Publication:

An observational study of antibiotic treatment in paediatric patients suffering from LRTI and Pneumonia in a tertiary care hospital

Background The observational study was conducted to evaluate the utilization of antimicrobials and sensitivity-resistance pattern in paediatric patients suffering from LRTI and Pneumonia. A prospective, non-interventional, pharmaco-vigilant study.

Methods 97 patients suffering from LRTI and Pneumonia admitted in paediatric ward, NICU and PICU from September 2012 to February 2014 were evaluated. The research protocol was approved by Institutional Ethical Committee, KIMS. Data were collected from case sheets of patients from the ward as well as Medical Record and Data section. Data on a continuous scale was expressed as a mean along with standard deviation. Categorical data was expressed as percentage. Comparative statistical analysis was done by using student's t-test in respect of data measured on a continuous scale. All differences with P value below 0.05 were labelled as statistically significant.

Results Among the 97 RTI cases 62 patients had pneumonia and LRTI in 35 patients. Antibiotics were found to be used in combination. Two drugs combination like, macrolide + ß-lactam (11.4%), cephalosporin + aminoglycoside (25.7%), amino-penicillin+ aminoglycoside (15.5%) and piperacillin + aminoglycoside (15%) were used in severe infection. Three drugs combination like Ceftriaxone±sul+Amikacin+anti-MRSA/carbapenem (5.1%), Macrolide (azithromycin and Clarithromycin) +Cephalosporin+Aminoglycoside (10.1%) were used in very severe infections. Significant resistance was observed against ß-lactam and Macrolides.

Conclusions Very severe infections with bacteremia or multiorgan failure were effectively treated with administration of Macrolide, Linezolid and Carbapenem with Ceftriaxone/ Piperacillin + Amikacin.