Prescribing Pattern and Antibiotic Use for Hospitalized Children in a Northern Nigerian Teaching Hospital

BACKGROUND Assessment of patterns of drug to detect performance problems and compliance with standards facilitates objective comparisons and impact evaluation. Children are at higher risk of consequences of irrational prescribing and antibiotic misuse. OBJECTIVE The objective of the study was to evaluate the prescribing pattern and utilization of antibiotics for children using standard prescribing indicators and indices of rational drug prescribing. MATERIALS AND METHODS This was a retrospective study of prescriptions for pediatric inpatients at a teaching hospital in Northern Nigeria. Information was obtained from eligible prescriptions received over 24-month period using a modified WHO prescribing indicator form. The WHO prescribing indicators and the Index of Rational Drug Prescribing (IRDP) were used to evaluate prescriptions. Data were analyzed and presented as proportions, means, tables, and charts, comparing with WHO standards and with findings of similar studies. RESULTS There were 3908 eligible prescription orders, with a mean patient age of 3.1 (±2.7) years. With an average of 2.1 drugs per prescription, 66.8% were written with generic names, whereas a single antibiotic was included among 63% of prescriptions with antibiotics. Antibiotics and injections were contained in 49.5% and 67.7% of prescriptions, respectively. Medications were available in the Essential Medicines List in 95.5% of cases. The IRDP obtained is 2.99, against a standard of 5. Aminoglycosides, cephalosporins, and penicillins were the most common choices, whereas ampicillin/cloxacillin was the most common combination. CONCLUSION Drug prescribing and antibiotic use were generally inappropriate compared with ideal standards. Continuous training/retraining on rational drug use, periodic monitoring, and use of treatment protocols in tertiary hospitals are recommended.