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[Prescription of antibiotic drugs for children at the Brazzaville University Hospital Center (Congo)].

UNLABELLED
Antibiotics are a class of drugs commonly prescribed in pediatric practice, often inappropriately.


OBJECTIVE
To determine the prevalence of antibiotic prescription in hospitalized children, assess the quality of prescribing, and identify factors related to inappropriate prescriptions.


METHODS
This retrospective study was conducted from July through December 2009 (6 months). It included data about 464 children aged from 1 month-16 years who received antibiotic therapy.


RESULTS
Antibiotics were prescribed to 61.5% of the children admitted to the hospital. Their mean age was 18.6 ± 20.2 months, and most (78%) were younger than 2 years. The indications for antibiotics were dominated by acute respiratory infections (46%), diarrhea (16%), and severe sepsis (12%). The prescriptions were written by pediatricians in 179 cases (38.6%), and by residents or interns in the other cases. The beta-lactam antibiotics (79%), aminoglycosides (8%) and sulfonamides (7%) were prescribed most often. The initial antibiotic therapy was changed in 82 cases. The indication for antibiotic therapy was correct in 325 cases and the type chosen appropriate in 229, the dosage correct in 437 cases, and the duration correct in 390. The route of administration was intravenous in 243 cases (40.3%), oral in 194 (41.8%), and intramuscular in 37 (7.9%). The qualification of the prescriber was associated with relevance, choice and dosage. The dosage was correct when the drug was administered parenterally in 248 cases (56.8%); in contrast, it was incorrect in 189 cases (43.7%; p>0.05) of oral administration. The route of administration was related to the choice of antibiotic. Thus, it was appropriate when the route was parenteral in 162 cases (70.7%) and in only 67 cases (29.3%) for the oral route (p <0.001).


CONCLUSION
Errors in antibiotic prescriptions could be improved by standardized treatment guidelines, compliance with international recommendations, a consistent approach to diagnosis, and better laboratory performance.