In-Patient Antibiotic Prescription Practices in Pediatric Cardiology Department of a Tertiary Care Children’s Hospital

Abstract

Objectives: To evaluate antibiotic prescription patterns in pediatric cardiac inpatients and assess the trends in single versus combination antibiotic therapy. Methodology: This retrospective, six-month study analyzed antibiotic prescribing patterns in the pediatric cardiology department of The Children’s Hospital, Lahore. All patients who received at least one antibiotic were included. Data collected included demographic characteristics, primary and secondary indications for admission, antibiotic regimens (single, dual, and triple combinations), and culture results. Results: Of 2,359 total admissions, 1,000 patients (42.4%) who were prescribed antibiotics were enrolled. Respiratory tract infection (RTI) was the most frequent indication for admission and antibiotic use (73.1%). The most common primary cardiac diagnoses were ventricular septal defect (18.3%) and tetralogy of Fallot (18.3%), followed by rheumatic heart disease (15.3%), dilated cardiomyopathy (14.2%), transposition of the great arteries (11.1%), and patent ductus arteriosus (9.5%). Antibiotic regimens included single therapy in 23.8%, dual therapy in 70.6%, and triple therapy in 1% of patients. The most frequently prescribed combinations were amikacin–co-amoxiclav (37.7%), ceftriaxone–co-amoxiclav (17.95%), ceftriaxone–amikacin (15.7%), ceftriaxone–vancomycin (13.16%), and piperacillin/tazobactam–vancomycin (9.31%). Conclusion: Empiric antibiotic prescription is routine in pediatric cardiac inpatients with coexisting infections, with dual therapy predominating. The observed diversity in prescribing practices underscores the need for structured, guideline-based antibiotic stewardship in this setting.