Evaluation of current practice of antimicrobial use and clinical outcome in the management of children with pneumonia admitted to Jimma Medical Center, Southwest Ethiopia: A prospective observational study

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Abstract

Background

Antimicrobial resistance is a global crisis that threatens to reverse a century of medical progress; threatening the effective prevention and treatment of common infectious diseases.

Objectives

To evaluate the current practices of antimicrobial utilization and clinical outcomes of children with pneumonia admitted to Jimma Medical Center, Ethiopia.

Method

A prospective observational study design was conducted on children admitted to the pediatric wards of Jimma Medical Center. The study was conducted from February 03, 2022, to June 03, 2022, and patients aged < 18 years and diagnosed with pneumonia were included. A chart review supplemented by a self-administered questionnaire was used to collect data. Descriptive statistics and binary logistic regressions were performed for data analyses.

Results

Among the total of 146 patients, 61.6% were male, and the mean age was 40.95 (+47.61) months. Microbiologically and radiologically examined patients were 47(32.19%) and 64 (43.8%), respectively. All the treatment approaches were found to be initiated empirically. Ceftriaxone was the most commonly prescribed antimicrobial. In-hospital mortality was 7.5%. Pre-admission antimicrobial use (AOR =3.87; 95% CI:1.34-11.16; P=0.012), antimicrobial change (AOR = 3.74; 95% CI: 1.522-9.22; P=0.004), and hospital stay (> 10 days) (AOR = 6.00; 95% CI: 2.53-14.22; P=0.029) were all independent predictors of poor clinical outcome.

Conclusion

An empirically initiated antimicrobial was completed without sufficient evidence of indication, such as microbiological and radiographic findings. More than one-fourth of the patients treated for pneumonia experienced poor outcomes, implicating the need for more attention during treatment.

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