Antimicrobial prescribing practices for children hospitalised with respiratory tract illnesses at a tertiary public sector hospital in South Africa ANTIMICROBIAL PRESCRIBING PRACTICES FOR CHILDREN HOSPITALISED WITH RESPIRATORY TRACT ILLNESSES AT A TERTIARY PUBLIC SECTOR HOSPITAL IN SOUTH AFRICA
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Abstract
Background. Antimicrobial prescribing practices for children hospitalised with lower respiratory tract infections (LRTIs) are infrequently reported, particularly in developing countries.
Objectives. We evaluated the antimicrobials prescribed to children with severe respiratory illness hospitalised at Chris Hani Baragwanath Academic Hospital (CHBAH) in Johannesburg, South Africa, from 22 July until 22 September 2021.
Methods. Children aged 1 month to 14 years who were hospitalised with severe acute respiratory illness were enrolled. We assessed frequency of antibiotic usage, admission diagnoses and 28-day outcomes.
Results. A total of 183 children were screened and 85 (46.4%) were enrolled. Most of the enrolled children (n/N=75/85; 88.2%) received antibiotic therapy. The most common diagnoses were bronchiolitis (n/N=30/85; 35.3%), LRTI (n/N=21/85; 24.7%), and pneumonia (n/N=18/85; 21.2%). Twenty-five (83.3%) of the children with bronchiolitis were treated with antibiotic therapy. Of the 122 antibiotics prescribed, 109 (89.3%) were classified in the WHO AWaRe groups of antimicrobials, and 95 (77.9%) were ‘Access’ antibiotics. Co-amoxiclav, amoxicillin and ampicillin were the most commonly prescribed antimicrobials. The median length of hospitalisation in those who survived to discharge was 3 (1 - 57) days. Three children died, two in-hospital and one post discharge.
Conclusion. Antimicrobials are commonly prescribed to children with severe respiratory illness hospitalised at CHBAH. Children with bronchiolitis were commonly treated with antimicrobials and should be targeted as a major focus group for optimisation of antimicrobial stewardship practice.
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