Antibiotic Prescribing Patterns in Pediatric Patients using the WHO AWaRe Framework in a Quaternary Hospital in Nampula, Mozambique

Background: Antibiotics are often prescribed inappropriately, either when they are not needed or with an unnecessarily broad spectrum of activity. This is a serious problem that can lead to the development of antimicrobial resistance (AMR). This study was conducted to assess the antibiotic prescribing pattern in pediatric patients hospitalized at a quaternary hospital in Nampula, Mozambique, using the WHO indicators and Framework as a reference. Methods: A cross-sectional study with a quantitative approach was conducted in 2020. The population consisted of children aged 0-10 years hospitalized in a ward of a quaternary-level hospital in Nampula, Mozambique. The prescription pattern was assessed using indicators and the WHO classification of antibiotics into AWaRe categories. Descriptive statistics were applied. Results: A total of 464 antibiotics were prescribed during the study. The age group of 1-3 years and 28 days-12 months were prescribed more antibiotics. The most common antibiotics were ceftriaxone and crystallized penicillin, which were frequently prescribed for patients suffering from bronchopneumonia, gastroenteritis, and malaria. 74.8% of the antibiotics prescribed belonged to the Access group, while 23.7% belonged to the Watch group. There were no prescriptions of antibiotics from the Reserve group. The average number of antibiotics per prescription was 1.51 (SD ± 0.725). The percentage of antibiotic prescribing was 97.5%, with 96.20% by injection. All antibiotics prescribed were on the essential medicines list and prescribed by generic name. Conclusion: These results are concerning and highlight the urgency of strengthening antimicrobial optimization measures, as well as implementing the AWaRe framework in antibiotic prescribing as an essential strategy to combat AMR.