Prescribing practices in childhood gastro-enteritis and its comparison with WHO guidelines

Background : 

Dehydration resulting from acute diarrhea kills 1.5 million children each year. Rational management is based on oral re-hydration as recommended by the World Health Organization. This study was conducted to define the rationality of prescriptions written for acute watery diarrhea in children.

Materials and methods : 

A cross-sectional study was done on children who had been treated for acute gastroenteritis during the two weeks prior to their visit to the clinics of two teaching hospitals. Information obtained through interviewing the caretakers and scrutinizing the prescriptions, was documented. Prescribing practices of general practitioners and pediatricians were compared in three settings private offices, hospital outpatients, and general polyclinics.

Results :

 273 prescriptions were analyzed. An average of 4.1±2.3 drugs had been prescribed on each visit. At least one antibiotic was included in more than 76% of prescriptions. 60% of children were not given ORS. An injection was written in 51% of prescriptions and anti-emetics in 61%. There was no significant difference between general practitioners and pediatricians in the number of drugs per prescription. 75.7% of pediatricians and 78.5% of GPs had prescribed at least one antibiotic (p=0.58). In teaching hospitals the average number of drugs prescribed for each visit was 3.1, in polyclinics, 3.2 and in private offices 3.6 (p=0.03).

Conclusion :

 Unjustified use of medicines and sub - optimal management of acute gastroenteritis were identified in more than 70% of prescriptions. Further studies and effective training programs are urgently needed to reverse current irrational treatment practices.