The Use of an Empiric Antibiotic in Children with Acute Diarrhea and Result of Stool Culture in Sikhiu Hospital, Nakhon Ratchasima

Abstract

Majority of acute diarrhea in children are always caused by viral infection. Antibiotic is indicated in case of mucous bloody diarrhea. Objective: To study the characteristic and appropriate use of an empirical antibiotic treatment in children with acute diarrhea and result of stool culture. Patients and Methods: Retrospective study from the medical records of children aged 1 month to 15 years old who had clinical diagnosis of acute diarrhea by WHO criteria from 1 June 2005 to 31 May 2006 in Sikhiu Hospital, Nakhon Ratchasima. Results:  The study included 1,264 children whose stool samples were cultured. Antibiotics were prescribed in 50%. Appropriate use of antibiotic was evident in 57.9%. Bacterial infections were isolated from stool 13.7%. In young children groups (aged 0-5 years) isolated Aeromonas was the most common, Vibrio parahemolyticus and Aeromonas were common in old children (aged older than 5 year). Cotrimoxazole was the empiric antibiotic most frequently used in young children as well as norfloxacin in older children. Fortunately, almost all bacteria was isolated from stools were sensitive to empiric antibiotics, except Shigella which was highly resistant to cotrimoxazole in 73.4%. Conclusion: The empirical antibiotic were administered in 50% of cases of acute diarrhea in Sikhiu Hospital, Nakhon Ratchasima while pathogenic organisms were isolated from 15% of cases. Antibiotics usage is 57.9% appropriate. Result of stool culture and sensitivity are less clinical useful.