Skip to main content

ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Infectious Diseases
Volume 12 - 2024 | doi: 10.3389/fped.2024.1469766
This article is part of the Research Topic Pediatric Infectious Diseases and Global Action Plan on AMR View all 7 articles

Identifying Targets for Antibiotic Stewardship Interventions in Pediatric Patients in Punjab, Pakistan: Point Prevalence Surveys Using AWaRe guidance

Provisionally accepted
Samia Sheikh Samia Sheikh 1Zikria Saleem Zikria Saleem 1*Shairyar Afzal Shairyar Afzal 2Muhammad Usman Qamar Muhammad Usman Qamar 3Ali Abuzar Raza Ali Abuzar Raza 4Syed Zeeshan Haider Naqvi Syed Zeeshan Haider Naqvi 4Basil A Al-Rawi Basil A Al-Rawi 5Brian Godman Brian Godman 6
  • 1 Bahauddin Zakariya University, Multan, Pakistan
  • 2 Department of Pharmacy, DHQ Hospital Jhelum, Jhelum, Pakistan, Jhelum, Pakistan
  • 3 3Institute of Microbiology, Faculty of Life Sciences, Government College University Faisalabad, Faisalabad 38000, Pakistan, Faisalabad, Pakistan
  • 4 Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan, Lahore, Pakistan
  • 5 Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia., Riyadh, Pakistan
  • 6 9StrathclInstitute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK, Glasgow, United Kingdom

The final, formatted version of the article will be published soon.

    Introduction: Surveillance of antibiotic use is crucial for identifying targets for antibiotic stewardship programs (ASPs), particularly in pediatric populations within countries like Pakistan, where antimicrobial resistance (AMR) is escalating. This point prevalence survey (PPS) seeks to assess the patterns of antibiotic use in pediatric patients across Punjab, Pakistan, employing the WHO AWaRe classification to pinpoint targets for intervention and encourage rational antibiotic usage.A PPS was conducted across 23 pediatric wards of 14 hospitals in the Punjab Province of Pakistan using the standardized Global-PPS methodology developed by the University of Antwerp. The study included all pediatric inpatients receiving antibiotics at the time of the survey, categorizing antibiotic prescriptions according to the WHO Anatomical Therapeutic Chemical classification and the AWaRe classification system.Results: Out of 498 pediatric patients, 409 were receiving antibiotics, representing an antibiotic use prevalence of 82.1%. A substantial majority (72.1%) of the prescribed antibiotics fell under the WHO's Watch category, with 25.7% in the Access category and 2.2% in the Reserve group. The predominant diagnoses were respiratory infections, notably pneumonia (32.4%). The most commonly used antibiotics were ceftriaxone (37.2%) and Vancomycin (13.5%). Only 2% of antibiotic uses were supported by culture sensitivity reports, highlighting a reliance on empirical therapy.The high prevalence of antibiotic use, particularly from the Watch category, and low adherence to culture-based prescriptions underscore the critical need for robust antibiotic stewardship programs in Pakistan. Strengthening these programs could help mitigate AMR and optimize antibiotic use, aligning with global health objectives.

    Keywords: pediatric, Antimicrobial resistance (AMR), Antimicrobial stewardship (AMS), Pakistan, Point prevalence survey

    Received: 24 Jul 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Sheikh, Saleem, Afzal, Qamar, Raza, Haider Naqvi, Al-Rawi and Godman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zikria Saleem, Bahauddin Zakariya University, Multan, Pakistan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.