(232) Antibiotic Exposure of Pediatric Patients: Local Study from an Urgent Care Clinic

Background: Antibiotic resistance (AMR) poses a major public health concern worldwide. One of the main drivers of AMR is (suboptimal) antibiotic use. Patient with infectious diseases are often present at urgent care clinics but despite this studies on antimicrobial prescribing are scarce from this setting.

Objectives: To characterize the scale and pattern of antibiotic utilization in pediatric patients with ED presentation.

Methods: We conducted a retrospective observational study in the biggest hospital in the most populous district in Central Java, Indonesia. Data were obtained from electronic medical records for year 2022. We included pediatric patients (aged 0 month–14 years) in the study who were prescribed systemic antibiotics (WHO ATC: J01) treatment. Demographic variables and all antibiotic related data were recorded. The outcome measure was the number of exposed individuals per year. Antibiotics were further classified according to the WHO’s AWARE classification.

Results: During the study year in total 1,980 pediatric patients received antibiotic therapy at the ED. The majority of exposed individuals were boys (64.3%), and aged 0-4 years (48.8% of the pediatric antibiotic use). Solid oral administration (51.2%) was the most common. Penicillins (J01C) and cephalosporins (J01D) were used extensively, with 29.9% and 42.5% share from total systemic antibiotic exposure, respectively. Most prescribed active agents (52.4%) were considered “Watch” group antibiotics. The top five antibiotics utilized were amoxicillin (23.5%), cefixime (18.4%), azithromycin (12.1%), cefadroxil (9.2%), and ceftriaxone (7.2%). Seasonal variations were observed, with peaks (241 patients) in scale of use in November and nadir (111 patients) in February.

Conclusions: Our study reveals a predominant use of Watch group antibiotics, indicating a reliance on broad-spectrum antibiotics such as amoxicillin and cephalosporins in the pediatric Emergency Department. Seasonal variations deserve further investigations into antibiotic utilization trends, contributing to efforts to combat antibiotic resistance.