Problems Associated with Reconstitution, Administration, and Storage of Antibiotic Suspensions for Pediatrics in Nablus City-Palestine

Rowa Al Ramahi's picture
Haya Ibrahim Anabousi
Problems Associated with Reconstitution, Administration, and Storage of Antibiotic Suspensions for Pediatrics in Nablus City-Palestine6.55 MB
Pediatric infectious diseases either viral or bacterial remain a very common community health problem; in bacterial infection an antibiotic is the drug of choice, to achieve therapeutic effect and prevent treatment failure antibiotics must be properly used. The objective of this study is to evaluate the appropriateness of antibiotic suspensions use for pediatrics among Palestinian mothers including their reconstitution, dose administration, duration, and storage condition. This study was a questionnaire based cross sectional descriptive study. It was conducted at Ministry of Health (MoH) primary health care Al-Wosta clinic and a pediatric private clinic in Nablus city between 22 January, and 22 March 2013. A sample of400 mothers, 200 visited MOH, and 200 visited the private clinic were met and asked to answer a face to face questionnaire. The results showed that most common pediatric infections were bronchitis 110 (27.5%), throat infection (pharyngitis) 110 (27.5%), and otitis media 108 (27.0%), the most commonly prescribed antibiotic was amoxicillin, amoxicillin and clavulanic acid, and azithromycin. Regarding mothers' practice 347 (86.8%) of mothers told that they read instructions, 311 (77.8%) could understand manufacturer instructions, and 176 (44.0%) of mothers asked pharmacists for advice if they didn’t understand the instructions. In order to prepare antibiotic suspension 302 (75.5%) used boiled then cooled tap water, and 192 (84.4%) of mothers used syringe to measure the needed amount of water, and 304 (76.6%) of mothers added water in two steps, 392(98.0%) of mothers claimed that they shook the drug bottle before used. Regarding dose administration, 313 (78.2%) considered syringe as the most accurate tool for dose administration, most of mothers told that they gave drug dose with major meals when direction were to give three times daily. About use duration 6 (1.5%) of mothers claimed that they used antibiotic suspension after 2 weeks, and 26 (6.5%) gave left over antibiotic suspension to another child. One hundred seventy seven (44.2%) of mothers told they stored dry powder antibiotic in medicinal cabinet, while 226 (56.5%) of them stored suspension in refrigerator. Although our results reflect good knowledge about antibiotic suspension use between Palestinian mothers there is a room for improvement. The pharmacists are recommended to explain directions to mothers and confirm on them by writing, to supply them with syringe with suitable calibration for dose administration, and to tell them about storage condition and duration of use.