Evidence mapPaperPMID 41997599Full record

ArticleBMJ paediatrics open2026

How are young children treated? Multiprovincial patterns of prescribing for children under 5 in Sri Lanka.

Kavinda Dayasiri, Gihan Gunarathna, Aruna De Silva, Nirubaa Umasankar, Krishnapradeep Sinnarajah, Nayani Suraweera, Vijayakumary Thadchanamoorthy

Abstract readMulticenter Study
In one paragraph

Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kavinda DayasiriDepartment of Paediatrics, University of Kelaniya Faculty of Medicine, Ragama, Western Province, Sri Lanka kavindadayasiri@gmail.com.ORCID http://orcid.org/0000-0003-0438-9837
Gihan GunarathnaDepartment of Paediatrics, University of Kelaniya Faculty of Medicine, Ragama, Western Province, Sri Lanka.
Aruna De SilvaDepartment of Paediatrics, University of Ruhuna Faculty of Medicine, Galle, Southern Province, Sri Lanka.
Nirubaa UmasankarDepartment of Paediatrics, University of Jaffna Faculty of Medicine, Jaffna, Northern Province, Sri Lanka.ORCID http://orcid.org/0000-0001-7118-8993
Krishnapradeep SinnarajahDepartment of Paediatrics, University of Peradeniya Faculty of Medicine, Peradeniya, Central Province, Sri Lanka.ORCID http://orcid.org/0000-0002-3101-1533
Nayani SuraweeraDepartment of Paediatrics, Rajarata University of Sri Lanka Faculty of Medicine and Allied Sciences, Saliyapura, Sri Lanka.
Vijayakumary ThadchanamoorthyDepartment of Paediatrics, Eastern University Sri Lanka Faculty of Health Care Sciences, Batticaloa, Eastern Province, Sri Lanka.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRational prescribing is essential for children under 5 years of age due to their vulnerability to dosing errors and adverse drug effects. Poor adherence to WHO prescribing guidelines may contribute to medication errors and antimicrobial resistance. This study evaluated paediatric prescribing patterns and adherence to WHO prescribing indicators across diverse healthcare settings in Sri Lanka.

methodsA descriptive, cross-sectional, multicentre study was conducted across six provinces in Sri Lanka. A total of 1400 outpatient prescriptions issued for children under 5 years were systematically sampled from public and private healthcare facilities. Prescriptions were assessed against WHO prescribing criteria, including patient information, drug-related details, prescriber identifiers and antibiotic use. Comparisons across healthcare sectors (government vs private) and prescription formats (handwritten vs typed) were performed using χ

resultsOf the 1400 prescriptions analysed, 94.6% were handwritten and 53.1% originated from the private sector. Critical patient details were incompletely documented, with weight recorded in only 43.0% and diagnosis in 36.0% of prescriptions. Antibiotics were prescribed in 57.2% of prescriptions. Government sector prescriptions showed significantly better documentation of patient identifiers and diagnoses (p<0.00001) and greater use of generic drug names (58.6% vs 26.6%, p<0.00001). In contrast, private sector prescriptions more frequently documented accurate dosing (92.9% vs 76.4%, p<0.00001), treatment duration (98.1% vs 86.3%, p<0.00001) and prescriber credentials (p<0.01). Typed prescriptions demonstrated superior documentation of patient identifiers, treatment duration, route of administration and prescriber identifiers compared with handwritten prescriptions (all p≤0.005).

conclusionPrescribing practices across the studied facilities showed notable gaps in prescription documentation and variability between healthcare sectors and prescription formats. These findings highlight areas that may benefit from improved prescribing practices, strengthened regulatory oversight and wider adoption of digital prescribing systems to enhance prescription quality and patient safety.

Indexed as

Anti-Bacterial AgentsDrug PrescriptionsGuideline AdherencePractice Patterns, Physicians'Child, PreschoolCross-Sectional StudiesFemaleHumansInfantMaleSri LankaAnti-Bacterial AgentsChild HealthChildrenCross-Sectional StudiesHealth PolicyHealth services research

Identifiers

PMID41997599
PMCPMC13110697

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.