Drug prescribing pattern in upper respiratory tract infections among the pediatric population attending outpatient clinics in pediatric hospitals

Table 1 Baseline characteristics, n (%)

Baseline characteristics		Count
Gender	Male	104 (52.0)
	Female	96 (48.0)
Current diagnosis	Acute pharyngitis	59 (29.5)
	Acute tonsillitis	38 (19.0)
	Acute sinusitis	27 (13.5)
	Acute otitis media	13 (6.5)
	Acute rhinitis and/or common cold	63 (31.5)
Physician grade	General practitioner	60 (30.0)
	Specialist (pediatrician and ENT)	140 (70.0)
Outpatient clinic	Pediatric	161 (80.5)
	ENT	39 (19.5)
Type of drug (antibiotics)	No	84 (42)
	Yes	116 (58)
Family of antibiotic prescribed	Penicillin family "ampicillin/sulbactam or amoxicillin/clavulanic acid"	53 (26.5)
	First-generation cephalosporin	25 (12.5)
	Macrolides	16 (8.0)
	Second-generation cephalosporin	2 (1.0)
	Third-generation cephalosporin	20 (10.0)
	No	84 (42.0)

ENT: Ear, nose and throat.

Table 2 Baseline characteristics regarding type of prescribed drug, n (%)

Baseline characteristics regarding type of prescribed drug		Count
Antihistamines	Yes	65 (32.5)
	No	135 (67.5)
Family of antihistamines	First-generation antihistaminic	17 (8.5)
	Second-generation antihistaminic	48 (24.0)
	No	135 (67.5)
Oral nasal decongestant	Yes	97 (48.5)
	No	103 (51.5)
Type of oral nasal decongestant	Oral nasal decongestant containing pseudoephedrine	70 (72.2)
	Containing phenylephrine	26 (26.8)
	Containing phenylpropanolamine	1 (1.0)
Antitussive medicine	No	139 (69.5)
	Yes	61 (30.5)
Antipyretic medicine	Yes	170 (85.0)
	No	30 (15.0)
Type of antipyretics	Paracetamol	39 (22.8)
	Ibuprofen	82 (48.0)
	Diclofenac Na/K	25 (14.6)
	Combinations	25 (14.6)
Route of administration of antibiotics	Orally	74 (37.0)
	Injection	21 (10.5)
	Both	21 (10.5)
	No	84 (42.0)
Laboratory investigations: Complete blood count and C-reactive protein	Not done	56 (28.0)
	Done	144 (72.0)

Table 3 Summary of study population attitude and practice regarding the provided medical service, n (%)

Attitude and practice regarding the provided medical service		Count
Seeking other medical service	No	125 (62.5)
	Pharmacy	39 (19.5)
	Hospital	11 (5.5)
	Private clinic	25 (12.5)
Parents’ satisfaction	Satisfied	155 (77.5)
	Unsatisfied	45 (22.5)
Vaccination history	Compulsory immunization schedule only	169 (84.5)
	Additional recommended vaccines	31 (15.5)
Mother's education	Educated	195 (97.5)
	Uneducated	5 (2.5)
Father's education	Educated	184 (92.0)
	Uneducated	16 (8.0)

Table 4 Intergroup comparison between the study populations when classified according to antibiotic administration status, n (%)

		Antibiotic prescription		P value
		Yes	No
Antitussive medicine	No	88 (76.5)	51 (60.0)	0.012
	Yes	27 (23.5)	34 (40.0)
Antipyretics	Yes	107 (93.0)	63 (74.1)	< 0.001
	No	8 (7.0)	22 (25.9)
Type of antipyretic	Paracetamol	12 (11.1)	27 (42.9)	< 0.001
	Ibuprofen	57 (52.8)	25 (39.7)
	Diclofenac Na/K	16 (14.8)	9 (14.3)
	Combinations	23 (21.3)	2 (3.2)
Route of administration of antibiotics	Orally	73 (63.5)	1 (1.2)	< 0.001
	Injection	21 (18.3)	0 (0.0)
	Both	21 (18.3)	0 (0.0)
	No	0 (0.0)	84 (98.8)
Laboratory investigations: Complete blood count and CRP	Not done	41 (35.7)	15 (17.6)	0.005
	Done	74 (64.3)	70 (82.4)
TLC in number	High	20 (26.7)	6 (8.6)	0.005
	Normal	55 (73.3)	64 (91.4)
TLC (differential count)	Normal	52 (69.3)	57 (81.4)	0.002
	Neutrophilia	18 (24.0)	3 (4.3)
	Lymphocytosis	5 (6.7)	8 (11.4)
	Eosinophilia	0 (0.0)	1 (1.4)
	Monocytosis	0 (0.0)	1 (1.4)
CRP	Positive	31 (41.3)	3 (4.6)	< 0.001
	Negative	44 (58.7)	62 (95.4)

CRP: C-reactive protein; TLC: total leukocyte count.

Table 5 Correlation between antibiotic administration in children with upper respiratory tract infections and other parameters

		Antibiotic prescription		P value
		Yes	No
Compliance to treatment	Regular	102 (88.7)	79 (92.9)	0.311
	Irregular	13 (11.3)	6 (7.1)
Response to treatment	Good	90 (78.3)	65 (76.5)	0.764
	Not good	25 (21.7)	20 (23.5)
Side effects appearance (rash, diarrhea, gastrointestinal upsets, etc.)	No	96 (83.5)	77 (90.6)	0.146
	Yes	19 (16.5)	8 (9.4)
Seeking other medical service	No	75 (65.2)	50 (58.8)	0.638
	Pharmacy	19 (16.5)	20 (23.5)
	Hospital	6 (5.2)	5 (5.9)
	Private clinic	15 (13.0)	10 (11.8)
Parents’ satisfaction	Satisfied	91 (79.1)	64 (75.3)	0.521
	Unsatisfied	24 (20.9)	21 (24.7)
Vaccination history	Compulsory immunization schedule only	102 (88.7)	67 (78.8)	0.057
	Additional recommended vaccines	13 (11.3)	18 (21.2)
Mother's education	Educated	112 (97.4)	83 (97.6)	1
	Uneducated	3 (2.6)	2 (2.4)
Father's education	Educated	101 (87.8)	83 (97.6)	0.011
	Uneducated	14 (12.2)	2 (2.4)