Antibiotic audit in a pediatric unit of a quaternary hospital in South India
Jeeson C. Unni, M. IrshadAbstract
BACKGROUND:
Antibiotic audit is an important armamentarium in a hospital antibiotic stewardship program (ASP). It ensures appropriate prescribing practices, reduces the development of antimicrobial resistance (AMR), enhances the quality of health care services and improves patient outcomes.
MATERIALS AND METHODS:
A retrospective audit was conducted of all children, under 18 years of age, admitted with fever during the month of December 2024, in 1 of the 4 child health units of our quaternary care hospital, The appropriateness of antibiotic use for the given infection, reasons for administering and not administering antibiotics and the resultant clinical outcomes were studied. The electronic medical records were reviewed and analysed retrospectively to avoid the bias that could creep into a prospective study. In the 6 month period starting July 1st, the month of December 2024 was randomly selected by lot method for the study.
RESULTS:
Out of 38 children admitted in the unit during the 1-month period, 30 had fever; 17 [56.7%] were managed without antibiotics and 13 [43.3%] were treated with antibiotics Respiratory illnesses contributed to the major chunk of patients who received antibiotics; 6 with Mycoplasma pneumoniae pneumonia [MPP] and 4 with a clinical diagnosis of atypical pneumonia. The others were a child each with pneumonia, sub-acute appendicitis and rhinosinusitis. Since there was a surge of mycoplasma pneumonia during the month, azithromycin was the most used antibiotic [8/13] and 3 received levofloxacin as they did not respond to azithromycin within 72 hours. All 17 who were managed without antibiotics had been admitted with viral illnesses.
CONCLUSION:
The findings suggest that many febrile cases can be effectively managed without antibiotics, highlighting the importance of accurate diagnoses and conservative treatment to address antibiotic resistance. A definite knowledge of the etiological agent, the appropriate antibiotic/s for that agent and regular antibiotic audits as part of effective hospital antibiotic stewardship program will help in improving antibiotic prescription practices.