Evaluation of Antibiotic Prescribing Patterns in Pediatric Wards of General Hospitals in Borno State Using WHO Prescribing Indicators

Inappropriate antibiotic prescribing in pediatric healthcare settings accelerates antimicrobial resistance and exposes children to unnecessary adverse effects. This study evaluated antibiotic prescribing patterns in pediatric wards of four general hospitals in Borno State, North East Nigeria, using established WHO drug use indicators. A retrospective review of 600 pediatric inpatient prescription records over 12 months was conducted. WHO core prescribing indicators assessed included the percentage of encounters with an antibiotic prescribed, average number of drugs per prescription, percentage of drugs prescribed by generic name, percentage prescribed from the Essential Medicines List, and the rate of injectable antibiotic use. Reasons for antibiotic prescriptions were categorized, and appropriateness was assessed against current standard treatment guidelines. Results showed that 74.3 percent of pediatric encounters involved antibiotic prescription. The mean number of drugs per prescription was 4.2. Generic prescribing was achieved in only 48.3 percent of cases. Antibiotics from the WHO Access group were prescribed in 51.2 percent of cases, while Watch antibiotics accounted for 34.7 percent and Reserve antibiotics for 4.1 percent. Broad-spectrum antibiotics were frequently prescribed empirically without microbiological evidence. These findings document significant prescribing irregularities in Borno State pediatric settings and highlight the critical role of microbiological culture data and standard treatment guidelines in rationalizing antibiotic prescribing. Keywords: antibiotic prescribing, pediatric wards, WHO indicators, antimicrobial stewardship, Borno State.