Abstract

PRESCRIBING PATTERNS OF ANTI BIOTIC FOR CHILDREN BEFORE ADMISSION IN PEDIATRIC WARDS OF TIKRIT TEACHING HOSPITAL.

Dr. Hussein Ali Hassan*, Dr. Jenan Mohammed Salih and Dr. Murad Wael Kamil

ABSTRACT

Anti – Biotic are commonly prescribed drugs in pediatrics. However the threat of anti – biotic resistance among children is cause for concern. Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth; in other words, the bacteria are "resistant" and continue to multiply in the presence of therapeutic levels of an antibiotic. Antibiotic resistance is a natural phenomenon. When an antibiotic is used, bacteria that can resist that antibiotic have a greater chance of survival than those that are "susceptible." Susceptible bacteria are killed or inhibited by an antibiotic, resulting in as elective for the survival of resistant strains of bacteria. Some resistance occurs without human action, as bacteria can produce and use antibiotics against other bacteria, leading to a low-level of natural selection for resistance to antibiotics. However, the current higher-levels of antibiotic-resistant bacteria are attributed to the overuse and abuse of antibiotics. In some countries and over the Internet, antibiotics can be purchased without a doctor's prescription. Patients sometimes take antibiotics unnecessarily, to treat viral illnesses like the common cold. Some bacteria are naturally resistant to certain types of antibiotics. However, bacteria may also become resistant in two ways: 1) by a genetic mutation or 2) by acquiring resistance from another bacterium. Mutations, rare spontaneous changes of the bacteria's genetic material, are thought to occur in about one in one million to one in ten million cells. Different genetic mutations yield different types of resistance. Some mutations enable the bacteria to produce potent chemicals (enzymes) that inactivate antibiotics, while other mutations eliminate the cell target that the antibiotic attacks. Still others close up the entry ports that allow antibiotics into the cell, and others manufacture pumping mechanisms that export the antibiotic back outside so it never reaches its target. Bacteria can acquire antibiotic resistance genes from other bacteria in several ways. By undergoing a simple mating process called "conjugation," bacteria can transfer genetic material, including genes encoding resistance to antibiotics (found on plasmids and transposons) from one bacterium to another. Viruses are another mechanism for passing resistance traits between bacteria. The resistance traits from one bacterium are packaged into the head portion of the virus. The virus then injects the resistance traits into any new bacteria it attacks. Bacteria also have the ability to acquire naked, "free" DNA from their environment. Any bacteria that acquire resistance genes, whether by spontaneous mutation or genetic exchange with other bacteria, have the ability to resist one or more antibiotics. Because bacteria can collect multiple resistance traits over time, they can become resistant to many different families of antibiotics. The patient and method. A study of the administration patterns of anti – biotics prior to admission was carried out on children admitted to pediatric ward of Tikrit teaching hospital from April to June 2014. by using pretested structured question air descriptive and basic stoical tests were used to analysethe data, the told number of admission to the wards was 300, out of which 156, 52 % had been given anti – biotic prior to admission of this 93, 31 % were infant. Of the entire cohort. study, anti – biotic were given to 93, 31 % and 14,4.6 % of them were giver two or more coarses of Anti – Biotics. Cephalosporins 69, 23 %. Amoxill 45, 15 % Erthromycen 25, 8.3%. 60, 20 % prescribed by mother and 38, 12.6 % by G.P only 10% of the parent knew the name and side effect of the anti – biotic used of children Hospital stay was significantly more for children given prior anti – biotic than for those who did not have prior anti – biotic. In order to reduce the risk of anti – biotic resistance of microbs.anti – biotic policy should be carefully instituted and implemented.

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