Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Abate Yeshidinber, Atnafu Mekonnen, Yemisrach Mekonnen and Gesit Metaferia
Saint Paul Hospital Millennium Medical College, Ethiopia
Scientific Tracks Abstracts: Pediatr Ther
Background & Aim: Th e irrational use of antibiotics is already a global problem. Not following clinical guidelines while prescribing is one of the main reasons for irrational use of antibiotics. Cough and/or diarrhea are the main childhood illnesses in Ethiopia and health care providers are expected to follow the available national guidelines while managing these illnesses. Th is study aimed to assess the extent of adherence to the guidelines by health care providers while managing cases of childhood diarrhea and/or cough in hospitals of Addis Ababa. Methods: Th e study was conducted in three public and 20 private-for-profi t hospitals in Addis Ababa which are providing pediatrics clinical service in the city. A total of 1073 children age 2 month to 59 months were included in the study. Sample size was determined based on the prevalence of inappropriate antibiotics prescription in a similar setting. Equal numbers of cases were allocated to each hospital and consecutive cases were included in the study until sample size was attained from each hospital. Th e data collectors approached the cases aft er the cases were seen by the health care provider. Data were collected prospectively from April to June 2016 using a structured pretested questionnaire. SPSS for windows version 20 was used to analyze the data. Result: Of the total, 936 (87.2%) children were seen at private for profi t hospitals and the rest at public hospitals. 571 (53.2%) of them were male. Out of the total, 490 (45.7%) attendants claimed that the reason for visiting a hospital was diarrhea and 653 (60.9%) attendants said cough was the reason for visiting a hospital. Only 72 (6.7%) attendants claimed the reason for bringing their child to hospital was because the child had both cough and diarrhea. Antibiotic was prescribed for 794 (74.0%) children and the rest were sent home with either simple advice or cough syrup or analgesics. Co-trimoxazole 209 (26.3%), amoxicillin 185 (23.3%) and cephalosporins 174 (21.9%) were the three antibiotics commonly prescribed. Of those children for whom antibiotics was prescribed, 688 (86.6%) of the prescription were inappropriate. Prescribing antibiotics when not necessary 631 (91.7%) and prescribing the wrong spectrum of antibiotics 57 (8.3%) were the two main reasons to say the prescriptions were inappropriate. Under multivariate analysis, child not having diarrhea were independently associated with appropriate antibiotic prescription (AOR=0.261, 95% CI: 0.095-0.714) while prescriber qualifi ed as a pediatrician was an independent predictor of inappropriate antibiotic prescription (AOR=9.967, 95% CI: 4.221-23.532). Conclusion: Th e magnitude of inappropriate antibiotic prescription in managing cough and/or diarrhea in our setting was high. Factors which contribute to inappropriate use of antibiotics among the health care providers have to be addressed by the responsib order to prevent emergence of antibiotic resistant micro-organisms.
Abate Yeshidinber is Pediatrician and Assistance professor at Saint Paul Hospital Milinnium Medical College, Ethipoia.