Antibiotic prescribing in treatment of non-severe paediatric Community Acquired Pneumonia at Limbe Health Centre, Blantyre.

Abstract

Introduction Pneumonia is one of the diseases with high child mortality worldwide. Appropriate antibiotic treatment is vital for treatment success and minimising emergence of antibiotic resistance. Adherence of prescribers to guidelines in the treatment of non-severe Community Acquired Pneumonia (CAP) is one aspect that can optimise treatment outcome and help mitigate emergence of antibiotic resistance. This study was conducted to investigate antibiotic prescribing patterns of clinical officers and medical assistants in the treatment of non-severe paediatric CAP at Limbe Health Centre (LHC). Materials and methods The study was conducted at LHC. Prescriptions of 53 children aged 2-59 months diagnosed and treated for non-severe CAP were reviewed for analysis of demographic and treatment data. Data collection was conducted from March to May 2017. Prescribed antibiotics by medical assistants and clinical officers were compared using Fischer’s exact test. Correctly and incorrectly prescribed antibiotic daily doses in the two groups of prescribers were compared using Chi-square test. In addition, we also analysed demographic and academic qualification data for prescribers. Results The 53 prescriptions included were either for cotrimoxazole (n=29), amoxicillin (n=19) or erythromycin (n=5). There was no significant difference in choice of antibiotic for the treatment of non-severe paediatric CAP between medical assistants and clinical officers (p=0.2). Based on age or weight of the participant, distribution of correctly and incorrectly prescribed daily doses was not significantly different in the two groups of prescribers (p>0.5). Of the 53 participants, 30 (57%) were under-dosed. Ten participants were under-dosed by 33%, while 20 participants were under-dosed by 34-50% of the recommended antibiotic daily dose. Participants were either prescribed a 5-day (n=51) or a 3-day (n=2) antibiotic treatment. Conclusion Amoxicillin, cotrimoxazole and erythromycin were prescribed for the treatment of non-severe paediatric CAP at LHC. More than half of the included patients were under-dosed. Antibiotic treatment for paediatric CAP at LHC was either for 3 or 5 days. Understanding antibiotic prescribing patterns is necessary in designing interventions aimied at improving antibiotic treatment and curbing the emergence of antibiotic resistance.