Antibiotic Prescribing Patterns in Hospitalized Pediatric Patients With Clinically Suspected Enteric Fever: A Descriptive Study

TL;DR

This study examines how antibiotics are prescribed to hospitalized children suspected of having enteric fever, finding that ceftriaxone is most commonly used.

Contribution

The study provides a descriptive analysis of real-world antibiotic prescribing patterns in pediatric patients with suspected enteric fever.

Findings

Injectable ceftriaxone was the most frequently prescribed antibiotic (83%).

Oral doxycycline, injectable ofloxacin, and injectable amikacin were also used but less frequently.

Antibiotic use varied with clinical features and laboratory parameters, though age was not significantly associated with selection.

Abstract

Background: Enteric fever remains an important cause of morbidity among children in developing regions and is frequently managed with empirical antimicrobial therapy. In the setting of evolving antimicrobial resistance and diagnostic limitations, describing real-world antibiotic prescribing practices in pediatric patients is essential. This study aimed to describe antibiotic prescribing patterns among hospitalized pediatric patients with clinically suspected enteric fever and to explore their distribution across clinical and laboratory parameters.

Methods: A hospital-based retrospective observational study was conducted among 100 hospitalized pediatric patients (>2 years of age) clinically diagnosed with enteric fever. Demographic details, clinical features, vaccination status, laboratory parameters (hemoglobin, total leukocyte count, erythrocyte sedimentation rate, platelet count, C-reactive protein, and Widal test results), and treatment details were extracted from medical records. Antibiotic utilization patterns involving injectable ceftriaxone, injectable ofloxacin, injectable amikacin, and oral doxycycline were analyzed using descriptive statistics. Associations between antibiotic use and selected clinical and laboratory variables were explored using the chi-square test, with a p-value ≤0.05 considered statistically significant.

Results: The mean age of patients was 6.03±3.08 years, with a near-equal gender distribution. Fever was the most common presenting symptom (90%), followed by vomiting (45%) and abdominal pain (23%). Laboratory evaluation revealed mild anemia and elevated inflammatory markers in a proportion of patients. Injectable ceftriaxone was the most frequently prescribed antibiotic (83%), followed by oral doxycycline (27%), injectable ofloxacin (26%), and injectable amikacin (11%). Variations in antibiotic use were observed across different clinical features, laboratory parameters, and treatment intensity. Age did not show a statistically significant association with antibiotic selection.

Conclusion: This study describes prevailing antibiotic prescribing patterns among hospitalized pediatric patients with clinically suspected enteric fever. Injectable ceftriaxone was the most commonly used empirical antibiotic, while other agents were prescribed selectively. The findings highlight existing prescribing trends in inpatient pediatric care and underscore the need for improved microbiological confirmation to better inform antibiotic selection in enteric fever.

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