Home⇛The PCMC Journal⇛vol. 19 no. 1 (2023)

Evaluation of Prescribing Patterns for Pediatric Community-Acquired Pneumonia in the Outpatient Department of a Tertiary-Care Medical Center in the Philippines

Teresa D. Dacalanio | Mary Antonette C. Madrid

Discipline: medicine by specialism

 

Abstract:

OBJECTIVES: This study evaluated the antibiotic prescribing patterns in pediatric patients in the Out Patient Department (OPD) of the Philippine Children’s Medical Center (PCMC) where it may encourage drug monitoring and improvement in the utilization of antibiotics in the department. MATERIALS AND METHODS: A descriptive, cross-sectional study involving patient encounters selected using convenience sampling was conducted at the outpatient department of PCMC. All previously healthy pediatric patients aged 3 months to 18 years diagnosed with pediatric community-acquired pneumonia (PCAP) with no known acute and chronic co-morbidities were included. The observed values of the antibiotic prescribing indicators were compared with the optimal values recommended by the World Health Organization (WHO), and the Index of Rational Drug Prescribing (IRDP) was calculated. RESULTS: A total of 600 patients diagnosed with PCAP were included in the study seen at the PCMC OPD from January 2020 to July 2022. Ninety-six percent of the patient encounters had at least one antibiotic prescribed (SD + 0.20). The average number of medicines prescribed per patient encounter was 2.05 (SD + 0.85). Of these, 100% were prescribed by generic name and were prescribed from the essential drug list. The most commonly prescribed medications were antibiotics (43.17%) with co-amoxiclav (42.93%), amoxicillin (37.76%), and cefuroxime (7.59%) being the top three commonly prescribed antibiotics. CONCLUSION: With respect to the IRDP, PCMC scores well with 3.16 where the most rational score is 4. However, this study highlights the high occurrence of prescribing antibiotics in the institution.



References:

  1. Center for Disease Control and Prevention [Internet]. Center for Disease Control and Prevention. Antibiotic Prescribing and Use; 2020 Oct 14.  Measuring Outpatient Antibiotic Prescribing [cited 2021 July 1]. Available from: https://www.cdc.gov/antibiotic-use/data/outpatient-prescribing/index.html. https://www.cdc.gov/antibiotic-use/community/programs-measurement/measuring-antibiotic-prescribing.html
  2. Lecciones, JA, Santos, LV, editors. 2019 Annual Report. Quezon City: Philippine Children's Medical Center; 2019.
  3. Philippine Statistics Authority [Internet]. Philippine Statistics Authority. Registered Deaths in the Philippines, 2017; 2019 Jun 10 [cited 2021 July 1]. Available from: https://psa.gov.ph/vital-statistics/registered-deaths-philippines-2017.
  4. Philippine Statistics Authority [Internet]. Philippine Statistics Authority. Registered Deaths in the Philippines, 2018; 2020 Feb 10 [cited 2021 July 1]. Available from: https://psa.gov.ph/content/registered-deaths-philippines-2018.
  5. Philippine Statistics Authority [Internet]. Philippine Statistics Authority. Causes of Deaths in the Philippines (Preliminary): January to December 2020; 2021 July 5 [cited 2021 July 1]. Available from: https://psa.gov.ph/content/causes-deaths-philippines-preliminary-january-december-2020-0.
  6. World Health Organization. How to investigate drug use in health facilities: selected drug use indicators [Internet].  1993 [cited 2022 June 28]. Available from: https://apps.who.int/iris/handle/10665/60519.
  7. Yimenu DK, Emam A, Elemineh E, et al. Assessment of Antibiotic Prescribing Patterns at Outpatient Pharmacy Using World Health Organization Prescribing Indicators. J Prim Care Community Health [Internet]. 2019 Jan-Dec [cited 2022 Jun 28];10:1-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836303/.
  8. Amaha, N.D., Weldemariam, D.G., Abdu, N. et al. Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study. Antimicrob Resist Infect Control 8 [Internet], 2019 Oct 22 [cited 2022 Oct 13];163. Available from: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0620-5
  9. Ofori-Asenso R. A closer look at the World Health Organization's prescribing indicators. J Pharmacol Pharmacother [Internet]. 2016 Jan-Mar [cited 2022 Oct 13];7(1):51-4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831494/
  10. Atif M, Sarwar MR, Azeem M, et al. Assessment of WHO/INRUD core drug use indicators in two tertiary care hospitals of Bahawalpur, Punjab, Pakistan. J Pharm Policy Pract [Internet]. 2016 Sep 22 [cited 2022 Jun 28];9(27). Available from: https://pubmed.ncbi.nlm.nih.gov/27688887/.
  11. Isah AO, Laing R, Quick J, et al. The Development of Reference Values for the World Health Organisation (WHO) Health Facility Core Indicators. West Afr J pharmacol, Drug Res [Internet]. 2002 [cited 2022 Jun 28]; 18(1 and 2): 6-1. Available from: https://www.ajol.info/index.php/wajpdr/article/view/14718
  12. Cole CP, James PB, Kargbo AT. An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. J Basic Clin Pharm [Internet]. 2015 Sep [cited 2021 Feb 16];6(4):109-14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660481/.
  13. Walid J, Moshref L, Aizanbagi M, et al. Antibiotic resistance pattern in healthy children diagnosed with community acquired respiratory tract infections in King Abdulaziz University Hospital. J Med Microb Diagn [Internet]. 2016 Jun 15 [cited 2022 Sep 30];5(2). Available from: https://www.hilarispublisher.com/open-access/antibiotic-resistance-pattern-in-healthy-children-diagnosed-withcommunity-acquired-respiratory-tract-infections-in-king-abdulazizu-2161-0703-1000232.pdf
  14. Howidi M, Muhsin H, Rajah J. The burden of pneumococcal disease in children less than 5 years of age in Abu Dhabi, United Arab Emirates. Ann Saudi Med [Internet]. 2011 Jul-Aug [cited 2022 Sept 30];31(4):356-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156510/
  15. Nguyen PT, Tran HT, Truong HT, et al. Paediatric use of antibiotics in children with community acquired pneumonia: A survey from Da Nang, Vietnam. J Paediatr Child Health [Internet]. 2019 Nov [cited 2022 Sep 30];55(11):1329-1334. Available from: https://pubmed.ncbi.nlm.nih.gov/30773763/
  16. Nguyen PT, Tran HT, Fitzgerald DA, et al. Antibiotic use in children hospitalised with pneumonia in Central Vietnam. Archives of Disease in Childhood [Internet]. 2020 Feb 20 [cited 2022 Sep 30];105(8):713-719. Available from: https://adc.bmj.com/content/archdischild/105/8/713.full.pdf
  17. Rashid MM, Chisti MJ, Akter D, et al. Antibiotic use for pneumonia among children under-five at a pediatric hospital in Dhaka city, Bangladesh. Patient Prefer Adherence [Internet]. 2017 Aug 3 [cited 2022 Sep 30];11:1335-1342. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548281/
  18. Mustafa ZU, Salman M, Aslam N, et al. Antibiotic use among hospitalized children with lower respiratory tract infections: a multicenter, retrospective study from Punjab, Pakistan. Expert Rev Anti Infect Ther [Internet]. 2022 Jan [cited 2022 Sept 30];20(1):131-136. Available from: https://pubmed.ncbi.nlm.nih.gov/34047247/
  19. Jalndoni-Cabahug, MV, Capeding, MR, et al. 2021 Clinical Practice Guidelines in the Evaluation and Management of Pediatric Community-Acquired Pneumonia. Philippine Academy of Pediatric Pulmonologists, Inc, Pediatric Infectious Disease Sociated of the Philippines, Inc; 2022 [cited 2022 Oct 3]. Available from: https://papp.org.ph/download/2021-papp-pidsp-pcap-cpg/
  20. Nduka SO, Edebeatu C, Isidienu CP, et al. Prescribing practices for pediatric out-patients: A case study of two teaching hospitals in Nigeria. Trop J Pharm Res [Internet], 2017 Mar [cited 2022 Oct 30]; 16(3): 705. Available from: https://www.ajol.info/index.php/tjpr/article/view/154379  
  21. Department of Health Pharmaceutical Division. Philippine National Formulary Essential Medicines List [Internet]. 8th. Department of Health; 2022 [cited 9 Oct 2022]. Available from: https://pharma.doh.gov.ph/the-philippine-national-formulary-essential-medicines-list/

Tools


Copyright © 2024  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic