Antibiotics Utilization Pattern in a Children’s Medical Center in North of Iran
Abstract
Background: The development of a system for rational use of antimicrobials seems mandatory. Furthermore, since hospitals do not share the same bacterial flora and have different patterns of antibiotic therapy the purpose of the present study is to perform a Drug Utilization Evaluation (DUE) on the pattern of antibiotic administration in patients hospitalized in 17 Shahrivar Pediatric Hospital, RASHT, Iran. Methods: In this descriptive cross-sectional study that was conducted in a one-year period (2021-2022), 560 patients were randomly selected and their medication data were collected based on the gender and age as well as the type, dose, duration of antibiotic therapy and the results of bacterial cultures and also susceptibility of the infectious microorganisms. Results: The average age of patients was 53.56 months with 46.9% of them being less than 24 months old. The highest rate of antibiotics administration belonged to the infectious diseases ward (30%) and 33% of antibiotics were prescribed by pediatric infectious diseases specialists. The result of most of the cultures was reported as negative (98.38%), the most prevalent microorganism was Escherichia Coli from urine cultures (2.38%) and Staphylococcus Aureus from sputum cultures (14.28%). The highest prescribed antibiotics were ceftriaxone (51.2%) and vancomycin (45.6%). It was determined the antibiotic stipend was 15.6% of the whole budget for purchasing medicine. Conclusions: It is necessary to develop a guideline regarding the prescription of antibiotics in children's departments, which reduces empiric treatment and the requirement to adjust the drug after a negative culture.
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2. Larsson DGJ, Flach CF. Antibiotic resistance in the environment. Nat Rev Microbiol. 2022;20(5):257-269.
3. Uddin TM, Chakraborty AJ, Khusro A, et al. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. J Infect Public Health. 2021 Dec;14(12):1750-1766.
4. Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf. 2014;5(6):229-41.
5. Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections - an overview. Infect Drug Resist. 2018;11:2321-2333.
6. Hassan Ahmed Khan, Fatima Kanwal Baig, Riffat Mehboob. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine. 2017;7(5): 478-482.
7. Mancuso G, Midiri A, Gerace E, Biondo C. Bacterial Antibiotic Resistance: The Most Critical Pathogens. Pathogens. 2021 Oct 12;10(10):1310.
8. van Duin D, Paterson DL. Multidrug-Resistant Bacteria in the Community: Trends and Lessons Learned. Infect Dis Clin North Am. 2016;30(2):377-390.
9. Özger HS, Fakıoğlu DM, Erbay K, Albayrak A, Hızel K. Inappropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study. BMC Infect Dis. 2020;20(1):289.
10. Sadatsharifi A, Davarpanah MA, Namazi S, Mottaghi S, Mahmoudi L. Economic burden of inappropriate empiric antibiotic therapy: a report from Southern Iran. Risk Manag Healthc Policy. 2019;12:339-348
11. Karbasian F, Dorrani Bakhsh A, Mirrahimi B, Armin S. Appropriateness of antibiotic prescribing in the emergency department of Mofid Children's Hospital: A retrospective cross-sectional study. Arch Pediatr Infect Dis. 2023;11(4):e136149.
12. Mostafavi N, Rashidian A, Karimi-Shahanjarini A, Khosravi A, Kelishadi R. The rate of antibiotic utilization in Iranian under 5-year-old children with acute respiratory tract illness: A nationwide community-based study. J Res Med Sci. 2015;20(5):429-33.
13. Ferguson J. Antibiotic prescribing: how can emergence of antibiotic resistance be delayed?. Aust Prescr. 2004; 27:39-42.
14. Noubarani M, Shafizade BH. Antibiotic Prescription Pattern in Vali- Asr Hospital Units of Zanjan City. J Adv Med Biomed Res. 2017; 24 (106): 122- 9.
15. Ansari F. Utilization review of systemic anti-infective agents in a teaching hospital in Tehran, Iran. Eur J Clin Pharmacol. 2001; 57 (6): 541- 6.
16. Ebrahimzadeh MA, Ansari F, Ramezani A, et al. Utilization Pattern of Antibiotics in Different Wards of Sari Imam Khomeini Teaching Hospital. J Mazandaran Univ Med Sci. 2007;17(61):166-9.
17. Ragnarson Tennvall G, Apelqvist J. Health-related quality of life in patients with diabetes mellitus and foot ulcers. J Diabetes Complications. 2000; 14 (5): 235- 41.
18. Williams DJ, Hall M, Shah SS, et al. Narrow vs broad-spectrum antimicrobial therapy for children hospitalized with pneumonia. Pediatrics. 2013; 132 (5).
19. Aghamahdi F, Hashemian H, Shafiei MS, Karkan MF. Etiologies and antibiotic resistance patterns in infants with urinary tract infections hospitalized in children medical centre, Rasht, Iran. 2013; 2019 (March 2018).
20. Khoshdel A PG. The pattern of antimicrobial utilization in patients of pediatric wards in Hajar hospital, Shahrekord, Iran in 2009- 2010. J Shahrekord University Med Sci. 2012; 14 (1):4- 7.
21. Mettler J, Simcock M, Sendi P, et al. Empirical use of antibiotics and adjustment of empirical antibiotic therapies in a university hospital: A prospective observational study. BMC Infect Dis. 2007;7: 1- 10.
22. Gholami A, Barati M, Vahdani M, Vahdani H KM. Pattern of empirical antibiotic administration in emergency department of an educational hospital in Tehran. RJMS. 2011; 18 (1): 17- 23.
23. Craig WA, Uman SJ, Shaw WR, Ramgopal V, Eagan LL, Leopold ET. Hospital use of antimicrobial drugs. Survey of 19 hospitals and results of antimicrobial control program. Ann Intern Med. 1978; 89 (5 II): 793- 5.
24. Mokhtari H, Habibi F, Gazerani M. An evaluation of antibiotics therapy and use in the internal sections of Arya and Bahma 22nd hospitals in Mashhad (2003- 2004). J Med Sci Islam Azad Univ Tehran. 2006; 2 (2): 19-23.
2. Larsson DGJ, Flach CF. Antibiotic resistance in the environment. Nat Rev Microbiol. 2022;20(5):257-269.
3. Uddin TM, Chakraborty AJ, Khusro A, et al. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. J Infect Public Health. 2021 Dec;14(12):1750-1766.
4. Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf. 2014;5(6):229-41.
5. Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections - an overview. Infect Drug Resist. 2018;11:2321-2333.
6. Hassan Ahmed Khan, Fatima Kanwal Baig, Riffat Mehboob. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine. 2017;7(5): 478-482.
7. Mancuso G, Midiri A, Gerace E, Biondo C. Bacterial Antibiotic Resistance: The Most Critical Pathogens. Pathogens. 2021 Oct 12;10(10):1310.
8. van Duin D, Paterson DL. Multidrug-Resistant Bacteria in the Community: Trends and Lessons Learned. Infect Dis Clin North Am. 2016;30(2):377-390.
9. Özger HS, Fakıoğlu DM, Erbay K, Albayrak A, Hızel K. Inappropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study. BMC Infect Dis. 2020;20(1):289.
10. Sadatsharifi A, Davarpanah MA, Namazi S, Mottaghi S, Mahmoudi L. Economic burden of inappropriate empiric antibiotic therapy: a report from Southern Iran. Risk Manag Healthc Policy. 2019;12:339-348
11. Karbasian F, Dorrani Bakhsh A, Mirrahimi B, Armin S. Appropriateness of antibiotic prescribing in the emergency department of Mofid Children's Hospital: A retrospective cross-sectional study. Arch Pediatr Infect Dis. 2023;11(4):e136149.
12. Mostafavi N, Rashidian A, Karimi-Shahanjarini A, Khosravi A, Kelishadi R. The rate of antibiotic utilization in Iranian under 5-year-old children with acute respiratory tract illness: A nationwide community-based study. J Res Med Sci. 2015;20(5):429-33.
13. Ferguson J. Antibiotic prescribing: how can emergence of antibiotic resistance be delayed?. Aust Prescr. 2004; 27:39-42.
14. Noubarani M, Shafizade BH. Antibiotic Prescription Pattern in Vali- Asr Hospital Units of Zanjan City. J Adv Med Biomed Res. 2017; 24 (106): 122- 9.
15. Ansari F. Utilization review of systemic anti-infective agents in a teaching hospital in Tehran, Iran. Eur J Clin Pharmacol. 2001; 57 (6): 541- 6.
16. Ebrahimzadeh MA, Ansari F, Ramezani A, et al. Utilization Pattern of Antibiotics in Different Wards of Sari Imam Khomeini Teaching Hospital. J Mazandaran Univ Med Sci. 2007;17(61):166-9.
17. Ragnarson Tennvall G, Apelqvist J. Health-related quality of life in patients with diabetes mellitus and foot ulcers. J Diabetes Complications. 2000; 14 (5): 235- 41.
18. Williams DJ, Hall M, Shah SS, et al. Narrow vs broad-spectrum antimicrobial therapy for children hospitalized with pneumonia. Pediatrics. 2013; 132 (5).
19. Aghamahdi F, Hashemian H, Shafiei MS, Karkan MF. Etiologies and antibiotic resistance patterns in infants with urinary tract infections hospitalized in children medical centre, Rasht, Iran. 2013; 2019 (March 2018).
20. Khoshdel A PG. The pattern of antimicrobial utilization in patients of pediatric wards in Hajar hospital, Shahrekord, Iran in 2009- 2010. J Shahrekord University Med Sci. 2012; 14 (1):4- 7.
21. Mettler J, Simcock M, Sendi P, et al. Empirical use of antibiotics and adjustment of empirical antibiotic therapies in a university hospital: A prospective observational study. BMC Infect Dis. 2007;7: 1- 10.
22. Gholami A, Barati M, Vahdani M, Vahdani H KM. Pattern of empirical antibiotic administration in emergency department of an educational hospital in Tehran. RJMS. 2011; 18 (1): 17- 23.
23. Craig WA, Uman SJ, Shaw WR, Ramgopal V, Eagan LL, Leopold ET. Hospital use of antimicrobial drugs. Survey of 19 hospitals and results of antimicrobial control program. Ann Intern Med. 1978; 89 (5 II): 793- 5.
24. Mokhtari H, Habibi F, Gazerani M. An evaluation of antibiotics therapy and use in the internal sections of Arya and Bahma 22nd hospitals in Mashhad (2003- 2004). J Med Sci Islam Azad Univ Tehran. 2006; 2 (2): 19-23.
| Files | ||
| Issue | Vol 12, No 2 (Spring 2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Antibiotics; Drug Utilization Evaluation; Pediatric | ||
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How to Cite
1.
Shahrokhi M, Hashemian H, Dadras M, Bouzar S, Shafaei-Bajestani N. Antibiotics Utilization Pattern in a Children’s Medical Center in North of Iran. J Pharm Care. 2024;12(2):73-77.
