TY - JOUR
T1 - Burden and risk factors of antimicrobial use in children less than 5 years of age with diarrheal illness in rural Bangladesh
AU - Ahmed, Shahnawaz
AU - Korpe, Poonum
AU - Ahmed, Tahmeed
AU - Chisti, Mohammod Jobayer
AU - Faruque, Abu Syed Golam
N1 - Funding Information:
This research protocol was funded by icddr,b’s core donors and Swedish International Development Cooperation Agency (Sida). International Center for Diarrheal disease research, Bangladesh acknowledges with gratitude the commitment of Swedish International Development Cooperation Agency (Sida) to its research efforts. International Center for Diarrheal disease research, Bangladesh also gratefully acknowledges the following donors who provide unrestricted support: Government of the People’s Republic of Bangladesh; Global Affairs Canada (GAC); Swedish International Development Cooperation Agency (Sida); and the Department for International Development, (UKAid). Our heartfelt thanks also go to the Medical Director of Kumudini Women’s Medical College and Hospital for his sincere support to the research team. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.
Funding Information:
Acknowledgments: This research protocol was funded by icddr,b’s core donors and Swedish International Development Cooperation Agency (Sida). International Center for Diarrheal disease research, Bangladesh acknowledges with gratitude the commitment of Swedish International Development Cooperation Agency (Sida) to its research efforts. International Center for Diarrheal disease research, Bangladesh also gratefully acknowledges the following donors who provide unrestricted support: Government of the People’s Republic of Bangladesh; Global Affairs Canada (GAC); Swedish International Development Cooperation Agency (Sida); and the Department for International Development, (UKAid). Our heartfelt thanks also go to the Medical Director of Kumudini Women’s Medical College and Hospital for his sincere support to the research team. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.
Funding Information:
This research protocol was funded by icddr,b?s core donors and Swedish International Development Cooperation Agency (Sida). International Center for Diarrheal disease research, Bangladesh acknowledges with gratitude the commitment of Swedish International Development Cooperation Agency (Sida) to its research efforts. International Center for Diarrheal disease research, Bangladesh also gratefully acknowledges the following donors who provide unrestricted support: Government of the People?s Republic of Bangladesh; Global Affairs Canada (GAC); Swedish International Development Cooperation Agency (Sida); and the Department for International Development, (UKAid). Our heartfelt thanks also go to the Medical Director of Kumudini Women?s Medical College and Hospital for his sincere support to the research team. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.
Publisher Copyright:
Copyright © 2018 by The American Society of Tropical Medicine and Hygiene.
PY - 2018
Y1 - 2018
N2 - Antimicrobial overuse contributes to antimicrobial resistance. Empiric use of antimicrobials for diarrheal illness is warranted only in a minority of cases, because of its self-limiting nature and multifactorial etiology. This study aims to describe the factors contributing to antimicrobial overuse for diarrheal disease among children less than 5 years of age in rural Bangladesh. A total of 3,570 children less than 5 years of age presenting with diarrhea in a tertiary level hospital were enrolled in the study. The rate of antimicrobial use at home was 1,395 (39%), compared with 2,084 (89%) during a hospital visit. In a multivariate analysis, factors associated with antimicrobial use at home included residence located more than 5 miles from a hospital; use of zinc and oral rehydration salts at home; vomiting; greater than 10 stools per 24 hours; diarrheal duration greater than 3 days; and rotavirus diarrhea (P < 0.05 for all). Characteristics of children more likely to be given antimicrobials in a health-care setting included greater than 10 stools per 24 hours; duration of diarrhea greater than 3 days; use of antimicrobials before hospital presentation; fever (3 37.8C); rectal straining; and Shigella infection (P < 0.05 for all). The most commonly used drugs in rotavirus diarrhea were azithromycin and erythromycin, both before hospital presentation and during hospital admission. Our study underscores the importance of diligent vigilance on the rationale use of antimicrobials both at home and in health-care facilities with a special concern for children less than 5 years of age living in rural Bangladesh.
AB - Antimicrobial overuse contributes to antimicrobial resistance. Empiric use of antimicrobials for diarrheal illness is warranted only in a minority of cases, because of its self-limiting nature and multifactorial etiology. This study aims to describe the factors contributing to antimicrobial overuse for diarrheal disease among children less than 5 years of age in rural Bangladesh. A total of 3,570 children less than 5 years of age presenting with diarrhea in a tertiary level hospital were enrolled in the study. The rate of antimicrobial use at home was 1,395 (39%), compared with 2,084 (89%) during a hospital visit. In a multivariate analysis, factors associated with antimicrobial use at home included residence located more than 5 miles from a hospital; use of zinc and oral rehydration salts at home; vomiting; greater than 10 stools per 24 hours; diarrheal duration greater than 3 days; and rotavirus diarrhea (P < 0.05 for all). Characteristics of children more likely to be given antimicrobials in a health-care setting included greater than 10 stools per 24 hours; duration of diarrhea greater than 3 days; use of antimicrobials before hospital presentation; fever (3 37.8C); rectal straining; and Shigella infection (P < 0.05 for all). The most commonly used drugs in rotavirus diarrhea were azithromycin and erythromycin, both before hospital presentation and during hospital admission. Our study underscores the importance of diligent vigilance on the rationale use of antimicrobials both at home and in health-care facilities with a special concern for children less than 5 years of age living in rural Bangladesh.
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U2 - 10.4269/ajtmh.17-0988
DO - 10.4269/ajtmh.17-0988
M3 - Article
C2 - 29714159
AN - SCOPUS:85048253765
SN - 0002-9637
VL - 98
SP - 1571
EP - 1576
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -