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Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF) without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropriate use of antibiotics in the country.
Objective To provide an analysis of diagnosis, grading, and prescribing of antibiotics in pediatric inpatients with DF in a tertiary care teaching hospital in India.
Methods Data from case sheets of all pediatric inpatients (n=370) diagnosed with DF without co-morbid conditions were collected with regards to diagnosis, grading, presence, and appropriateness of antibiotic usage according to the 2009 WHO Guidelines, the National Vector Borne Disease Control Program (NVBDCP) of India Guidelines, and the Hospital Infection Society (HIS) Guidelines.
Results Platelet count determination (50% of the cases) was the major diagnostic method for dengue. Inappropriate grading of DF was seen in 20% of patients. Almost 75% of the 370 dengue cases were prescribed antibiotics for the expressed purpose of avoiding hospital-acquired infections. A single antibiotic was given in 225 cases (60.81%), 2 antibiotics in 33 (8.91 %) cases, and 3 antibiotics in 9 (2.43%) cases.
Conclusions From the results it is clear that antibiotics were prescribed to treat DF where the antibiotics do not have any role. DF is a self-limiting viral infection that can be treated with proper management of hemodynamic status with IV fluids. To avoid the usage of antibiotics in the treatment of dengue, awareness has to be created in healthcare professionals regarding the treatment guidelines for dengue and appropriate use of antibiotics to avoid hospital acquired infections.
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2. Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015;40:277-83.
3. Read AF, Woods RJ. Antibiotic resistance management. Evol Med Public Health. 2014;2014:147.
4. Eandi M, Zara GP, Della Pepa C. Application of pharmacoeconomics to the use of antibiotics. Clin Microbiol Infect. 2000;6:90-2.
5. World Health Organization. Dengue: guidelines for diagnosis, treatment, prevention and control. Geneva: World Health Organization; 2009. p.1-147.
6. National vector borne disease control programme. National guidelines for clinical management of dengue fever. 2014 Dec; [cited 2016 March 17] Available from: https://www.scribd.com/document/347257604/Dengue-National-Guidelines-2014-Compressed.
7. Hospital Infection Society guidelines. Nosocomial Infection – Prevention and Management. 1-10; [cited 2016 March 15]. Available from: http://www.apiindia.org/pdf/pg_med_2008/Chapter-08.pdf.
8. World Health Organization. Prevention of hospital-acquired infections: a practical guide. Malta: WHO; 2002. p.1-64.
9. Mohammed M, Mohammed A, Mirza M, Ghori A. Nosocomial infections: an overview. Int Res J Pharm. 2014;5:7-12.
10. Murray NE, Quam MB, Wilder-Smith A. Epidemiology of dengue: past, present and future prospects. Clin Epidemiol. 2013;5:299-309
11. Ghazala Z, Anuradha HV, Shivamurthy MC. Pattern of management and outcome of dengue fever in pediatric in-patients in a tertiary care hospital: a prospective observational study. International Journal of Basic & Clinical Pharmacology. 2014; 3:534-8. DOI: http://dx.doi.org/10.5455/2319-2003.ijbcp20140623.
12. Bisordi I, Rocco IM, Suzuki A, Katz G, Silveira VR, Maeda AY, et al. Evaluation of dengue NS1 antigen detection for diagnosis in public health laboratories, São Paulo State, 2009. Rev Inst Med Trop São Paulo. 2011;53:315-20.
13. HL Sharma, KK Sharma. Penicillins, cephalosporins and other β-lactam antibiotics. In: Kothari Divyesh A, editors. Principles of pharmacology. 2nd ed. New Delhi: Paras Medical Publisher; 2103. p. 722-8.
14. Sharma HL, Sharma KK. Aminoglycosides. In: Kothari Divyesh A, editor. Principles of pharmacology. 2nd ed. New Delhi: Paras medical publisher; 2103. p. 738.
15. Harvey RA. Protein synthesis inhibitors. In: Clark MA, editor. Pharmacology. 6th ed. New Delhi: Lippincott's Illustrated Reviews Series; 2012. p. 395-404.
16. Sharma HL, Sharma KK. Broad spectrum antibiotics: tetracyclines and chloramphenicol. In: Kothari Divyesh A, editor. Principles of pharmacology. 2nd ed. New Delhi: Paras medical publisher; 2103. p. 748-50.
17. Sharma HL, Sharma KK. Macrolides, ketolides, lincosamides, oxazolidones and other antibacterial drugs. In: Kothari Divyesh A, editor. Principles of pharmacology. 2nd edition. New Delhi: Paras medical publisher; 2103. p. 741-3.
18. Sharma HL, Sharma KK. Antiamoebic and other antiprotozoal drugs. In: Kothari Divyesh A, editor. Principles of pharmacology. 2nd ed. New Delhi: Paras Medical Publisher; 2103. p. 819-21.
19. Vangay P, Ward T, Gerber JS, Knights D. Antibiotics, pediatric dysbiosis, and disease. Cell Host Microbe. 2015;17:553-64.