Patterns of antibiotic usage in children at the Queen Elizabeth Hospital, Barbados

ABSTRACT

Seven hundred and thirty-two paediatric patients treated with antibiotics at the Queen Elizabeth Hospital were reviewed. There were 522 outpatients seen in the casualty area and 230 inpatients admitted to the Paediatric wards. Six hundred and forty-seven (87 percent) patients were on the medical service and 105 (13 percent) on the surgical service respectively. Tonsillitis, otitis media and pneumonia were the most commonly documented conditions treated in inpatients whereas upper respiratory tract infections, tonsillitis and otitis media were the most commonly treated conditions in outpatients. In both patient groups, penicillin and trimethoprim-sulphamethoxazole were the most frequently prescribed antimicrobial agents. Antibiotic therapy was further classified according to the documented diagnoses into groups of (1) indicated, (2) not indicated, (3) inappropriate or (4) prophylactic. In 34 percent of inpatients and 54 percent outpatients, antibiotic therapy was classified as no indicated. Conditions in inpatients most frequently treated with "not indicated" antibiotics included cases of post-operative tonsillectomy and andenoidectomy without documented clinical or bacteriological evidence of infection, gingivostomatitis and upper respiratory tract infections. Bacterial culture negative gastroenteritis, gingivostomatitis and bronchial asthma were the most frequently treated conditions receiving "not indicated" therapy in outpatients. In most of these conditions, the infection was most frequently of viral aetiology (AU)