Clinical Audit of Antibiotic Prescribing for Pediatric Community-Acquired Pneumonia at Zawia Medical Center, Libya

Hatem Omar; Ridha Itrunbah; Baha Ettrmal; Enas Ramih; Hana Almashkawi

doi:10.54361/ajmas.2694033

Authors

Hatem Omar Pediatrics Department, Faculty of Medicine, University of Zawia, Libya https://orcid.org/0000-0002-9337-1809
Ridha Itrunbah Pediatrics Department, Faculty of Medicine, University of Zawia, Libya https://orcid.org/0000-0001-8426-430X
Baha Ettrmal Pediatrics Department, Faculty of Medicine, University of Zawia, Libya https://orcid.org/0009-0007-0967-1221
Enas Ramih Family & Community Medicine Department, Faculty of Medicine, University of Zawia, Libya https://orcid.org/0009-0007-0113-9839
Hana Almashkawi Surgery Department, Faculty of Medicine, University of Zawia, Libya https://orcid.org/0009-0004-0624-9760

DOI:

https://doi.org/10.54361/ajmas.2694033

Keywords:

Community-Acquired Pneumonia, Children, Antibiotic Prescribing, Clinical Audit

Abstract

Community-acquired pneumonia (CAP) remains a major cause of pediatric morbidity and antibiotic exposure in low- and middle-income settings. This prospective clinical audit evaluated antibiotic prescribing patterns, pathogen distribution, and short-term outcomes among 300 children aged 3 months to 5 years managed for CAP at Zawia Medical Center, Libya, during 2025. Fever (93.3%), cough (89.0%), and difficulty breathing (72.7%) were the predominant presenting features; 34.3% met the World Health Organization criteria for severe pneumonia. When microbiology was available, Streptococcus pneumoniae (38.0%) and Haemophilus influenzae type b (22.0%) were the leading pathogens. Amoxicillin was the most frequently prescribed empirical antibiotic (39.0%), followed by amoxicillin-clavulanic acid (18.7%) and ceftriaxone (14.0%). Oral therapy was used in 68.0% of children and intravenous therapy in 32.0%. Treatment duration was 6–10 days in 61.0% of cases. Prescribing was considered rational in 70.7% of records, while 29.3% showed deviations from preferred practice. Clinical improvement was documented in 88.3% of patients, readmission within 30 days occurred in 9.3%, and mortality was 2.3%. The findings suggest generally acceptable adherence to pediatric CAP treatment principles, but they also identify a substantial opportunity to strengthen antimicrobial stewardship, reduce unnecessary broad-spectrum use, and standardize duration of therapy.