Impact of an antimicrobial resistance control program: pre- and post-training antibiotic use in children with typhoid fever
Journal Title: Paediatrica Indonesiana - Year 2016, Vol 56, Issue 4
Abstract
Inappropriate use of antibiotics may lead to antimicrobial resistance. In 2012, Dr. Soetomo Hospital conducted training for pediatric residents on the proper use of antibiotics to limit antimicrobial resistance.Objective To evaluate the impact of a rational, antibiotic-use training program for pediatric residents on their antibiotic prescriptions for patients with typhoid fever.Methods A cross-sectional, analytic study was conducted. We collected data from children with typhoid fever who were hospitalized in Dr. Soetomo Hospital, pre- and post-training on antibiotic prescriptions. Children with other known bacterial infections or who were discharged on request were excluded. Antibiotic prescriptions were evaluated using Gyssens algorithm based on the local protocol. Chi-square test was used to compare the quality of antibiotic prescriptions, before (year 2012) and after (year 2013) the training.Results Forty-nine patients with 67 prescriptions in 2012 and 34 patients with 48 prescriptions in 2013 fulfilled the inclusion criteria. Patients’ ages ranged from 1-18 years. Diagnoses of uncomplicated and complicated typhoid were found in 74% and 26% of subjects, respectively. First line (chloramphenicol, thiamphenicol, ampicillin, trimetroprim and sulfametoxazol) and second line (ceftriaxone and cefixime) use were 72% and 28%, respectively. All patients were discharged in good condition. Appropriate use of antibiotics was noted in 61% of subjects in 2012 and in 81% of subjects in 2013 (P=0.036). The most common type of error in 2012 and 2013 was dosage imprecision (25% and 17%, respectively).Conclusion Training on appropriate use of antibiotics significantly improved the quality of antibiotics prescribed in children with typhoid fever in Dr. Soetomo Hospital.
Authors and Affiliations
Elfrida Rachmah, Maftuchah Rochmanti, Dwiyanti Puspitasari
Keywords
Related Articles
- EP ID EP446135
- DOI 10.14238/pi56.4.2016.205-10
- Views 72
- Downloads 0
Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children
Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive.Objectives To distinguish...
Pattern and frequency of pediatric congenital heart disease at the Cardiac Research Institute of Kabul Medical University, Afghanistan
Background Congenital heart disease (CHD) is the most common birth defect, with incidence of 0.7-0.9 live birth; it increases to 2-6% if first degree relative is affected. In Afghanistan majority of births take place at...
Risk factors for mortality in children with Wilms tumor
Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality i...
Association between sleep quality and obesity in adolescents
Background Sleep quality can be measured by the Pittsburgh Sleep Quality Index (PSQI). One component of the PSQI is duration of sleep, which is often highly inadequate in adolescents. Inadequate sleep may lead to obesity...
Hunter syndrome with hyperthyroidism: a 16 month follow-up reprt
Mucopolysaccharidosis (MPS) is a rare genetic disorder caused by a deficiency in the activity of lysosomal enzymes required for glycosaminoglycan (GAG) degradation. An accumulation of GAG in many organs results in progre...