ANTIMICROBIAL RESISTANCE PATTERNS IN PEDIATRIC RESPIRATORY TRACT INFECTIONS – A PROSPECTIVE HOSPITAL-BASED STUDY.

Respiratory tract infections (RTIs) are a major cause of morbidity and mortality across the globe in children. These infections are harder to treat with the emergence of antimicrobial resistance (AMR). The knowledge of the local antimicrobial resistance trends in pediatric RTIs is essential to successful treatment, particularly in hospital care, such as Pediatric Intensive Care Unit (PICU). Objectives To determine the pattern of antimicrobial resistance against pediatric respiratory tract infections; and to determine the efficacy of commonly used antibiotics in treating the illness in Pediatric Intensive Care Unit (PICU). Methods This is a prospective hospital-based Study conducted in Khyber Teaching Hospital, Peshawar. RTI patients (pediatric) were enrolled. Isolated pathogens were subjected to antimicrobial susceptibility testing and microbiological cultures were obtained. Demographic, clinical presentation and resistance data were gathered. We performed statistical analysis using the relevant parametric and non-parametric tests with p less than 0.05 as statistically significant. Results 200 pediatric patients and the mean age of the patients was 5.1 years (SD +- 3.4). Most of the patients were confirmed with upper respiratory tract infection (60%), and lower respiratory tract infection (40%). Streptococcus pneumoniae (25%), Haemophilus influenzae (18%), and Moraxella catarrhalis (15%) were the most common pathogens to be identified. The level of resistance against amoxicillin and ceftriaxone was also high, especially with S. pneumoniae (40) and H. influenzae (25). TXA group exhibited a large decrease in blood loss relative to the control group, whereby the mean blood loss was 480 mL and 740 mL respectively (p < 0.001). Conclusion The increasing rates of antimicrobial resistance to infections of the respiratory tract among children. The high resistance rates to most popular antibiotic drugs, e.g. amoxicillin and ceftriaxone, require continuous monitoring and the implementation of more specific antibiotic treatment. Antimicrobial stewardship and culture-based sensitivity testing should be strengthened to enhance patient outcomes and workload reduction of AMR in the pediatric contexts.