Assessment and evaluation of rational use of antibiotics in pediatric population at a tertiary care hospital

Background: Rational antibiotic use in paediatric patients is essential to optimize treatment outcomes and minimize adverse effects. Inappropriate prescribing may result in treatment failure, toxicity, and antimicrobial resistance. The objectives are to assess antibiotic prescribing patterns, evaluate appropriateness, describe culture and susceptibility findings, and assess antibiotic optimization among paediatric inpatients in a tertiary care hospital. Methods: A prospective observational study was conducted among 250 paediatric inpatients aged below 18 years who received at least one systemic antibiotic for suspected or confirmed infection. Data were collected from case notes, medication charts, and laboratory reports. Appropriateness was assessed according to the hospital antibiotic policy, and culture and susceptibility results were reviewed. Results: Toddlers (39.2%) and children (36.4%) constituted the largest age groups, while males accounted for 53.6% of participants. Respiratory tract infections were the predominant indication (44.7%). Among 414 antibiotics prescribed, ceftriaxone (28.5%), azithromycin (18.8%), and amoxicillin-clavulanate (17.1%) were most frequently used. Intravenous administration accounted for 71.49% of prescriptions. Overall, 98% of prescriptions were appropriate, 0.8% inappropriate, and 1.2% not assessable. Watch antibiotics constituted 64% of use. Four mild, probable adverse drug reactions were reported. Escherichia coli was the most frequently isolated organism, with 91.3% susceptibility to imipenem. Conclusions: Antibiotic prescribing was generally appropriate; however, the high use of Watch antibiotics emphasizes regular prescription review, culture-guided therapy, adherence to hospital guidelines, and continued antimicrobial stewardship.