Epidemiology Unit, Ministry of Health, No 54/A, New Jayaweera Road, Ethul-Kotte, Sri Jayawardhanapura Kotte, Colombo, 10100, Sri Lanka.
BMC Pediatr. 2024 Apr 4;24(1):241. doi: 10.1186/s12887-024-04725-y.
Reconstitution of oral pediatric antibiotic suspension by primary caregivers plays an essential role in determining the overall health outcome of the child. Incorrect reconstitution techniques could lead to underdosing, overdosing, or introduction of infection. Underdosing could lead to non-resolving infection and antimicrobial resistance.
To assess the practice and associated factors on reconstitution of oral pediatric antibiotic suspensions (OPAS) among primary caregivers of 3-5-year-old children in a selected district in Sri Lanka.
A cross-sectional study was carried out among 835 primary caregivers selected using two-stage cluster sampling at field clinics to assess practices for the reconstitution of OPAS. A live demonstration of the reconstitution of the OPAS was assessed by a checklist. Associated factors with caregiver practices on reconstitution were assessed using Chi-square with the statistical significance level set at 0.05.
A total of 820 respondents were recruited and completed the study (response rate = 98.2%). Overall, 56.0% displayed good performance in the demonstration of reconstitution of oral pediatric antibiotic suspension. Poorest performances were observed in shaking the bottle to loosen the powder (Correct: 53.7%), topping up the bottle with water up to the marked line (Correct: 58.0%), and filling the water below the marked line in the bottle (Correct: 59.0%). Caregivers in urban areas compared to rural and estate regions (45.6% vs. 22.7% and 26.5% respectively) and caregivers aged 35 years or above compared to less than 35 years age group (31.5% vs. 22.5%) performed the reconstitution of OPAS poorly. Parental factors, namely age, gender, level of education, and geographical region (urban/rural/estate) were significantly associated with the performance in reconstituting the oral paediatric antibiotic suspension (p = 0.002, p < 0.001, p < 0.001, and p < 0.001 respectively). Factors related to the child, specifically whether they attend preschool and whether they have an older sibling, were found to have a significant association with the correct execution of the reconstitution of OPAS (p = 0.017, and p = 0.030 respectively).
A significant number of primary caregivers displayed poor practice in key steps during the reconstitution of OPAS, which could have a negative impact on the health of the child. Targeted place-based behavioural change health programs with the use of infographic leaflets/ posters may correct the practices of caregivers.
初级保健人员对儿童口服抗生素混悬剂（OPAS）进行再配制对于儿童的整体健康结果至关重要。不正确的再配制技术可能导致剂量不足、剂量过大或感染。剂量不足可能导致感染未得到解决和抗菌药物耐药性。
评估斯里兰卡选定地区 3-5 岁儿童的初级保健人员在配制口服儿科抗生素混悬剂（OPAS）方面的实践和相关因素。
在实地诊所采用两阶段聚类抽样选择 835 名初级保健人员进行横断面研究，以评估再配制 OPAS 的实践情况。通过检查表评估再配制 OPAS 的现场演示。使用卡方检验评估与护理人员再配制实践相关的因素，统计显著性水平设为 0.05。
共招募了 820 名应答者并完成了研究（应答率=98.2%）。总体而言，56.0%的人在演示口服儿科抗生素混悬剂的再配制方面表现良好。在摇动瓶子以松开粉末（正确：53.7%）、将瓶子加满水至标记线（正确：58.0%）和将水填充到瓶子低于标记线（正确：59.0%）方面表现最差。与农村和庄园地区相比，城市地区的护理人员（分别为 45.6%、22.7%和 26.5%）和 35 岁或以上的护理人员（分别为 31.5%、22.5%）的 OPAS 再配制表现较差。父母因素，即年龄、性别、教育程度和地理位置（城市/农村/庄园）与口服儿科抗生素混悬剂再配制表现显著相关（p=0.002，p<0.001，p<0.001 和 p<0.001 分别）。与儿童相关的因素，特别是他们是否上幼儿园以及是否有哥哥姐姐，与 OPAS 再配制的正确执行有显著关联（p=0.017 和 p=0.030 分别）。
相当数量的初级保健人员在 OPAS 再配制过程中的关键步骤中表现出不良行为，这可能对儿童的健康产生负面影响。使用信息图传单/海报的基于地点的有针对性的行为改变健康计划可能会纠正护理人员的行为。
