Point Prevalence Study of Antibiotics use in Paediatric Wards of a Tertiary Health Facility in Kaduna Nigeria

Children often receive prescriptions for antibiotics due to their relatively high rates of infection. Overuse or inappropriate antibiotics prescription can contribute to the development of drug resistance, longer hospital stays, and higher healthcare costs. Proper regulation of antibiotic use is necessary to protect the effectiveness of these limited treatment options. This study was conducted to determine prevalence of antibiotics use to establish baseline data for audit, formulate guidelines, support prescribing initiatives and ultimately improve quality of antibiotics use. Treatment charts in all paediatric wards were reviewed on a single day for antibiotics prescription. The names, doses, routes, duration and indications for antibiotics use were noted. Appropriateness of the antibiotic agent, doses, frequency and route of administration was determined through unanimous decision of all authors using best available evidence. A total of 83 children were on admission and 66 (79.5%) were receiving antibiotics, 62 (93.9%) parenterally. Rates of antibiotics use in the wards were 80.0%, 70.6%, 64.3%, 93.3% and 97.7% in Emergency Paediatric Unit (EPU), Paediatric Medical Ward (PMW) and B, and out born and inborn units of Special Care Baby Unit (SCBU) respectively. The most prescribed antibiotic was Ceftrixone (74.2%). Some of the irrational antibiotic use noted are prolonged duration of antibiotic (63.6%), no microbiological requests (62.1%), incorrect doses (37.9%) and inappropriate choice of antibiotics for infection type (27.3%). In a quarter of cases antibiotics were not indicated. Low antibiotics prescription threshold was observed with antibiotics started empirically and continued against microbiological evidence. Differences exist in antibiotic usage in the wards with high variability in dosing for same indications.