A clinical audit to evaluate antibiotic prescribing practice in pediatric patients admitted for enteric fever. Rationalizing antibiotic stewardship program | [Pakistan Journal of Pharmaceutical Sciences • 2022]

Author(s):

1. Muhammad Numan Zahid: Pediatric Medicine Department, Services Hospital,Lahore,Pakistan

2. Fatima Naheed: Shalamar Hospital,Lahore,Pakistan

3. Iftikhar Ali: Pediatric Medicine Department, Services Hospital,Lahore,Pakistan

4. Muhammad Nabeel Hassan: Pediatric Medicine Department, Services Hospital,Lahore,Pakistan

5. Ayesha Shahid: Shaikh Zayed Hospital,Lahore,Pakistan

6. Maryam Shahid: Mayo Hospital,Lahore,Pakistan

7. Iram Asghar Gill: Sahiwal Medical College,Sahiwal,Pakistan

8. Usman Asghar: Pediatric Medicine Department, Services Hospital,Lahore,Pakistan

9. Abdullah Hussain: Pediatric Medicine Department, Services Hospital,Lahore,Pakistan

Abstract:

To evaluate the antibiotic prescribing practice in pediatric patients for enteric fever, and to assess the need of developing and implementing the Antibiotic Stewardship Program (ASP) for the hospital. A prospective audit was completed in the pediatric ward of tertiary care hospital of Lahore for one year. Blood culture reports were collected from microbiology departed and clinical data were assessed regarding the choice of antibiotics, frequency, dosage and clinical outcome. All the statistics were analyzed using SPSS software and compared with the guidelines. Out of 157 cases hospitalized with suspicion of enteric fever, 137 cultures were positive for salmonella. Monotherapy of ceftriaxone (70%) was prescribed mostly as empirical therapy. About 20% of patients received a combination of antibiotics empirically. Susceptibility reports showed only 7 cases were of non-resistant typhoid, 15 multi-drug resistant and 115 extensively drug-resistant. Nearly 46% of patients were discharged earlier whose empirical therapy was changed either before or promptly after susceptibility reporting. Commonly used definitive antibiotics (32%) were a combination of azithromycin and meropenem. Inappropriate use of antibiotics was noted frequently as compared to the guidelines. However, recommendations themselves need to be reviewed as antibiotic resistance patterns are changing drastically.

Page(s): 993-997

DOI: 10.36721/PJPS.2022.35.4.REG.993-997.1

Published: Journal: Pakistan Journal of Pharmaceutical Sciences, Volume: 35, Issue: 4, Year: 2022

Keywords:

Typhoid fever , Clinical audit , antibiotic protocols

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