people, pharmacy keepers are not able to judge the proper use of medicine like dose in the children.
Objectives: To evaluate the frequency of different antibiotics prescribed, to assess the most frequently prescribed antibiotic, to identify the medication errors in prescriptions on the basis of recommended guidelines, to identify the type of antibiotic which is changed due to ineffectiveness. The study also focused to identify the medication errors in prescriptions on the basis of WHO and FDA guidelines.
Material and method: A prospective observational study was performed and prescriptions were collected by random sampling technique from pediatric ward of the hospitals of Jamshoro and Hyderabad. Data was collected from patient’s medication record file and recorded on pre-designed questionnaire and were evaluated for objectives on the basis of authenticated drug references.
Results: From total of 824 patients, 42% were female and 58% were male. Patients with lower respiratory infections were 64.1% and upper respiratory tract infection were 35.1%. Most affected age group is newborn with 29.9% out of total. 31.19% were patients of pneumonia. Most prescribed drug is ceftriaxone with 44.67% and most prescribed combination is cefotaxime and gentamycin. The combination of cefotaxime and gentamycin is greatly changed to cefotaxime and vancomycin. In pneumonia 75.58% of the cases were deviating from the standard line of therapy. In cold and cough antibiotics were prescribed which is against WHO guidelines. 59.7% cases of bronchiolitis were deviating from guidelines.
Conclusion: Results show that significant number of pediatric patients were having prescriptions, deviating from FDA and WHO.
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