A Study on Antibiotic Usage Pattern in Pediatric Population for Urinary Tract Infection

Abstract

A prospective observational cohort study was conducted on 144 patients admitted with UTI for a period of 1 year and observed for the recurrence  for next 1year. The objective was to study the antibiotic resistance pattern  of uropathogens in UTI and to assess the antimicrobial utilization pattern in the pediatric ward of a tertiary care hospital. The confirmatory test used for UTI was urine culture. The most common causative agent for UTI was found to be Escherichia coli followed by Klebsiella. Antibiotic testing of E.coli and other isolates was done which showed greater sensitivity to meropenem and amikacin compared to other antibiotics tested. This isolates showed increasing resistance to commonly used antibiotics. Most of the children (74.31%) were treated with a single antimicrobial agent. Cephalosporins (n = 87; 60.41%) were prescribed to majority of the children, followed by Penicillin derivatives (n = 42; 29.17%) and Carbapenems (n = 16; 11.11%). The percentage of antimicrobials administered by parenteral route was found to be 79.17%. The major problems encountered in the management are relapse of UTI and treatment failure. Out of 144 children, 40 children had recurrent UTI. Among them for 25 children, antibiotics were not given according to the culture sensitivity pattern during their first UTI. Recurrent UTI can occur if adequate antimicrobial therapy based on antimicrobial susceptibility test is not given during initial UTI. This demonstrates the need for rational use of antimicrobials and judicious prescribing. The implementation of antibiotic policy and treatment guidelines based on regional data on antimicrobial susceptibility of uropathogens with periodic assessment of the clinical pharmacist in the study area is recommended.