The pattern of empirical and targeted antibiotic use in hospitalised pediatric patients at a tertiary health facility
Background: Children in sub-Saharan Africa have high infection burden, leading to prevalent empirical antibiotic use, a driver for antibiotic resistance.
Aim and objectives: This study assessed outcomes of empirical and targeted antibiotic therapy on symptom resolution in hospitalised paediatric patients at Tamale Teaching Hospital (TTH).
Methods: A cross-sectional study assessed the proportion of empirical and targeted antibiotic use among paediatric patients with bacterial infections and treatment outcomes. Fisher’s exact test was used to statistically analyse the data.
Results: The 371 participants were mostly males (62.0%), with a median age of 1.08 years (range 0.08-12 years). The prevalent infections were gastrointestinal infections (34.2%) and pneumonia (31.8%), with culture and sensitivity testing (CST) requests (p<0.001) being common in sepsis, UTIs, and CNS infections. The 640 antibiotics prescribed, mainly cephalosporins (47.8%) and penicillins (21.6%), consisted of 55.0% Access antibiotics and 45% Watch antibiotics. Overall, CST findings were used for targeted therapy in 4.9% of participants. The most prevalent bacterial isolates were Acinetobacter baumanni and Klebsiella pneumoniae, both of which are multidrug-resistant. At the end of antibiotic treatment, the proportion of patients who had symptom resolutioon was higher in those who received targeted therapy compared to those who received empiric antibiotic use, but this difference was not statistically significant.
Conclusion: Antimicrobial stewardship at TTH should emphasise the use of local antibiograms to optimise pharmacotherapy.
Keywords: empirical, targeted, AWaRe antibiotics, antibiotic resistance, culture and sensitivity test.
