Clinical Spectrum and Antibiotic Resistance Patterns in Upper and Lower Respiratory Tract Infections: A One-Year Observational Study in the Pediatric Population

Authors

  • Salman Ali Department of ENT, Nishtar Medical University and Hospital, Multan – Pakistan
  • Asra Ferozi Department of Community Medicine, Times Institute, Multan - Pakistan
  • Uzma Arshad Department of Community Medicine, Multan Medical and Dental College, Multan – Pakistan
  • Ayesha Saddique Department of Community Medicine, Multan Medical and Dental College, Multan – Pakistan
  • Muhammad Abdullah Islam Maryam Hospital, Bahawalpur – Pakistan

Keywords:

Pediatric Respiratory Infections, Antimicrobial Resistance, Upper Respiratory Tract Infection, Lower Respiratory Tract Infection

Abstract

Background:Respiratory tract infections are a major cause of morbidity in children, with a high burden in low- and middle-income countries like Pakistan. Inappropriate antibiotics use further compounds antimicrobial resistance. Local epidemiological and resistance data are essential to guide empiric therapy and stewardship strategies. Objective:To evaluate the clinical characteristics, prevalence, and etiological patterns of upper and lower respiratory tract infections in the pediatric population, and to assess the antibiotic resistance profiles of the causative pathogens over a one-year period. Methodology:We conducted a one-year observational study (January–December 2024) at a tertiary care hospital in Multan, enrolling 1,180 pediatric patients with clinically diagnosed URTIs or LRTIs. Data on demographics, seasonal trends, microbiology, and antibiotic resistance were collected. Microbiological testing followed CLSI guidelines, and antimicrobial susceptibility was assessed by Kirby–Bauer disk diffusion. Statistical analysis was performed using SPSS v26 with p<0.05 considered significant. Results:URTIs accounted for 71.4% of cases, while LRTIs were more frequent in children under five (OR 1.69; 95% CI 1.27–2.24). Culture positivity was higher in LRTIs (78.9%) than URTIs (47.7%, p<0.001), with S. pneumoniae and H. influenzae predominating. Amoxicillin resistance exceeded 50% in major pathogens, azithromycin resistance was moderate, and ceftriaxone retained good activity. Hospitalization was required in 19.1% of patients, predominantly with LRTIs. Conclusion:Pediatric respiratory infections in Multan show high antibiotic resistance, particularly to amoxicillin, with seasonal peaks in winter and monsoon. Findings underscore the need for locally tailored empiric guidelines, vaccination, and stewardship interventions. Strengthening surveillance can help optimize antimicrobial use and improve child health outcomes.

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Published

2024-09-02

How to Cite

Ali, S., Ferozi, A. ., Arshad, U. ., Saddique, A. ., & Islam, M. A. . (2024). Clinical Spectrum and Antibiotic Resistance Patterns in Upper and Lower Respiratory Tract Infections: A One-Year Observational Study in the Pediatric Population. Pakistan Journal of Chest Medicine, 30(3), 372–380. Retrieved from http://pjcm.net/index.php/pjcm/article/view/977

Issue

Vol. 30 No. 3 (2024)

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Original Article

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