Comparative Evaluation of Antibiotic Prescribing Patterns in Hospitalized Paediatric Patients at Government and Private Tertiary Care Hospitals: A Prospective Observational Study
DOI:
https://doi.org/10.51168/ha3fnv20Keywords:
Antibiotics, Tertiary care hospital, antimicrobial resistance, Comparison, Ceftriaxone, SensitivityAbstract
Background:
To compare antibiotic prescribing patterns among hospitalized paediatric patients at a government and a private tertiary care hospital in Karnataka, India.
Methods:
A prospective observational study was conducted in the Department of Paediatrics at Koppal Institute of Medical Sciences (government hospital) and Lake View Hospital, Belagavi (private hospital). Two hundred hospitalized patients aged under 18 years who received at least one antimicrobial agent were consecutively enrolled from each site following informed parental consent. Demographic, clinical, and antibiotic-prescribing data were collected from case records and analysed using SPSS v26.0, with Chi-square and independent-samples t-tests applied as appropriate (significance at p<0.05).
Results:
Demographic and diagnostic profiles were broadly comparable, though the government hospital served predominantly rural, lower-socioeconomic patients while the private hospital served urban, higher-socioeconomic patients (p<0.001). The private hospital generated more antibiotic prescriptions (380 vs. 250) and higher per-patient antimicrobial intensity (1.90 vs. 1.25 antimicrobials/encounter; 3.6 vs. 2.8 drugs/patient). Ceftriaxone and cephalosporins predominated at both sites but more markedly in the private hospital (59.2% vs. 46.0% of prescriptions). Treatment duration was longer in the government hospital for several agents, along with longer overall hospital stay (6.5 vs. 4.2 days). Generic-name documentation was complete at both sites, though the private hospital also recorded brand names.
Conclusion:
Government and private tertiary hospitals exhibit distinct antibiotic prescribing cultures—the private sector favouring higher prescribing intensity, and the government sector favouring prolonged treatment durations likely linked to delayed microbiological diagnostics. These findings indicate that antimicrobial stewardship interventions in this region should be tailored to each sector rather than applied uniformly.
References
1. Priyadharsini RP, Kesavan R. Antibiotic prescribing pattern among paediatric patients attending tertiary care hospital in South India. International Journal of Basic & Clinical Pharmacology. 2020 Jun 26;9:1028. doi:10.18203/2319-2003.ijbcp20202935
2. Ramaiah J, Narayana G, Reddy Y, Alameri T, Pradeepkumar B. Assessment of Antibiotic Prescribing Pattern in Pediatric Patients: A Cross-Sectional Hospital-Based Survey CHRISMED Journal of Health and Research. 2017;4(4):235-237. doi:10.4103/cjhr.cjhr_52_17
3. T Rajavardhana, A Naga Jyothi, G Naresh Babu. Prescribing Patterns of Antibiotics in Pediatric Patients of Tertiary Care Hospital in South Indian Resource Limited Settings. Inventi Impact: Pharmacy Practice, 2019(2):76-81, 2019.Murray CJL, Ikuta KS, Sharara F, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325):629-655.
4. Mukwege D, Mitangala P, Byabene A, Busha E, Laethem YV, Vandenberg O. Global burden of antimicrobial resistance: essential pieces of a global puzzle. The Lancet. 2022 Jun 25;399(10344):2348. doi:10.1016/S0140-6736(22)00944-8
5. Sharma M, Damlin A, Sharma A, et al. Antibiotic prescribing among pediatric inpatients with potential infections in two private sector hospitals in Central India. PLoS One. 2015;10(11):e0142317.
6. Skender K, Singh V, Stalsby-Lundborg C, Sharma M. Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study. Karunasagar I, editor. PLoS ONE. 2021 Jan 27;16(1):e0245902. doi:10.1371/journal.pone.0245902
7. Sharma M, Weyer SVD, Lundborg CS. 10-year diagnosis-specific antibiotic prescribing trends among paediatric inpatients at two private-sector hospitals in central India: a prospective observational study. BMJ Open. 2025 Mar 1;15(3):e087901. doi:10.1136/bmjopen-2024-087901
8. Sheikh S, Saleem Z, Afzal S, Qamar MU, Raza AA, Haider Naqvi SZ, et al. Identifying targets for antibiotic stewardship interventions in pediatric patients in Punjab, Pakistan: point prevalence surveys using AWaRe guidance. Front Pediatr. 2025 Jan 10;12. doi:10.3389/fped.2024.1469766
9. Bhattacharjee S, Mothsara C, Shafiq N, Panda PK, Rohilla R, Kaore SN, et al. Antimicrobial prescription patterns in tertiary care centres in India: a multicentric point prevalence survey. eClinicalMedicine. 2025 Apr 1;82. doi:10.1016/j.eclinm.2025.103175.
10. Rajendran R, Mahadeva K, Bhandarkar S, Khader MA, Balakrishnan JM, Nair S, et al. Patterns of antibiotic use in Indian secondary care hospitals: Results from a multicenter point prevalence survey. International Journal of Infectious Diseases. 2026 Sep 1;170:108880. doi:10.1016/j.ijid.2026.108880
11. 2019 WHO AWaRe Classification Database of Antibiotics for evaluation and monitoring of use [Internet]. Available from: https://www.who.int/publications/i/item/WHOEMPIAU2019.11
12. Abdelsalam Elshenawy R, Umaru N, Aslanpour Z. WHO AWaRe classification for antibiotic stewardship: tackling antimicrobial resistance – a descriptive study from an English NHS Foundation Trust prior to and during the COVID-19 pandemic. Front Microbiol. 2023 Dec 11;14:1298858. doi:10.3389/fmicb.2023.1298858
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Copyright (c) 2026 Dr. Girish Hiremath, Dr. Shashikant, Dr. Harsha, Dr. Nikita Sudhir Kulgod, Akash Gadgade, Sagar Chidanand Duganavar (Author)
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