Samir Nora, Hassan Md Zakiul, Biswas Md Abdullah Al Jubayer, Chowdhury Fahmida, Akhtar Zubair, Lingam Raghu, Banu Sayera, Homaira Nusrat
Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, The University of New South Wales, Sydney 2031, Australia.
Programme for Emerging Infections, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.
Antibiotics (Basel). 2021 Sep 24;10(10):1153. doi: 10.3390/antibiotics10101153.
Fever in children under five years of age is a common and predominantly self-limiting sign of illness. However, in low- and middle-income countries, antibiotics are frequently used in febrile children, although these children may not benefit from antibiotics. In this study, we explored the prevalence of, and factors associated with, antibiotic use in children under five years old with febrile illness in Bangladesh. We analysed data from the 2017-2018 Bangladesh Demographic and Health Survey to determine the prevalence of antibiotic use in children under five years of age with a febrile illness. We used a causal graph and performed a multivariable logistical regression to identify the factors associated with antibiotic use in children under five years old with febrile illness in Bangladesh. Of the 2784 children aged less than five years with fever included in our analysis, 478 (17%, 95% CI 15% to 19%) received antibiotics. Unqualified sources, including unqualified providers and pharmacies, contributed to 60% of antibiotic prescriptions in children with fever, followed by the private medical sector (29%) and the public sector (23%). The highest use of antibiotics was found in children under six months of age (25%). Children with parents who completed secondary or higher education were more likely to receive antibiotics (adjusted OR (aOR): 2.61 (95% CI 1.63 to 4.16)) than children whose parents did not complete primary education. Educational interventions promoting rational use of antibiotics and improved regulations governing over the counter purchase of antibiotics in Bangladesh may improve antibiotic dispensing practices.
五岁以下儿童发热是一种常见且大多会自愈的疾病症状。然而，在低收入和中等收入国家，发热儿童经常使用抗生素，尽管这些儿童可能无法从抗生素中获益。在本研究中，我们探讨了孟加拉国五岁以下发热疾病儿童中抗生素使用的流行情况及其相关因素。我们分析了2017 - 2018年孟加拉国人口与健康调查的数据，以确定五岁以下发热疾病儿童中抗生素的使用 prevalence。我们使用因果图并进行多变量逻辑回归，以确定孟加拉国五岁以下发热疾病儿童中与抗生素使用相关的因素。在我们分析的2784名五岁以下发热儿童中，478名（17%，95%置信区间15%至19%）接受了抗生素治疗。不合格来源，包括不合格的医疗服务提供者和药店，占发热儿童抗生素处方的60%，其次是私立医疗部门（29%）和公立部门（23%）。六个月以下儿童抗生素使用最高（25%）。父母完成中等或高等教育的儿童比父母未完成小学教育的儿童更有可能接受抗生素治疗（调整优势比（aOR）：2.61（95%置信区间1.63至4.16））。在孟加拉国，促进抗生素合理使用的教育干预措施以及改善非处方购买抗生素的监管可能会改善抗生素配药做法。
