Antibiotic Prescription Pattern, Appropriateness, and Associated Factors in Patients Admitted to Pediatric Wards of Tibebe Ghion Specialized Hospital, Bahir Dar, North West Ethiopia

Abstract

Irrational prescribing of antibiotics leads to the emergence of resistant bacteria. Despite this fact, antimicrobial agents are commonly prescribed in the inpatient setting, especially in infants and children. The aim of this study was to assess the pattern of antibiotic prescription, appropriateness, and associated factors in pediatric wards of Tibebe Ghion Specialized Hospital (TGSH), Bahir Dar, North West Ethiopia, September 11th, 2021 to October 12th, 2021 GC (Gregorian Calendar). An institution-based cross-sectional study was conducted in the pediatric wards of TGSH from September, 2020 to August, 2021 GC. Data were collected using a structured checklist containing each patient's socio-demographic characteristics, clinical information, list of prescribed drugs, and reason for prescription. A systematic random sampling technique was used to select pediatric patients' medical records containing prescribed antibiotics. The collected data were entered and analyzed using SPSS version 25 software. A total of 279 pediatric patients' medical cards including at least one antibiotic were reviewed. The study revealed that antibiotics were prescribed for most of the patients (88.9%) for empiric treatment purposes. The main medical conditions for which antibiotics were prescribed were pneumonia (16.8%) and early-onset neonatal sepsis (14.0%). Ceftriaxone was the most widely used (84.9%) antibiotic among the monotherapeutic antibiotics, while ceftriaxone plus metronidazole (23.5%) was the most frequently used combination of antibiotics. A high proportion (30.8%) of the pediatric patients was exposed to inappropriate treatment. Residence in rural areas (P=0.046) and being 1 year old or younger (P<0.05) were found to be independent determinants of inappropriate drug use. Antibiotics were the most prescribed class of medications for pediatric patients in TGSH. Ceftriaxone and ampicillin were the most frequently prescribed antibiotics in the pediatric wards of TGSH. A high proportion of patients had been exposed to inappropriate antibiotic treatment. Early age and rural residence were found to be the factors that were significantly associated with inappropriate antibiotic utilization.