Drug Utilization Study in Pediatric Patients with Typhoid Fever

Drug utilization study was observational concurrent study in which 75 pediatric patients with culture or serologically proven typhoid fever were enrolled from 5 private children hospitals of Surat region during September to December, 2021. Information like age, sex, weight, treatment history, presenting symptoms, haematological and diagnostic test data, pattern of use of antibiotic including type, route, dose, frequency, duration and response of patient to drug in term of fever clearance time were collected in patient data collection form. The typhoid fever was predominantly found in patients of age between 2 to 10 years. Ceftriaxone was used in 86.6% of patients.  Only 18.3% patients had received dose of Ceftriaxone in range recommended by IAP and WHO i.e. between 75-100mg/kg. Rest patients had received drugs like cefixime, azithromycin, ofloxacin, ciprofloxacin, gatifloxacin or chloramphenicol alone or in combination. The clinical resistance with ceftriaxone was observed in 6% of patients. Mean fever clearance time with ceftriaxone used as single therapy was found to be 3.30 days, which was not significantly different from that of those patients who received its combination with other drugs. Anemia, moderate thrombocytopenia and leukocytosis were found in 50.7%, 9.3% and 14.7% of patients respectively. The predominant features were fever (100%), anorexia (63.33%) followed by cough (25.33%), abdominal pain (24%) and diarrhea (18.6%). In Surat region, ceftriaxone is commonly used antimicrobial in hospitalized children with typhoid fever. Treatment protocol is not matched with IAP guideline but matched with trend of antibiotic used in another region. Indiscriminate use of drug is one of the important factors leading to drug resistance.