Photo: iStock
Photo: iStock

Children up to 4 years worst target of antibiotics prescribed by private doctors: Study

  • A study shows that from May 2013 to April 2014 antibiotic prescription rates were highest for children aged 0–4 years
  • Around 519 million antibiotic prescriptions were dispensed in 2014, which translate into 412 prescriptions per 1,000 persons per year

NEW DELHI : Children between 0 to 4 years have been found to be the most targeted segment among patients for antibiotics prescribed by private doctors, a study has shown.

The study published in latest issue of PLOS ONE journal, done by Public Health Foundation of India (PHFI), a public private initiative in public health has revealed that from May 2013 to April 2014 antibiotic prescription rates were highest for children aged 0–4 years. Also, approximately one-fifth antibiotic prescriptions were dispensed for upper respiratory infections, which rarely require an antibiotic therapy, the study said.

The researchers used a 12-month period (May 2013 to April 2014) medical audit dataset from IQVIA (formerly IMS Health) an American Contract Research Organization and Pharmaceutical Service Consulting. The researchers also calculated and reported antibiotic prescription rate per 1,000 persons per year, by age groups, antibiotic class and disease conditions.

Presenting new evidence on outpatient antibiotic prescription rates and pattern in the private sector in India, the study said that around 519 million antibiotic prescriptions were dispensed in 2014, which translate into 412 prescriptions per 1,000 persons per year. The antibiotic prescription rates were found to be highest for children aged 0–4 years (636 prescriptions per 1,000 persons) and lowest in the age group 10–19 years (280 prescriptions per 1,000 persons).

“Our estimates suggest high proportion of antibiotic prescription for upper respiratory tract infections (acute upper respiratory infections (20.4%), cough (4.7%), acute nasopharyngitis (4.6%), and acute pharyngitis (3.9%)). Generally, these infections are viral in origin and are self-limiting in nature," said Sakthivel Selvaraj, director, Health Economics, Financing and Policy, PHFI.

The findings also stated that the prescriptions for unspecified acute lower respiratory infection were 12.8%; disorders of urinary system were 6.0%; 4.7% for cough; and 4.6% for acute nasopharyngitis.

“In the light of evidence based medicine and standard treatment guidelines, it may be argued that a significant proportion of these antibiotic prescriptions might be inappropriate in nature. Previous research on prescription practices also highlighted the problem of inappropriate use of broad-spectrum antibiotics in India," Selvaraj said.

The findings highlighted that across all age groups, beta-lactam, cephalosporins had the highest prescription rates (38.3% of all antibiotic prescriptions) followed by beta-lactam, penicillins (22.8%) and quinolones (16.3%). “Cephalosporins were the most commonly prescribed antibiotic across all diagnoses with the exception of disorders of urinary system where quinolones were more commonly prescribed," said Selvaraj.

The researchers have argued that overall antibiotic prescription rates in India are still much lower than Europe. However, prescription rates for broad-spectrum beta-lactam antibiotics are much higher as compared to European nations, especially in children.

“Our findings highlight that primary care physicians in the private sector can play a key role in reducing antibiotic misuse and overuse. This baseline information can also be used as a benchmark for measuring the impact of current and future interventions directed towards reducing inappropriate antibiotic use," said Selvaraj.

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