Evaluation of drug use in pediatric acute gastroenteritis patients.

| Posted in: Science

Journal name: World Journal of Pharmaceutical Research
Original article title: A prospective drug utilisation evaluation of acute gastroenteritis in pediatric patients in a tertiary care teaching hospital
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Dr. Pathan Amanulla Khan, Naureen Fatima, Juwerriah Nishaat and Neda Fatima


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: A prospective drug utilisation evaluation of acute gastroenteritis in pediatric patients in a tertiary care teaching hospital

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr20168-6793

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

1) Introduction

Acute gastroenteritis (AGE) is a significant contributor to morbidity and mortality in the pediatric population globally, leading to millions of outpatient visits and hospitalizations annually. In many parts of the world, including India, diarrheal diseases are a leading cause of child mortality, with AGE primarily caused by viral and bacterial infections. The study aimed to evaluate the prescription patterns and treatment protocols employed for pediatric patients suffering from AGE at a tertiary care teaching hospital in Karnataka, India. Researchers aimed to assess the extent of drug utilization and the rationality of prescribed therapies among children with AGE.

2) Patterns of Drug Utilization

The evaluation of the pediatric patients' prescriptions uncovered a total of 162 drugs prescribed over the study period. The most commonly utilized drugs included cephalosporins, constituting 27.16% of prescriptions, followed by anti-gastrics and intravenous fluids, each representing 28.39%. The study found that cephalosporins were favored as the primary antibiotic treatment, with Ranitidine frequently used as the anti-gastric drug. Interestingly, intravenous fluids (IVF) were also commonly prescribed, particularly in cases of severe dehydration—a critical concern in managing AGE in children.

3) Antibiotic and Polypharmacy Concerns

Among the 51 prescriptions analyzed, a striking 84.3% included combinations of antibiotics with anti-gastric medications, signifying a preference for polypharmacy. Most patients received single antibiotic therapy (64.7%), while two antibiotics were prescribed in 17.64% of cases. Despite the common prescription of antibiotics, concerns about the empirical treatment approach emerged, as it appeared that causative organisms were frequently not evaluated before prescribing, potentially leading to irrational use of antibiotics and increased risk of antibiotic resistance in pediatric patients.

4) Adherence to Guidelines and Recommendations

The study highlighted discrepancies in adherence to established guidelines regarding the use of oral rehydration therapy (ORT) as the first-line treatment for AGE. Only 17.64% of patients received ORT, while the majority were administered antibiotics. This finding aligns with previous literature which emphasizes the promotion of ORT, particularly in cases of non-severe dehydration, to manage AGE holistically and effectively. Additionally, the under-utilization of ondansetron, an antiemetic linked to reduced hospitalizations due to vomiting in gastroenteritis, suggested room for improvement in managing the symptoms associated with AGE.

5) Conclusion

The findings of the study provide pivotal insights into the prescription practices for pediatric AGE patients, revealing a tendency towards antibiotic prescription and a reliance on polypharmacy. While cephalosporins emerged as the dominant antibiotic choice, it was concerning that empirical treatments often occurred without organism evaluation. This study highlights the importance of employing rational drug therapy and assessing the clinical pharmacist's role in optimizing patient care. Better awareness of treatment guidelines and a shift towards evidence-based management, including sufficient use of ORT and careful antibiotic administration, are essential to improve health outcomes in children facing acute gastroenteritis.

FAQ section (important questions/answers):

What is the primary focus of the study on AGE?

The study aimed to assess the drug utilization patterns in pediatric patients suffering from acute gastroenteritis (AGE) in a tertiary care teaching hospital.

What were the most commonly prescribed drugs for AGE?

The most commonly prescribed drugs included Cephalosporins (27.16%), Ranitidine for gastric issues, intravenous fluids for dehydration, and Ondansetron as an antiemetic.

How many pediatric patients were included in the study?

A total of 51 pediatric inpatients diagnosed with AGE were analyzed during the one-month study period.

What was the aim of the study regarding prescriptions?

The study aimed to assess the rationality of drug therapy and the prevalence of polypharmacy and monotherapy among the prescriptions given to pediatric patients with AGE.

Which age group was most affected by AGE in this study?

The study found that children less than one year old were most affected by AGE, with a notable prevalence among males aged 1-12 years as well.

What was the conclusion about antibiotic usage in treating AGE?

The study concluded that empirical antibiotic treatment was often used without identifying the causative pathogens, which could lead to irrational prescribing practices in treating AGE.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Evaluation of drug use in pediatric acute gastroenteritis patients.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Study (Studying):
The study represents a systematic examination of drug utilization patterns in pediatric patients with acute gastroenteritis. It assesses prescription trends, evaluates therapies used, and aims to improve patient outcomes. By analyzing 51 inpatient instances, researchers seek to assess treatment efficacy and adherence to clinical guidelines in a hospital setting.

2) Antibiotic (Antibacterial):
Antibiotics are critical in the treatment of bacterial infections. In this study, the focus is on their prescription patterns in pediatric patients suffering from acute gastroenteritis. The utilization, effectiveness, and potential over-prescription of antibiotics like cephalosporins are key components analyzed for optimizing pediatric drug therapy.

3) Drug:
Drugs encompass all therapeutic substances used in managing acute gastroenteritis. This study investigates both the types of drugs prescribed and their combinations—highlighting the role of drugs like anti-gastrics, NSAIDs, and IV fluids in providing comprehensive care for pediatric patients during hospitalization.

4) India:
India is significant in this study as it experiences a high burden of pediatric gastroenteritis cases. The aim is to understand regional healthcare practices, prescription patterns, and the impact of local healthcare challenges on treatment outcomes, particularly in a tertiary care setting where the study is conducted.

5) Male:
The term 'male' is relevant in the context of gender distribution among pediatric patients with acute gastroenteritis. The study's findings show a higher incidence of the disease in male patients, indicating potential gender-related differences in health care access, treatment response, and vulnerability to certain diseases.

6) Vomiting:
Vomiting is a common symptom associated with acute gastroenteritis. This study categorizes and quantifies episodes of vomiting among pediatric patients, aiding in the understanding of the disease's clinical presentation. Management strategies for related symptoms are also evaluated to improve overall treatment protocols in pediatric wards.

7) Disease:
The study focuses on acute gastroenteritis as a significant disease affecting pediatric populations. Understanding its impact on morbidity and mortality informs the need for efficient management strategies and highlights treatment guidelines that could prevent serious complications like dehydration and improve recovery rates in children.

8) Table:
Tables in the study are utilized to present organized data regarding patient demographics, clinical features, and prescription summaries. They provide a clear overview of findings, such as the distribution of symptoms among different age groups and the frequency of prescribed medications, enhancing data interpretation and analysis.

9) Fever:
Fever is another prevalent symptom in acute gastroenteritis cases among pediatric patients. The study captures the prevalence of fever as a clinical feature and highlights the importance of monitoring this vital sign to guide treatment decisions and evaluate the severity of illness in young children.

10) Teaching:
The study is conducted in a teaching hospital, which emphasizes the role of academic medical institutions in patient care and clinical research. Teaching hospitals often provide training for future healthcare professionals, integrating patient care with education to improve clinical practices in managing conditions like gastroenteritis.

11) Suffering:
The notion of suffering reflects the distress pediatric patients experience due to acute gastroenteritis. This study aims to address the suffering through effective treatment evaluation, understanding the burden of the disease, and striving for improved management strategies that can alleviate symptoms and improve overall patient well-being.

12) Reason:
The reason for hospital admission in this study primarily relates to gastrointestinal symptoms like diarrhea and vomiting. Understanding the reasons for seeking medical care is crucial for healthcare providers, as it aids in developing targeted interventions and educational initiatives aimed at preventing dehydration and hospitalization.

13) Line:
The term 'line' refers to 'first-line' treatments or recommended therapy protocols in managing acute gastroenteritis. The study emphasizes adherence to these established treatment lines, such as the use of oral rehydration solutions, and critically analyzes how well they are implemented in practice among pediatric patients.

14) Discussion:
The discussion component of the study synthesizes the findings and contextualizes them within existing literature and clinical guidelines. It highlights the implications of observed prescription patterns, evaluates the appropriateness of treatments administered, and suggests necessary changes to improve care for pediatric patients with gastroenteritis.

15) Developing:
The term 'developing' pertains to the context of healthcare in India and similar nations facing challenges in managing diseases like gastroenteritis. The study's insights aim to inform healthcare providers in developing countries about prescription practices, potential drug resistances, and strategies for improving pediatric outcomes.

16) Karnataka:
Karnataka is the geographical location of the study, providing a specific context for examining acute gastroenteritis treatment patterns. Understanding local healthcare practices, disease prevalence, and resource availability in Karnataka highlights variables that impact patient management and informs targeted health policies for the region.

17) Medicine:
Medicine signifies the field concerned with the diagnosis, treatment, and prevention of diseases. This study is rooted in medical practice, specifically within pediatrics, aiming to optimize treatment regimens and enhance patient outcomes through analyzing drug utilization patterns in pediatric gastroenteritis cases.

18) Account:
The term 'account' refers to the recorded and analyzed data within the study, providing a comprehensive view of the treatment patterns among pediatric patients. The findings presented in this research contribute to understanding and accounting for the variations in clinical practices and patient outcomes.

19) Nausea:
Nausea is a common symptom in gastroenteritis that often accompanies vomiting. This study collects data on nausea incidence among pediatric patients, emphasizing its relevance in understanding the full clinical picture and informing treatment approaches that address multiple gastrointestinal symptoms for better patient management.

20) Ulcer:
Ulcer refers to a condition that may coincide with acute gastroenteritis, affecting treatment choices. The study monitors co-morbid conditions like ulcers to ascertain their impact on therapy effectiveness and underscores the need to tailor treatment plans for patients with multiple gastrointestinal issues.

21) Death:
Death is the most severe consequence of untreated or poorly managed acute gastroenteritis, especially in vulnerable pediatric populations. The study aims to highlight the importance of appropriate treatment strategies and early intervention to mitigate the risk of mortality associated with severe gastroenteritis cases.

22) Visit:
Visits to healthcare facilities for gastroenteritis are significant due to the disease's impact on pediatric health. The study discusses the frequency of outpatient visits correlated to AGE, underscoring the importance of effective management to reduce hospitalizations, improve health outcomes, and minimize healthcare burdens.

23) Sign:
Signs refer to observable indicators of a medical condition, such as dehydration in gastroenteritis. The study emphasizes recognizing signs early to implement timely interventions, which can enhance patient care and prevent complications associated with acute gastroenteritis in pediatric patients.

24) Pain:
Pain is a symptom that may accompany gastroenteritis, impacting a child's quality of life. The study acknowledges pain management strategies that can enhance patient comfort during treatment and emphasizes the importance of assessing pain in conjunction with other symptoms for comprehensive care.

25) Neta:
Neda refers to one of the researchers or authors involved in the study, contributing to the overall analysis and interpretations of the data. Recognizing individual contributions emphasizes collaborative efforts in research and the collective responsibility of healthcare professionals in enhancing pediatric patient care.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Evaluation of drug use in pediatric acute gastroenteritis patients.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Treatment Protocol, Pediatric Population, Morbidity and Mortality, Acute gastroenteritis, Polypharmacy, Aminoglycosides, Ranitidine, Oral rehydration solution, Antiemetic, IV fluid, Hospitalization rate, Cephalosporin.

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