Title:Antibiotic use Evaluation in Hospitalized Pediatric Patients with Respiratory
Tract Infections: A Retrospective Chart Review Study
Volume: 17
Issue: 1
Author(s): Amir Ali Mahboobipour, Shadi Baniasadi*, Elahe Saberi Shahrebabaki, Sabereh Tashayoie-Nejad and Maryam Hassanzad*
Affiliation:
- Tracheal Diseases Research Center, National
Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases,
Shahid Beheshti University of Medical Sciences, Tehran, Iran
Keywords:
Adherence, antibiotics, guideline, pediatrics, pulmonary infection, respiratory tract infections, treatment.
Abstract:
Introduction: Respiratory tract infections (RTIs) are a common cause of antibiotic usage
in hospitalized pediatric patients. Inappropriate use of antibiotics may lead to the emergence of
multidrug-resistant microorganisms and increased treatment costs.
Objective: This study was designed to assess antibiotic usage in hospitalized pediatric patients with
RTIs.
Methods: Medical charts of the patients admitted to the pediatric ward (PW) and pediatric intensive
care unit (PICU) of a tertiary respiratory center were reviewed. Patients’ demographic and clinical
data, including gender, age, weight, history of allergy, length of hospital stay, clinical diagnosis,
and prescribed antibiotics (indication, dose, and frequency of administration) were collected.
The appropriateness of antibiotic usage was evaluated in each patient according to international
guidelines.
Results: Two hundred seventy-nine hospitalized patients were included in the study. The most common
reason for hospitalization was pneumonia (38%), followed by cystic fibrosis (20.1%) and
bronchitis (5%). The most commonly used antimicrobial agents were ceftriaxone, azithromycin,
and clindamycin which guideline adherence for their usage was 85.3%, 23.3%, and 47%; respectively.
Inappropriate dose selection was the main reason for non-adherence to the guidelines. The
adherence rate to RTIs’ guidelines (considering all parameters for each patient) was 27.6%. Multivariate
logistic regression analysis demonstrated CF and prescription of azithromycin are predictors
of guideline non-adherence.
Conclusion: We found relatively low adherence to international guidelines in our center that could
be related to restricted definitions of optimal antibiotic therapy. Despite most patients received logical
antimicrobial therapy, actions should be taken into account to reach optimal antibiotic usage.
