Pattern and predictors of antibiotic prescriptions by physicians to paediatric outpatients in a Nigerian Tertiary Care Hospital: A call for antibiotic stewardship

Abstract

Background: Irrational antibiotic use for childhood illnesses is prevalent, especially in developing countries. There is a need to provide evidence-based data for the implementation of antimicrobial stewardship programmes (ASP) in healthcare facilities. This study was conducted to describe the pattern and predictors of antibiotic prescriptions to paediatric patients at the outpatient clinic of Federal Medical Centre Umuahia Abia State, Southeast Nigeria.
Method: We conducted a retrospective review of patients’ encounters in one year at the outpatient paediatric clinics (2022). An electronic data extraction form was used to collect information from patient’s case notes. Descriptive, bivariate and multivariate analyses were done using SPSS version 26. The level of significance was set at 5%.
Results: Records of 722 encounters were retrieved. A total of 694 antibiotics were prescribed. The antibiotic prescription rate was 74.4% (95% CI: 71.2–77.6). The most frequently prescribed antibiotic was amoxicillin/clavulanic acid (34.9%). Most prescribed antibiotics (53.6%) were in the ‘access’ group of antibiotics. The commonest indication for the use of antibiotics was the treatment of respiratory infections (28.1%). The predictors of antibiotic prescription included younger age (aOR = 2.48; 95% CI: 1.50–3.80), four or more drugs prescribed (aOR = 9.43; 95% CI: 3.90 - 22.10), and therapeutic treatment type (aOR = 3.24; 95% CI: 1.10–9.40).
Conclusion: Irrational prescriptions of antibiotics by physicians were prevalent in the  paediatric outpatient  clinic of the facility. We recommend the implementation of the ASP in the hospital to address irrational antibiotic prescriptions in line with rational drug policy.