Govindarajan Srinidhi, Shenoy Preethi J
Department of Pharmacology, Kasturba Medical College, Mangalore, Karnataka, India.
Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Pharm Bioallied Sci. 2020 Oct-Dec;12(4):423-427. doi: 10.4103/jpbs.JPBS_235_19. Epub 2020 Oct 8.
A constant update of antibiotic sensitivity of pathogens of the area, country, or institution helps in interventions that would improve the prescribing pattern and rational use of drugs in children. This study aimed to assess prescribing trends for urinary tract infection (UTI), a common distressful pediatric infection in a tertiary care teaching hospital.
This study was a descriptive, retrospective, cross-sectional, and record-based analysis including pediatric patients aged <18 years of either gender diagnosed with UTI. The case record files retrieved from medical records department based on the International Classification of Diseases, 10th Revision (ICD-10) disease coding were analyzed for demographics, and details of drugs including dose and route of administration, frequency, and duration of treatment with antimicrobial used and other concurrent drugs were recorded.
Of 42 patients included in the study, 14 (33.3%) were males and 28 (66.67%) were females. Third-generation cephalosporins were the most commonly used antibiotics (71.4%) followed by aminoglycosides (35.7%), amoxicillin clavulanate (11.9%), fluoroquinolones (7.1%), and miscellaneous (doxycycline, metronidazole, and nitrofurantoin) (9.5%). Ceftriaxone among the cephalosporins and amikacin among the aminoglycosides were the most commonly used drugs. Intravenous route was the most commonly used route of administration followed by patients who received by both intravenous and oral routes. The average duration of therapy was 4.43 ± 1.9 days.
This study concludes that third-generation cephalosporin is used as first-line drugs irrespective of the causative agent for UTI which should ideally be reserved for complicated UTIs. Moreover, existing guidelines also indicate that the duration of antimicrobial therapy should be seven to 14 days. These results highlight the necessity for a remedial education program within the health care system designed to improve pharmacotherapy of UTI.
不断更新某地区、国家或机构病原体的抗生素敏感性，有助于采取干预措施，改善儿童用药模式和合理用药情况。本研究旨在评估三级护理教学医院中常见的令人困扰的儿科感染——尿路感染（UTI）的用药趋势。
本研究为描述性、回顾性、横断面且基于记录的分析，纳入年龄小于18岁、诊断为UTI的各性别儿科患者。根据国际疾病分类第10版（ICD - 10）疾病编码从病历科检索病例记录文件，分析患者人口统计学信息，并记录药物详情，包括剂量、给药途径、频率以及使用的抗菌药物和其他同时使用药物的治疗持续时间。
纳入研究的42例患者中，男性14例（33.3%），女性28例（66.67%）。第三代头孢菌素是最常用的抗生素（71.4%），其次是氨基糖苷类（35.7%）、阿莫西林克拉维酸（11.9%）、氟喹诺酮类（7.1%）和其他类（多西环素、甲硝唑和呋喃妥因）（9.5%）。头孢菌素类中的头孢曲松和氨基糖苷类中的阿米卡星是最常用的药物。静脉途径是最常用的给药途径，其次是接受静脉和口服两种途径给药的患者。平均治疗持续时间为4.43±1.9天。
本研究得出结论，无论UTI的病原体是什么，第三代头孢菌素都被用作一线药物，而第三代头孢菌素理想情况下应仅用于复杂性UTI。此外，现有指南还表明抗菌治疗的持续时间应为7至14天。这些结果凸显了在医疗保健系统内开展补救教育项目以改善UTI药物治疗的必要性。
