Presentation (CTI)

OBJECTIVES: To assess the clinical severity of Respiratory Tract Infections (RTIs) among hospitalized paediatric patients using the Paediatric Respiratory Severity Score (PRESS) and to evaluate the prescribing patterns through World Health Organization (WHO) drug utilization indicators.
METHODS: A 6-month prospective cross-sectional study was conducted in the paediatric ward of a tertiary care hospital in India. Children aged 0-12 years admitted with all types of Respiratory Tract Infections were enrolled in the study. Patient's demographic, clinical, laboratory information were collected using a pre-defined structured case-report form. Clinical severity was assessed using PRESS. Drug Use Evaluation was performed using WHO prescibing indicators and we have assessed the prescribing patterns, antibiotic utilization, route of administration, generic versus brand prescibing, fixed dose combinations, nebulization therapy, length of hospital stay and potential drug interactions from the patient's prescription chart. Data were analysed using descriptive statistics and chi-square tests, with findings presented graphically.
RESULTS: A total of 123 children (mean age 4.2, with SD 3.1 years, 54% male) with upper and RTIs were enrolled. Lower RTIs were predominant (83.7%) with 69.9% of admissions in children under 5. According to PRESS, most of the cases (42.3%) were classified as mild. Analysis of prescribing patterns revealed that 58.3% of all drugs were administered parenterally, antibiotics accounted for 34.7% of drug encounters. A significant discrepancy was observed between prescribed daily doses and recommended standards (p<0.05).
CONCLUSIONS: This study reveals a high burden of lower RTIs in young children, frequent use of parenteral and branded antibiotics with a notable dosing inconsistency. These findings underscore the need for strengthened antibiotic stewardship and improved adherence to dosing guidelines.