Laboratory Parameters Influencing the Use of Antbiotics Amongst Paediatricians

Abstract

Objectives: The set protocol for initiation of antibiotic therapy initiation varies in every doctor-patient-disease situation. Our objective was to identify the most common laboratory parameters advised and used for further initiation of antibiotics in a paediatric OPD and IPD setup.

Methods: A validated questionnaire was circulated among 2 groups paediatric OPD and IPD setup respectively and their responses were noted.

Results: It was observed that in OPD practice, 93.84% of practitioners prefer CBC+CRP while 96.22% of practitioners prefer CBC+CRP+Procalcitonin as a laboratory parameter of choice for assessment of fever in children. When 80% of practitioners initiated antibiotic therapy based on CBC and a positive CRP report in OPD practice, 96.22% preferred to initiate antibiotic therapy based on a positive CBC+CRP+Blood culture/Procalcitonin. It was also observed that 12.30% of practitioners initiated investigation in a fever of less than 3 days duration while 53.84% of practitioners initiated antibiotic therapy in a fever of less than 3 days.

Conclusion: This study concludes that though most practitioners prefer to investigate a fever of more than 7 days, almost 1/3rd of practitioners initiate an investigation in a fever of less than 3 days. Thus, the clinical assessment takes priority over the dictum of set protocol for initiation of antibiotics related to the duration of fever. Regulation of antibiotics and their overuse continues to be a major worry among healthcare guards. The major challenge lies in the years ahead to expand the use of antibiotics and maintain stewardship while prescribing the same.