OBJECTIVES:

Drug Utilization Evaluation (DUE) studies are designed to assess drug usage appropriateness. With the major concern of raising antimicrobial resistance, our study aimed at evaluating appropriate use of most widely used class of antibiotics; Cephalosporins, in pediatric department in a teaching hospital in Andhra Pradesh, India. Patterns of prescribing studies in Pediatrics as found very less in India. Hence the study was conducted.

METHODS:

It is an observational study carried in inpatients for a period of 5 months (September 2018 to January 2019).115 patients who received Cephalosporins were randomly assigned to this study. Every patient was observed until discharge. Prospective review of patient’s records was carried out. Data were converted to Defined Daily Dose (DDD) and the ratio of prescribed daily dose per DDD was calculated. Assessment of Cephalosporins use was made by using WHO prescribing indicators.

RESULTS:

Among these 115 children, (61.10%) were males. The majority of the children belonged to the preschool age group. Third generation cephalosporins are mostly prescribed of them ceftrioxine 50(43%) is seen to be prescribed more.The ratio of prescribed daily dose to DDD was 1.5 for antibiotics. Most of the patients received Cephalosporins as empiric therapy. Only 13 patients received their antibiotics consistent with American Hospital Formulary System (AHFS) mentioned indication. Baseline Blood Urea Nitrogen (BUN) and serum Creatinine were ordered for only 27 patients 5 abnormal results but dose adjustment performed just in one case with decreased renal function.

CONCLUSIONS:

In conclusion, the majority of courses Cephalosporins were empirically selected and continued and required lab tests for drug monitoring and dose adjustments were not performed in most cases. Educational interventions, developing a local formulary and a strict antibiotic prescribing policy for example by prior approval by an infectious disease consultant can help significantly to overcome these problems.