ASSESSMENT OF ANTIBIOTIC PRESCRIBING PATTERNS IN PEDIATRIC OUTPATIENT CLINICS
Main Article Content
Keywords
Antibiotic prescribing, pediatric outpatients, antimicrobial resistance, stewardship
Abstract
Background: Antibiotic misuse in pediatric practice contributes to antimicrobial resistance and increased healthcare costs. Evaluating prescribing trends in pediatric outpatient settings helps identify irrational practices, improve guideline adherence, and promote antibiotic stewardship for safe and effective treatment of common infections in children.
Objectives: To assess antibiotic prescribing patterns, evaluate compliance with WHO prescribing indicators, and determine factors influencing irrational antibiotic use in pediatric outpatient clinics.
Study design: cross-sectional
Place and duration of the study: This study was conducted at department of medicine bacha khan medical college mardan from January 2023 to January 2024.
Methods: A study was conducted at department of pediatric medicine Bacha Khan Medical College Mardan from January 2023 to January 2024 children aged 1–12 years attending pediatric outpatient clinics. Prescriptions were analyzed using WHO core drug use indicators. Data on antibiotic type, frequency, indication, and duration were collected using structured forms. Statistical analysis was performed using SPSS version 24.0, with significance set at p < 0.05.
Results: A total of 250 pediatric prescriptions were reviewed. The mean age of participants was 6.2 ± 3.4 years, with 54% males and 46% females. Antibiotics were prescribed in 64% of cases, with amoxicillin-clavulanate (32%) and azithromycin (18%) being most common. The mean number of drugs per prescription was 2.8 ± 1.1, and empirical prescribing occurred in 45% of cases. The difference in antibiotic use between age groups was statistically significant (p = 0.041).
Conclusion: The study reveals a high prevalence of antibiotic prescribing in pediatric outpatient settings, with frequent empirical use and poor adherence to WHO guidelines. Strengthening stewardship programs, encouraging evidence-based prescribing, and promoting awareness among healthcare providers are vital to improving rational antibiotic utilization in children.
References
2. Almansoori N, Parag N. Antibiotic prescribing patterns in Emergency Department at Regional Hospital in South Africa. African health sciences. 2021;21:1651-61. doi: https://doi.org/10.4314/ahs.v21i4.19.
3. Alshareef H, Alanazi A, Alatawi N, Eleshmawy N, Ali M. Assessment of antibiotic prescribing patterns at dental and primary health care clinics according to WHO Access, Watch, Reserve (AWaRe) classification. American journal of infection control. 2023;51:289-94. doi: https://doi.org/10.1016/j.ajic.2022.07.009.
4. Al-Shatnawi SF, Al-Hosban SY, Altawalbeh SM, Khasawneh RA. Antibiotic prescribing patterns for childhood infections in ambulatory settings in Jordan. International journal of clinical practice. 2021;75:e14740. doi: https://doi.org/10.1111/ijcp.14740.
5. Asaduzzaman M, Rahaman MZ, Afrin S, Ara R, Mehmood S, Boriani E, et al. Antibiotic prescribing patterns in the community and primary care settings through a gender lens: A systematic review. Public health. 2025;242:311-8. doi: https://doi.org/10.1016/j.puhe.2025.03.020.
6. Blanco MV, Hamdy RF, Liu CM, Jones H, Montalbano A, Nedved A. Antibiotic Prescribing Patterns for Pediatric Urgent Care Clinicians. Pediatric emergency care. 2022;38:e1538-e40. doi: https://doi.org/10.1097/pec.0000000000002809.
7. Chattopadhyay A, Mukherjee A, Kabra SK, Lodha R. Antibiotic Stewardship Practices and Prescribing Patterns Across Indian PICUs. Indian journal of pediatrics. 2022;89:872-8. doi: https://doi.org/10.1007/s12098-021-03929-9.
8. Cherry MD, Tapley A, Quain D, Holliday EG, Ball J, Davey A, et al. Antibiotic prescribing patterns of general practice registrars for infective conjunctivitis: a cross-sectional analysis. Journal of primary health care. 2021;13:5-14. doi: https://doi.org/10.1071/hc20040.
9. Coritsidis GN, Yaphe S, Rahkman I, Lubowski T, Munro C, Lee TK, et al. Outpatient Antibiotic Prescribing Patterns for Adult End-Stage Renal Disease Patients in New York State. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2021;73:e4493-e8. doi: https://doi.org/10.1093/cid/ciaa1801.
10. Dionne E, Spadaro JZ, Atayde AMP, Kombo N. Antibiotic Prescribing Patterns Among U.S. Ophthalmologists and Optometrists from 2018 to 2021 in the Medicare Part D Database. Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics. 2024;40:144-51. doi: https://doi.org/10.1089/jop.2023.0126.
11. Ji L, Yoshida S, Kawakami K. Trends and patterns in antibiotic prescribing for adult outpatients with acute upper respiratory tract infection in Japan, 2008-2018. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 2021;27:1584-90. doi: https://doi.org/10.1016/j.jiac.2021.07.001.
12. Kissa J, Chemlali S, Gharibi A. Systemic antibiotic prescribing patterns of dentists in Morocco: A questionnaire study. Annals of African medicine. 2023;22:293-9. doi: https://doi.org/10.4103/aam.aam_50_22.
13. Knobloch MJ, Musuuza J, Baubie K, Saban KL, Suda KJ, Safdar N. Nurse practitioners as antibiotic stewards: Examining prescribing patterns and perceptions. American journal of infection control. 2021;49:1052-7. doi: https://doi.org/10.1016/j.ajic.2021.01.018.
14. Pauwels I, Versporten A, Drapier N, Vlieghe E, Goossens H. Hospital antibiotic prescribing patterns in adult patients according to the WHO Access, Watch and Reserve classification (AWaRe): results from a worldwide point prevalence survey in 69 countries. The Journal of antimicrobial chemotherapy. 2021;76:1614-24. doi: https://doi.org/10.1093/jac/dkab050.
15. Salgado-Peralvo Á O, Kewalramani N, Pérez-Jardón A, Pérez-Sayáns M, Mateos-Moreno MV, Arriba-Fuente L. Antibiotic prescribing patterns in the placement of dental implants in Europe: A systematic review of survey-based studies. Medicina oral, patologia oral y cirugia bucal. 2024;29:e441-e50. doi: https://doi.org/10.4317/medoral.26450.
16. Schmidt J, Kunderova M, Pilbauerova N, Kapitan M. A Review of Evidence-Based Recommendations for Pericoronitis Management and a Systematic Review of Antibiotic Prescribing for Pericoronitis among Dentists: Inappropriate Pericoronitis Treatment Is a Critical Factor of Antibiotic Overuse in Dentistry. International journal of environmental research and public health. 2021;18:doi: https://doi.org/10.3390/ijerph18136796.
17. Senthinathan A, Penner M, Tu K, Morris AM, Craven BC, Li Z, et al. Identifying Patterns of Primary Care Antibiotic Prescribing for a Spinal Cord Injury (SCI) Cohort Using an Electronic Medical Records (EMR) Database. Topics in spinal cord injury rehabilitation. 2023;29:153-64. doi: https://doi.org/10.46292/sci23-00047S.
18. Silva JBB, Riester MR, Zullo AR. Antibiotic Prescribing Patterns for Urinary Tract Infections and Pneumonia by Prescriber Type and Specialty in Nursing Home Care, 2016-2018. Journal of the American Medical Directors Association. 2024;25:769-73.e9. doi: https://doi.org/10.1016/j.jamda.2024.01.019.
19. Skender K, Singh V, Stalsby-Lundborg C, Sharma M. Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study. PloS one. 2021;16:e0245902. doi: https://doi.org/10.1371/journal.pone.0245902.
20. Stacherl B, Renner AT, Weber D. Financial incentives and antibiotic prescribing patterns: Evidence from dispensing physicians in a public healthcare system. Social science & medicine (1982). 2023;321:115791. doi: https://doi.org/10.1016/j.socscimed.2023.115791.
21. Thompson W, Teoh L, Hubbard CC, Marra F, Patrick DM, Mamun A, et al. Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada). Infection control and hospital epidemiology. 2022;43:191-8. doi: https://doi.org/10.1017/ice.2021.87.
22. Wang W, Yu S, Zhou X, Wang L, He X, Zhou H, et al. Antibiotic prescribing patterns at children's outpatient departments of primary care institutions in Southwest China. BMC primary care. 2022;23:269. doi: https://doi.org/10.1186/s12875-022-01875-9.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Naveed
Department of pharmacology GKMC Swabi, KPK Pakistan
Niaz khan
Department of pharmacology GKMC Swabi, KPK Pakistan
Umar Alim
Department of pharmacology Saidu Medical College Swat, KPK Pakistan
Ihsan Ullah
Department of pharmacology Saidu Medical College Swat, KPK Pakistan
Mohammad Iftikhar Adil
Department of pharmacology GKMC Swabi, KPK Pakistan
Muhammad Bilal
Department of ophthalmology BKMC Mardan, KPK Pakistan
Gulmakay Zaman
Department of biochemistry North West Medical School Peshawar, KPK Pakistan
Tariq Zubair
Department of medicine, GKMC Swabi, KPK Pakistan
Shabir Hussain
Associate Professor Medicine Nowshera Medical College Nowshera