臨床小児皮膚科 オープンアクセス

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Cardiology 2015: Antibiotic prescribing practice in the management of cough or diarrhea among children visiting hospitals of Addis Ababa: A cross sectional planned study - Abate Yeshidinber - Saint Paul Hospital Millennium Medical College

Abate Yeshidinber

Introduction:

Utilization of antibiotics without clinical signs, treatment of a condition with an antibiotic not suggested for that condition, and mistaken dosing or route of administration. Non-indicated antibiotic treatment is a significant public health threat around the world. Inappropriate antibiotic use for common childhood conditions is significantly progressively articulated in low-and middle income nations (LMICs). As per the World Health Organization (WHO), just 70% of pneumonia cases in LMICs are treated with a fitting antibiotic and about portion of all acute viral upper respiratory tract contaminations (RTIs) and viral diarrhea cases are dealt with improperly with antibiotics.

The WHO Global Action Plan on Antimicrobial Resistance distinguishes proof based solution of antibiotics for specific diagnoses as a significant technique to improve the proper utilization of antimicrobial medicines. In spite of worldwide affirmation of clinically unjustified antibiotic use, facility-level data to identify gaps and guide intercessions to improve proof based antibiotic prescribing practices are limited in LMICs.

Childhood diarrhea remains the subsequent driving reason for morbidity and mortality among children younger than five. Oral rehydration treatment and zinc tablets are the foundation for its management both at home and in the health facilities. Primary health care is the primary degree of contact of people and communities with the health care system and proper solution is pivotal for maintainable medical advantages.

Background & Aim:

The irrational use of antibiotics is already a global problem. Not following clinical rules while prescribing is one of the primary explanations behind irrational use of antibiotics. Cough and/or diarrhea are the principle childhood sicknesses in Ethiopia and health care providers are relied upon to follow the accessible national guidelines while dealing with these ailments. This examination planned to evaluate the degree of adherence to the rules by health care providers while overseeing instances of childhood diarrhea and/or cough in hospitals of Addis Ababa.  

Methods:

The examination was led in three open and 20 private-for-profit hospitals in Addis Ababa which are giving pediatrics clinical assistance in the city. A sum of 1073 kids age of 2 month to 59 months were included in the study. Sample size was resolved dependent on the commonness of improper antibiotics prescription in a similar setting. Equivalent quantities of cases were allotted to every medical hospital and consecutive cases were included in the study until sample size was accomplished from each hospital. The data collectors approached the cases after the cases were seen by the health care provider. Data were collected prospectively from April to June 2016 using a structured pretested questionnaire. SPSS for windows version 20 was used to analyze the data.

Result:

Of the aggregate, 936 (87.2%) kids were seen at private for profit hospitals and the rest at public hospitals. 571 (53.2%) of them were male. Out of the aggregate, 490 (45.7%) attendants guaranteed that the purpose behind visiting a hospital was the diarrhea and 653 (60.9%) attendants said cough was the explanation behind visiting an emergency clinic. Just 72 (6.7%) attendants asserted the explanation behind carrying their children to emergency clinic was on the grounds that the kid had both cough and diarrhea. Antibiotic was prescribed for 794 (74.0%) kids and the rest were sent home with either straightforward guidance or cough syrup or analgesics. Co-trimoxazole 209 (26.3%), amoxicillin 185 (23.3%) and cephalosporin’s 174 (21.9%) were the three antibiotics commonly prescribed. Of those children for whom antibiotics was prescribed, 688 (86.6%) of the prescription were improper. Prescribing antibiotics when not necessary (91.7%) and prescribing an inappropriate range of antibiotics 57 (8.3%) were the two primary motivations to state the prescriptions were inappropriate. Under multivariate examination, child not having the diarrhea were autonomously connected with proper antibiotic (AOR=0.261, 95% CI: 0.095-0.714) while prescriber qualified as a pediatrician was a independent predictor of wrong antibiotic prescription (AOR=9.967, 95% CI: 4.221-23.532).

Conclusion:

The magnitude of improper antibiotic prescription in overseeing cough and/or diarrhea in our setting was high. Factors which contribute to inappropriate use of antibiotics among the health care providers have to be addressed by the responsible order to prevent emergence of antibiotic resistant micro-organisms.