OBJECTIVES : Inappropriate use of antibiotics especially in children undermines treatment goals constituting significant danger to the development of the child. Local monitoring of prescribing in relation to diagnosis is necessary for improved prescription practices. The study aimed to analyze the prescribing of antibiotics among children under five at a university teaching hospital in Nigeria

METHODS : A cross-sectional observational study was conducted in a university teaching hospital in south eastern Nigeria, selected based on availability of reliable data and consent to participate in the study. Data were retrospectively collected from patient folders and prescription records over the period of January to June 2016, using a customized form for relevant information. Only cases prescribed antibiotics were included for analysis while incomplete data were excluded. Antibiotics were categorized according to the Anatomical Therapeutic Chemical (ATC) classification system and analyzed to include the Daily Defined Dose (DDD) per patient pay day

RESULTS : The study analyzed a total of 480 prescriptions with antibiotics in children who met required criteria. Mean age of the children was 0.85 (±1.04) years, with majority (68%) below age 1.There were more males (68%) compared to females (32%).Up to 78% of encounters were prescribed a single antibiotic as the whole encounters averaged 1.26 (±0.43) antibiotics per prescription. Most (57%) of the antibiotics were prescribed for parenteral administration while 47% were given through oral route. Cephalosporins (47%) followed by penicilins (42%) were the most prescribed classes of antibiotics. Gastrointestinal disorders (32%) were the most commonly diagnosed/treated conditions. Mean cost of antibiotics per prescription was N1,802.55±N900.29 ($5.01)

CONCLUSIONS : Findings suggest significant rational prescribing of antibiotics in the study facility. However, there appears to be an overuse of penicilins and cephalosporins mostly among children below one year, with limited laboratory investigations. There is scope for enhanced adherence to guidelines to help prevent antibiotic resistance