Abstract
Introduction: Antibiotics are generally overused in children. Frequent inappropriate use of antibiotics and poor compliance contributes to antibiotic resistance. An observational study was undertaken to determine the pattern of antibiotic use and compliance for common ailments in children attending a tertiary care hospital in Puducherry, South India. Methods: Data was obtained from 197 consecutive children who had visited a health care provider during the previous two weeks for any ailment, in a pretested semi structured questionnaire. Data was entered on MS Excel spreadsheet and analysed using Stata14.0 (Stata Corp, College Station, Tx). Chi square test with Fisher’s modification and logistic regression models were used in the analysis. Results: Acute respiratory infections were the most common infections in all age groups followed by diarrheal disorders in infants and fever in older children. Proportion of illnesses which received antibiotics was 75% for respiratory illnesses, 78% for fever, 50% for diarrheal disorders and 64% for other infections, there being no statistically significant difference between them. Out of 143 children who were prescribed antibiotics, 127 (89%) gave the medicines as prescribed. However, only 53 (37%) completed the full course of antibiotics. Compliance with treatment was not associated with age or the type of illness. Most of the parents (73%) discontinued antibiotics because of worsening of symptoms. Adverse reaction to antibiotics was seen in 32 (22%) children. Conclusion: Overuse of antibiotics for common ailments and poor compliance with treatment were perhaps important contributory causes for development of antimicrobial resistance in this region.
Highlights
This is less than over 80% reported by some investigators, it is higher than that observed in some studies, where the antibiotic prescription rates range from 35% to 65% [12,13,14]
Our study showed that 75% of children with respiratory infections were prescribed antibiotics which is similar to 79.9% observed by Barathyraja et al [20]
Despite World Health Organization (WHO) guidelines for managing diarrheal illness being in practice for several decades, our findings suggest that there continues to be overuse of antibiotics for this condition
Summary
An observational study was undertaken to determine the pattern of antibiotic use and compliance for common ailments in children attending a tertiary care hospital in Puducherry, South India. Conclusion: Overuse of antibiotics for common ailments and poor compliance with treatment were perhaps important contributory causes for development of antimicrobial resistance in this region. Antibiotics are one of the most widely used medications in children, prescribed by both public and private health care providers. Prescription of antibiotics for a sick child is influenced by several factors and shows a wide variation across countries, health care settings, age of the child, season, type of practice, prescribing physicians etc.[3,4,5]. It has been observed that a higher proportion of sick children are prescribed antibiotics compared to sick adults [2, 6]
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