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Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan

1
Akhtar Saeed College of Pharmaceutical Sciences, Lahore 54000, Pakistan
2
Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Punjab, Pakistan
3
College of Pharmacy, Al Ain University of Science and Technology, Al Ain, PO Box 64141, Abu Dhabi, UAE
4
College of Pharmacy, University of the Punjab, Lahore 54000, Pakistan
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(2), 44; https://doi.org/10.3390/medicina55020044
Received: 5 October 2018 / Revised: 29 January 2019 / Accepted: 5 February 2019 / Published: 11 February 2019
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Abstract

Background and objective: The noncompliance of treatment guidelines by healthcare professionals, along with physiological variations, makes the pediatric population more prone to antibiotic prescribing errors. The present study aims to evaluate the prescribing practices and errors of the most frequently prescribed antibiotics among pediatric patients suffering from acute respiratory tract infections who had different lengths of stay (LOS) in public hospitals. Methods: A retrospective, cross-sectional study was conducted in five tertiary-care public hospitals of Lahore, Pakistan, between 1 January 2017 and 30 June 2017. The study population consisted of pediatric inpatients aged 0 to 9 years. Results: Among the 11,892 pediatric inpatients, 82.8% were suffering from lower acute respiratory tract infections and had long LOS (53.1%) in hospital. Penicillins (52.4%), cephalosporins (16.8%), and macrolides (8.9%) were the most frequently prescribed antibiotics. Overall, 40.8% of the cases had antibiotic prescribing errors related to wrong dose (19.9%), wrong frequency (18.9%), and duplicate therapy (18.1%). Most of these errors were found in the records of patients who had long LOS in hospital (53.1%). Logistic regression analysis revealed that the odds of prescribing errors were lower in female patients (OR = 0.6, 95% CI = 0.1–0.9, p-value = 0.012). Patients who were prescribed with ≥3 antibiotics per prescription (OR = 1.724, 95% CI = 1.1–2.1, p-value = 0.020), had long LOS (OR = 12.5, 95% CI = 10.1–17.6, p-value < 0.001), and were suffering from upper respiratory tract infections (URTI) (OR = 2.8, 95% CI = 1.7–3.9, p-value < 0.001) were more likely to experience prescribing errors. Conclusion: Antibiotics were commonly prescribed to patients who had long LOS. Prescribing errors (wrong dose, wrong frequency, and duplicate therapy) were commonly found in cases of lower respiratory tract infections (LRTIs), especially among those who had prolonged stay in hospital. View Full-Text
Keywords: pediatrics; antibiotics; acute respiratory tract infections; prescribing errors pediatrics; antibiotics; acute respiratory tract infections; prescribing errors
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Iftikhar, S.; Sarwar, M.R.; Saqib, A.; Sarfraz, M.; Shoaib, Q.-U.-A. Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan. Medicina 2019, 55, 44.

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