{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T02:21:13Z","timestamp":1778206873129,"version":"3.51.4"},"reference-count":52,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Asia link","award":["348-2006-6633"],"award-info":[{"award-number":["348-2006-6633"]}]},{"name":"Erasmus Mundus","award":["Lot-15"],"award-info":[{"award-number":["Lot-15"]}]},{"name":"Vetenskapsr\u00e5det, Sweden","award":["2017-01327"],"award-info":[{"award-number":["2017-01327"]}]},{"name":"Vetenskapsr\u00e5det, Sweden","award":["2018\u20132021"],"award-info":[{"award-number":["2018\u20132021"]}]},{"name":"Vetenskapsr\u00e5det, Sweden","award":["2022\u20132025"],"award-info":[{"award-number":["2022\u20132025"]}]},{"name":"Vetenskapsr\u00e5det, Sweden","award":["K2010-396-70X-20514-04-3"],"award-info":[{"award-number":["K2010-396-70X-20514-04-3"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,2,14]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyse, compare and present the 10-year diagnosis-specific antibiotic prescribing trends for paediatric inpatients at a non-teaching hospital (NTH) and a teaching hospital (TH) in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>A prospective, observational study of antibiotic prescriptions in paediatric departments of two private-sector hospitals in central India. Inpatients were grouped into clinically confirmed infections, suspected infections and no infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Patients in the NTH and TH and duration of antibiotic prescription, the ratio of prescribed daily dose and defined daily dose i.e. PDD* per 100 bed days, diagnosis-specific patterns and trends, adherence to the Access, Watch and Reserve (AWaRe) classification and prescribing guidelines with significant p value&lt;0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 19 027, 17\u2009458 inpatients aged less than 18 years stayed at least one night (NTH: 11\u2009415 and TH: 6043). More patients were prescribed antibiotics in the NTH than in the TH (NTH: 80%, TH: 23%, p&lt;0.001) and had shorter antibiotic treatment (NTH: 3\u2009days, TH: 5\u2009days, p&lt;0.001). In the NTH, 43% of prescribed antibiotics were \u2018Not recommended\u2019; in the TH, 56% were from the \u2018Watch\u2019 group (AWaRe). Ceftriaxone with a beta-lactamase inhibitor (\u2018Not recommended\u2019, 39%) was most prescribed in the NTH, and ceftriaxone (\u2018Watch\u2019, 31%) in the TH.<\/jats:p>\n                    <jats:p>The reduction in the prescription rates of the most prescribed antibiotic classes for PDD*\/100 bed days was observed over 10 years, for infectious acute gastroenteritis, typhoid fever and lung infections, especially in the NTH. For hernia patients, the antibiotic prescribing trend of third-generation cephalosporins increased significantly (\u03b2=0.13, p=0.02) while decreased for second-generation cephalosporins (\u03b2=0.002, p=0.01). The trends decreased in both hospitals for the most common confirmed infections over 10 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This decadal study observes the practices of overuse of antibiotics in both hospitals yet more in the NTH. High prescribing rates of the \u2018Not recommended\u2019 and \u2018Watch\u2019 warrant understanding the underlying reasons for targeted interventions. Nonetheless, a significant overtime decrease in prescribing antibiotics for infectious diagnosis indicates the potential for the success of antibiotic stewardship in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087901","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T16:40:19Z","timestamp":1741884019000},"page":"e087901","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["10-year diagnosis-specific antibiotic prescribing trends among paediatric inpatients at two private-sector hospitals in central India: a prospective observational study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-9393","authenticated-orcid":false,"given":"Megha","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Pharmacology, R. D. Gardi Medical College, Ujjain, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0789-6072","authenticated-orcid":false,"given":"Sarah","family":"Van De Weyer","sequence":"additional","affiliation":[{"name":"Department of Global Public Health, Health Systems and Policy, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Stalsby Lundborg","sequence":"additional","affiliation":[{"name":"Department of Global Public Health, Health Systems and Policy, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"2025121220371671000_15.3.e087901.1","unstructured":"The World Health Organization . Global action plan on antimicrobial resistance. 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