EVALUATION OF CRYSTALLINE PENICILLIN UTILIZATION IN PEDIATRICS WARD OF TERTIARY CARE HOSPITAL OF EASTERN ETHIOPIA: THE CASE OF HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL

Abstract

Background: Crystalline penicillin is one the commonly prescribed antibiotics that has been used for the treatment of certain susceptible bacterial infections over several years in Ethiopia. However, little is known about the appropriateness of clinical indication, dose and frequency of administration, duration and therapeutic outcome of patients in general and pediatrics in particular. Therefore, the study aimed to evaluate the rational use of crystalline penicillin injection in pediatrics ward of Hiwot Fana Specialized University Hospital (HFSUH), Eastern Ethiopia. Methods: Retrospective cross sectional study was employed for evaluating medication records of hospitalized pediatric patients who received crystalline penicillin from Dec 1, 2015- Feb 29, 2016 at pediatrics ward of HFSUH. Based on Joint Commission on Accreditation of Healthcare Organizations (JCAHCO) criteria, 114 medical records (20%) were selected by systematic random sampling from the total of 570 records. The study was conducted from Mar 1-Mar 15, 2016. Besides, the data were evaluated against Standard treatment guideline (STG) of Ethiopia for general hospitals and World Health Organization (WHO) drug use evaluation guideline Results: Among the 114 medical records of pediatric patients included in the study, the dose and frequency of administration, contra-indications and drug interactions of crystalline penicillin were according to the STG of Ethiopia for general hospitals, and WHO Guidelines for the management of common illnesses in children in areas with limited resources. All the 114 (100%) cases were consistent with guidelines for contra-indications and drug interaction of crystalline penicillin use. Moreover, 108(94.74%) and 112 (98.24%) of the cases were in accordance with the guidelines for the dose and frequency of administration, respectively. However, 93 (81.58%), 59 (51.75%) and 59 (51.75%) of the patient cases were not according to the guidelines of crystalline penicillin use for indications, duration and outcome of therapy, respectively. Conclusion: Crystalline penicillin utilization pattern in pediatric ward of HFSUH has fully adhered to the STG of Ethiopia for general hospitals and WHO Guideline for the majority of the parameters with regard to dose and frequency of administration, contraindications, and drug interactions as well as met the thresholds set for most of the DUE criteria. However, indication, duration and outcome of therapy were not in accordance with the guideline. Keywords: Drug use evaluation; Pediatrics; medication records; crystalline penicillin; Standard treatment Guidelines; World Health Organization