Evaluation of antibiotic prescribing and treatment outcomes among paediatric patients to tertiary care hospital Ajman, United Arab Emirates.
Main Article Content
Keywords
Infectious Disease Trends, Treatment Outcomes, paediatric patients, Antimicrobial resistance
Abstract
Background: Infectious diseases and antimicrobial resistance are profoundly impacted by the extensive use of antibiotics, raising significant global concerns. Objectives: This study’s primary objective is to assess antibiotic usage in pediatric patients admitted to a tertiary care hospital for various infectious diseases, evaluating treatment outcomes, adverse events, de-escalation duration, and duration of hospitalization. Methodology: A retrospective study was conducted during from January 2022 to April 2023, at a tertiary care facility in Ajman, United Arab Emirates. Data was collected by physically reviewing patients’ medical records/files, with eligibility based on predefined criteria for paediatric patients with infectious diseases. Results: A total of 200 paediatric participants were included in this study. The age distribution showed that most participants fell into the age groups of 3 to 5.9 years (35.0%) and 6 to 8.9 years (29.0%), rest 36.0% aged between 9 and 12 years old. Body Surface Area (BSA) ranged from 0.40 to 1.89 m2, with the majority (61.0%) ranges in-between 0.40 - 0.89 m2. Fever was the most recorded symptom in 196 (98%) patients followed by cough (150; 75%) and sore throat (146; 73%). Among the male participants (n=68), many infections were bacterial (88.2%), followed by viral (3.8%), bacterial and viral co-infections (2.5%), and parasitic infections (1.3%).The data reveals a relatively even distribution of re-admissions within 30 days among patients on combination therapy and monotherapy, with no significant difference (p = 0.643). Conclusion: The study concluded limited practices of culture & sensitivity testing prior to initiation of antibiotic prescribing. The study also reported high success rate among the study population. The combination or monotherapy prescribing has no impact on the clinical outcomes of the study
References
8;430(6996):242-9.
2. Institute of Medicine (US) Committee on Emerging Microbial Threats to Health in the 21st Century.Microbial Threats to Health:
Emergence, Detection, and Response. Smolinski MS, Hamburg MA, Lederberg J, editors. Washington (DC): National Academies
Press (US); 2003. PMID: 25057653.
3. Binder S, Levitt AM, Sacks JJ, Hughes JM. Emerging infectious diseases: public health issues for the 21st century. Science. 1999
May 21;284(5418):1311-3. doi:10.1126/science.284.5418.1311.
4. Ording AG, Sørensen HT. Concepts of comorbidities, multiple morbidities, complications, and their clinical epidemiologic
analogs. Clinical epidemiology. 2013 Jul 1:199-203.
5. Holman RC, Folkema AM, Singleton RJ, Redd JT, Christensen KY, Steiner CA, et al. Disparities in infectious disease hospitalizations
for American Indian/ Alaska Native people. Public Health Rep. 2011 Jul-Aug;126(4):508-21. doi: 10.1177/003335491112600407.
6. Saliba W, Fediai A, Edelstein H, Markel A, Raz R. Trends in the burden of infectious disease hospitalizations among the elderly
in the last decade. European Journal of Internal Medicine. 2013; 24(6), 536-540. doi.org/10.1016/j.ejim.2013.06.002
7. Nardi R, Scanelli G, Corrao S, Iori I, Mathieu G, Amatrian R C. Co-morbidity does not reflect complexity in internal medicine
patients. European journal of internal medicine. 2007; 18(5), 359-368. doi.org/10.1016/j.ejim.2007.05.002
8. Alsulami Z, Conroy S, Choonara I. Medication errors in the Middle East countries: a systematic review of the literature. European
journal of clinical pharmacology. 2013 Apr; 69:995-1008.
9. Mathew R, Sayyed H, Behera S, Maleki K, Pawar S. Evaluation of antibiotic prescribing pattern in pediatrics in a tertiary care hospital. Avicenna Journal of Medicine. 2021 Jan;11(01):15-9.
10. Ghei P. How to investigate drug use in health facilities? Selected drug use indicators: WHO publications, Geneva, 87 pp., 1993. Health Policy. 1995;34(1):73-1.
11. Anderson H, Vuillermin P, Jachno K, Allen KJ, Tang ML, Collier F et. al., Prevalence and determinants of antibiotic exposure in
infants: A population-derived Australian birth cohort study. Journal of paediatrics and child health. 2017; 53(10), 942–949. https://doi.org/10.1111/jpc.13616
12. Biezen R, Pollack AJ, Harrison C, Brijnath B, Grando D, Britt HC, et. al., Respiratory tract infections among children younger than 5 years: current management in Australian general practice. Medical Journal of Australia. 2015; 202(5), 262-265.
13. Thiruthopu NS, Mateti UV, Bairi R, Sivva D, Martha S. Drug utilization pattern in south Indian pediatric population: A prospective
study. Perspect Clin Res. 2014; 5:178–83.
14. Freedman J, Leibovitz E, Sergienko R, Levy A. Risk factors for hospitalization at the pediatric intensive care unit among infants
and children younger than 5 years of age diagnosed with infectious diseases. Pediatr Neonatol. 2023;64(2):133-139. doi:
10.1016/j.pedneo.2022.06.012.
15. Ruggieri A, Anticoli S, D’Ambrosio A, Giordani L, Viora M. The influence of sex and gender on immunity, infection and vaccination. Ann Ist Super Sanita. 2016;52(2):198-204. doi: 10.4415/ANN_16_02_11.
16. Velavan TP, Pallerla SR, Rüter J, Augustin Y, Kremsner PG, Krishna S, et. al., Host genetic factors determining COVID-19
susceptibility and severity. EBioMedicine. 2021; 72. doi:0.1016/j.ebiom.2021.103629.
17. Yow HY, Govindaraju K, Lim AH, Abdul Rahim N. Optimizing Antimicrobial Therapy by Integrating Multi-Omics With
Pharmacokinetic/Pharmacodynamic Models and Precision Dosing. Front Pharmacol. 2022;13:915355. doi: 10.3389/fphar.2022.915355.
18. Marwali EM, Kekalih A, Yuliarto S, Wati DK, Rayhan M, Valerie IC, et al. Paediatric COVID-19 mortality: a database analysis of
the impact of health resource disparity. BMJ Paediatrics Open 2022;6:e001657. doi: 10.1136/bmjpo-2022-001657
19. Gharbi M, Doerholt K, Vergnano S, Bielicki JA, Paulus S, Menson E, et. al., Using a simple point-prevalence survey to define
appropriate antibiotic prescribing in hospitalised children across the UK. BMJ open. 2016; 6(11), e012675. doi: 10.1136/bmjopen-2016-012675.
20. Teo K, Yong CW, Chuah JH, Hum YC, Tee YK, Xia K, et al.,. Current Trends in Readmission Prediction: An Overview of Approaches.
Arab J Sci Eng. 2021:1-18. doi: 10.1007/s13369-021-06040-5.
21. Rangchian M, Shah-Ebrahimi T, Mehrpooya M. The Sustainability of the Impact of Pharmacists’ Educational Programs on the
Adherence to the Recommendations of Preoperative Antibiotic Prophylaxis Guidelines. Curr Drug Saf. 2023;18(1):39-50. doi: 10.2174/1574886317999220405113744.
22. Wallis RS, O’Garra A, Sher A, Wack A. Host-directed immunotherapy of viral and bacterial infections: past, present and future. Nat Rev Immunol. 2023;23(2):121-133. doi: 10.1038/s41577-022-00734-z.
23. Tobin DM. Modelling infectious disease to support human health. Dis Model Mech. 2022;15(8): dmm049824. doi: 10.1242/dmm.049824.
24. Duong QA, Pittet LF, Curtis N, Zimmermann P. Antibiotic exposure and adverse long-term health outcomes in children: A
systematic review and meta-analysis. J Infect. 2022;85(3):213-300. doi: 10.1016/j.jinf.2022.01.005.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.