Objectives: In present day practice, the antimicrobials are the most frequently used medications in any hospital setting. Though they are life-saving in an infective disease background, if selected appropriately, but are not devoid of side effects. We conducted an observational study on children admitted to a teaching hospital in Eastern India, to document the range of antimicrobials being used as well as to detect any suspected adverse drug reactions (ADRs) attributable to them.

Methods: Hospitalized children of either sex, aged from 1 month to 12 years were studied. Data included - baseline demographic, socio-economic and clinical features, duration of hospital stay, Paediatric Intensive Care Unit (PICU) admission, antimicrobials received in hospital along with their dosing and indications and details of suspected ADRs attributable to them. The latter data were taken using the ADR-reporting form of the National Pharmacovigilance Programme of India. Causality assessment was done by using the World Health Organization - Uppsala Monitoring Centre criteria.

Results: Over the three months of the study 102 admissions were screened, of which approximately 34.39% were females. The median age of the patients was 5 years. Ceftriaxone and amikacin and co-amoxiclav were the principal antibacterials used. The initial choice was often empirical and occasionally included cefotaxime and cefpodoxime. Vancomycin, piperacillin-tazobactam and acyclovir were used in children requiring PICU admission. The most commonly encountered ADRs were rashes, related to vancomycin; and diarrhoea, related to ceftriaxone and co-amoxiclav.

Conclusions: In our setting, a limited range of antimicrobials are being used. Antibacterials are frequently started empirically, and changed subsequently, in some cases, depending on clinical parameters and culture-sensitivity reports. ADRs to antimicrobials are common and usually mild, serious ADRs were not encountered.

Keywords: antimicrobial, ADRs, drug rash, maculopapular, diarrhoea, raised creatinine, ceftriaxone, vancomycin

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Dr Satabdi Pande

Department of Pharmacology & Therapeutics, Burdwan Medical College, Baburbag, Burdwan-713104