Abstract:
Background: World Health Organization(WHO) established indicators to measure quality and pattern of use of drugs especially in low resource settings. Utilization of antibiotics among children in developing countries has not been fully studied.
Objectives: To evaluate the quality and pattern of use of antibiotics among children in a Nigerian referral hospital and to assess prescription quality compliance with WHO prescribing indicators.
Methods: Folders and prescriptions of children from 2010 to 2011 in Enugu State University of Technology Teaching Hospital were randomly sampled. Prescriptions with antibiotics or at least an infection were sorted, coded and entered into the SPSS version 16 for stasitical analysis. Descriptive and inferential analyses (prediction using logistic regression) were conducted using patients’ demographic data, prescribed drugs and their cost.
Results: Cephalosporins were the most prescribed antibiotics and the mean (SD) number of antibiotics per prescription visit was 1.21(0.44) with nearly 45% of the children receiving antibiotics as injections. Only 27% of the drugs were prescribed as generics and only about 58.3% were listed on the essential drugs list. Broad spectrum antibiotics were mostly prescribed (50.4%), as they increased from 2010 to 2011 specifically driven by factors such as higher cost of the antibiotic (p<0.001), high cost of other drugs (p<0.001), not being listed on the EDL (P<0.001) and being an injection (p<0.001). Cost/DDD showed cephalosporins as the most costly antibiotic compared to other antibiotics with ten antibiotics making up the DU90%.
Conclusion: Utilization of antibiotics in this hospital was not excessive but not in compliance with WHO guidelines. The use trend analysis of broad spectrum agents was on the increase over the years under study and should be handled with caution so as to preserve the therapeutic life of these antibiotics.
