Empiric antibiotic prescription among febrile under-five Children in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

Abstract

Background: More than 97% of febrile infants and young children have self-limiting viral infection and therefore, would not require antibiotics. Over prescription of antibiotics increases antibiotics exposure and development of resistance among patients. There is need to evaluate empiric antibiotic
prescription in order to limit its use to only febrile children with bacterial infection.

Aim and Objectives: The aim of this study was to determine the prevalence of empiric antibiotic prescription among febrile underfive, post neonatal children presenting in the children outpatient clinic of the  University of Port Harcourt teaching hospital.

Method: Febrile Children aged 29 days to <60 months who presented in the outpatient clinic were recruited from September 2010 to January 2011. Their weight, biodata, symptoms, Physician’s diagnosis, and names of antibiotic prescribed were entered into a predetermined proforma and analysed.

Result: A total of 362 children with male to female ratio of 1.03:1 were
studied. Two hundred and eighty three (78.2%) febrile children received
empiric antibiotic prescriptions. The most frequent antibiotic prescribed was amoxicillin 80 (28.3%). Children aged 1-12months received the highest
number of prescriptions 113 (80.7%). There was no significant relationship between age, temperature level, weight for age, number of symptoms and frequency of antibiotic prescription (p>0.05). Upper respiratory tract  infection (83.7 %) and diarrhea (55.9%) were significantly associated with
empiric antibiotic prescription (P=0.05 and 0.002 respectively).

Conclusion: Empiric antibiotic prescription for febrile under-five children is a common practice in UPTH. Physicians should therefore reduce the  frequency of antibiotics prescription in febrile children unless there is clinical
evidence of bacterial infection.

Key words: Empiric Antibiotics, Fever, post neonatal under-five, Nigeria