Antibiotic treatment of children with upper respiratory infections in Karachi

Objective: To describe clinical predictors for antibiotic use by practitioners for treatment of upper respiratory tract infection (sore throat and acute otitis media) in pediatric age group. Materials and Methods: Data was collected from practicing pediatricians and pediatric residents in the city of Karachi, Pakistan. Data was collected on a predesigned questionnaire from practitioners treating sore throat and Acute otitis media in children aged 6 months to 5 years. Data was analyzed on 73 completely filled questionnaires. Results: Majority of the physicians, (84.0%) were aware that antibiotic overuse leads to drug resistance. Despite this knowledge physicians were prescribing antibiotics for multiple social reasons, like meeting parental expectations (35%), fear of losing patients (24.7%), convenience of prescription of antibiotic as compared to explaining the course of the illness (33%) and avoiding the cost of a return visit (26%).Other reasons were for hyperemic throat (44%) and for a greenish nasal discharge in (50%) of the cases. Majority of the physicians were prescribing the correct first line antibiotic (amoxicillin or augmentin) for the treatment of both sore throat and Acute otitis media but the duration of antibiotic was less than the recommended period of 10 days in 50% of the cases. Conclusion: Realization by physicians as well as parental education is very much needed to restrict antibiotic overuse in upper respiratory tract infections.