TITLE:
Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel Touré Teaching Hospital, Bamako, Mali
AUTHORS:
Pierre Togo, Hawa Konaré, Mariam Maïga, Karamoko Sacko, Djénéba Konaté, Abdoul Karim Doumbia, Adama Dembélé, Oumar Coulibaly, Aminata Sangaré, Mohamed Elmouloud Cissé, Fousseyni Traoré, Belco Maïga, Ibrahim Ahamadou, Aminata Doumbia, Lala N’Drany Sidibé, Amadou Touré, Yacouba Aba Coulibaly, Kalirou Traoré, Tati Simaga, Souleymane Sagara, Leyla Bagna Maïga, Bory Traoré, Abdoul Aziz Diakité, Fatoumata Dicko, Mariam Sylla, Sounkalo Dao, Boubacar Togo
KEYWORDS:
Antibiotic Prescription, Hospitalization, Child
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.14 No.3,
May
28,
2024
ABSTRACT: Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.