Assessment of antibiotics use for children upper respiratory tract infections: a retrospective, cross-sectional study from Pakistan

Background: Since drug utilization evaluation is essential to assess the appropriate use of medications, the present study was carried out to evaluate antibiotics use for children upper respiratory tract infections (URTIs). Methods: A retrospective, cross-sectional study was conducted in the six health care settings of central Punjab, Pakistan. Medical records of children <= 12 years who were admitted in the study settings from 1(st) Jan-28(th) Feb 2019 were reviewed. Patterns of antibiotic use were assessed in the light of the WHO prescribing indicators and appropriateness of antibiotics treatment was assessed from British National Formulary for children. Results: A total of 1843 cases of URTI were analyzed, containing 6635 total medications. All of the patients were given antibiotics (mean 1.94 +/- 0.63 antibiotics). Cephalosporin was the most commonly used antibiotics class (37.8%) followed by penicillins. Injections were given to all the patients. Only 11% of the cases received appropriate therapy according to the indication. Of these (n = 204), around 93% received right dose whereas right frequency and duration were found in 96.5% and 95.5% of the cases, respectively. Conclusion: Our study revealed alarmingly high utilization of antibiotics among Pakistani children with URTIs. A great emphasis should be placed on implementing antimicrobial stewardship strategies for the rational use of antimicrobials in Pakistan and pharmacists should be in the front and centre to lead antimicrobial stewardship.