EVALUATION OF ANTIBIOTIC PRESCRIBING PATTERNS FOR PEDIATRIC UPPER RESPIRATORY TRACT INFECTIONS IN A TERTIARY CARE HOSPITAL

Abstract

Background: Upper respiratory tract infections (URTIs) are among the most common pediatric illnesses, with most being of viral origin. Objective: This study aimed to evaluate the antibiotic prescribing patterns for pediatric URTIs and identify the factors influencing these practices. Methods: A cross-sectional observational study was conducted at the paediatrics department, Swat Medical Complex Teaching Hospital Saidu Sharif Swat  from September  2024 to February 2025, including 255 pediatric patients aged 1 to 12 years diagnosed with URTIs. Data was collected through medical record reviews to assess antibiotic prescriptions, physician specialty, and parental expectations. Results: Out of the 255 patients, 162 (63.5%) were diagnosed with viral URTIs, and 93 (36.5%) had bacterial infections. Antibiotics were prescribed to 81% of children with viral URTIs, despite guidelines recommending against their use. The most commonly prescribed antibiotics were amoxicillin (43%), azithromycin (28%), and cefixime (18%). Physician specialty (pediatrician vs. general practitioner) and parental demand for antibiotics were significant factors influencing antibiotic prescriptions (p < 0.05). Logistic regression analysis revealed that parental expectations increased the likelihood of antibiotic prescriptions for viral infections (OR = 3.5, 95% CI: 2.1–5.8). Conclusion: A substantial overuse of antibiotics for viral URTIs in pediatric patients was observed, with physician specialty and parental expectations being significant determinants. Despite adherence to clinical guidelines being suboptimal, the findings highlight the need for improved communication with parents and targeted interventions for healthcare providers to reduce unnecessary antibiotic prescriptions.