Antibiotic prescribing patterns in the emergency department at the Wendy Fitzwilliam Pediatric Hospital

ABSTRACT

Objective: This study aims to assess the quantity and quality of antibiotic prescribing in the emergency department at Wendy Fitzwilliam Pediatric Hospital (WFPH), per World Health Organization (WHO) and National Antimicrobial Prescribing Survey (NAPS) indicators. Design and Methodology: A clinical notes review of patients (aged one month to 13 years) seen in the WFPH emergency department was conducted between March and May 2018. The study population was 12,293 patients, convenience sampling was used and eligible patient notes were reviewed. For each encounter, patient demographics, prescription and indication were recorded. The analysis of the data, conducted using Microsoft Excel 2016, was based on WHO prescribing indicators (generic name and model formulary percentage) and NAPS compliance with guidelines indicators. Results: The study included 119 patients with a mean age of 5 years (s=3.55 years) and 52% (n=62) were male. 13.5% of the prescribed antibiotics included the drug's generic name while 95.7% were found on the WHO model formulary. Of all the prescribed antibiotics, 58% was compliant. Of the 141 antibiotics prescribed, 83% (n=117) were broad-spectrum, with amoxicillin/ clavulanic acid (48%) and amoxicillin (17%) being the most common. The most common indications were respiratory tract infections (42%) and skin, and soft tissue infections (40%). Conclusions: The WFPH emergency department had good adherence to an essential formulary and mostly complied with guidelines. However, the high number of broad-spectrum antibiotics prescribed for common infections indicate a need for further research, toward implementing a rational antibiotic prescribing policy in Trinidad and Tobago.