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Antibiotic Use Among Children Under 5 Years of Age in a Tertiary Care Hospital, Bangladesh

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Abstract

Antimicrobial resistance is common in low-middle-income countries caused by inappropriate and irrational use of antibiotics in humans and animals. Bangladesh has very limited information on antibiotic use and associated resistance. This study explored the prescribing pattern of antibiotics uses among children visiting a tertiary care hospital in Bangladesh. We conducted a cross-sectional study among 400 hospitalized children less than 5 years of age from February to April, 2019, in a tertiary hospital in Bangladesh. Among the 400 children, >50% belonged to the age group for less than 1 year and >60% were male. The average hospital stay period was 3 days (range 1–14 days). The majority of the children had a history of respiratory illnesses (32.2%) and 31% had diarrhea. Most of the children (81.7%) were prescribed one or more antibiotics. The average number of antibiotics per child was 1.17. A combined form of antibiotics was prescribed in 17.43% of children. A total of 14 different antibiotics were prescribed. The most common antibiotic was ceftriaxone (62.39%), followed by azithromycin (18.65%). The parental route was mostly preferred (74.92%) for antibiotic administration. The antibiotic prescription was common in children less than 5 years of age visiting a tertiary level hospital. Most of the prescribed antibiotics were broad spectrum that can promote bacterial resistance. The study’s finding is useful to draw attention to the public health policymakers for taking necessary actions on the appropriate use of antibiotics among children in Bangladesh.

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References

  1. Gwimile JJ, Shekalaghe SA, Kapanda GN, Kisanga ER. Antibiotic prescribing practice in management of cough and/or diarrhoea in Moshi Municipality, Northern Tanzania: cross-sectional descriptive study. Pan Afr Med J. 2012;12(1).

  2. Gandra S, Singh SK, Jinka DR, Kanithi R, Chikkappa AK, Sharma A, et al. Point prevalence surveys of antimicrobial use among hospitalized children in six hospitals in India in 2016. Antibiotics. 2017;6(3):19.

    Article  PubMed Central  Google Scholar 

  3. Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. Pharm Ther. 2015;40(4):277–83.

    Google Scholar 

  4. Ahmed I, Rabbi MB, Sultana S. Antibiotic resistance in Bangladesh: a systematic review. Int J Infect Dis. 2019;80:54–61.

    Article  PubMed  Google Scholar 

  5. Williams DJ, Edwards KM, Self WH, Zhu Y, Ampofo K, Pavia AT, et al. Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines. Pediatrics. 2015;136(1):44–52.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bartoloni A, Gotuzzo E. Bacterial-resistant infections in resource-limited countries. Antimicrobial Resistance in Developing Countries: Springer; 2010. p. 199–231.

  7. Kebede HK, Gesesew HA, Woldehaimanot TE, Goro KK. Antimicrobial use in paediatric patients in a teaching hospital in Ethiopia. PLoS One. 2017;12(3):e0173290.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cole CP, James PB, Kargbo AT. An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. J Basic Clin Pharm. 2015;6(4):109–14.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Osowicki J, Gwee A, Noronha J, Palasanthiran P, McMullan B, Britton PN, et al. Australia-wide point prevalence survey of the use and appropriateness of antimicrobial prescribing for children in hospital. Med J Aust. 2014;201(11):657–62.

    Article  PubMed  Google Scholar 

  10. Gharbi M, Doerholt K, Vergnano S, Bielicki JA, Paulus S, Menson E, et al. Using a simple point-prevalence survey to define appropriate antibiotic prescribing in hospitalised children across the UK. BMJ Open. 2016;6(11).

  11. Ahmad A, Parimalakrishnan S, Mohanta GP, Patel I, Manna P. A study on utilization pattern of higher generation antibiotics among patients visiting community pharmacies in Chidambaram, Tamil Nadu at South India. Int J Pharm. 2012;2(3):466–71.

    Google Scholar 

  12. Padmaja U, Adhikari P, Pereira P. A prospective analysis of adverse drug reactions in a South Indian Hospital. Online J Health Allied Sci. 2009;8(3).

  13. Kaur A, Bhagat R, Kaur N, Shafiq N, Gautam V, Malhotra S, et al. A study of antibiotic prescription pattern in patients referred to tertiary care center in Northern India. Ther Adv Infect Dis. 2018;5(4):63–8.

    PubMed  PubMed Central  Google Scholar 

  14. Cars O, Högberg L. Innovating for antibacterial resistance. Professional affairs [2007] Available from: https://www.reactgroup.org/uploads/publications/react-publications/innovating-for-bacterial-resistance.pdf. Accessed 4 February 2018. 2008.

  15. Ilić K, Jakovljević E, Škodrić-Trifunović V. Social-economic factors and irrational antibiotic use as reasons for antibiotic resistance of bacteria causing common childhood infections in primary healthcare. Eur J Pediatr. 2012;171(5):767–77.

    Article  PubMed  Google Scholar 

  16. Ara F, Alam MK, Momen A. Prescribing pattern of antimicrobials in acute watery diarrhea in children below five years in the tertiary hospitals in Dhaka city. J Dhaka Natl Med Coll Hosp. 2011;17(1):22–4.

    Article  Google Scholar 

  17. Laizu J, Parvin R, Sultana N, Ahmed M, Sharmin R, Sharmin Z. Prescribing practice of antibiotics for outpatients in Bangladesh: rationality analysis. Am J Pharm. 2018;1(1):1008.

    Google Scholar 

  18. Biswas M, Roy DN, Tajmim A, Rajib SS, Hossain M, Farzana F, et al. Prescription antibiotics for outpatients in Bangladesh: a cross-sectional health survey conducted in three cities. Ann Clin Microbiol Antimicrob. 2014;13(1):15.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Begum MM, Uddin MS, Rahman MS, Nure MA, Saha RR, Begum T, et al. Analysis of prescription pattern of antibiotic drugs on patients suffering from ENT infection within Dhaka Metropolis, Bangladesh. Int J Basic Clin Pharmacol. 2017;6(2):257–64.

    Article  Google Scholar 

  20. Rashid MM, Chisti MJ, Akter D, Sarkar M, Chowdhury F. Antibiotic use for pneumonia among children under-five at a pediatric hospital in Dhaka city, Bangladesh. Patient Prefer Adher. 2017;11:1335–42.

    Article  Google Scholar 

  21. MOHFW. Ministry of Health and Family Welfare, Bangladesh. Sher-e-bangla Medical College Hospital. https://app.dghs.gov.bd/localhealthBulletin2016/publish/publish.php?org=10001978&year=2016&lvl=5 (accessed on 30 March 2020). HEALTH BULLETIN 2016. 2016.

  22. Kanish R, Gupta K, Juneja S, Bains H, Kaushal S. Prescribing pattern of antibiotics in the department of pediatrics in a tertiary care medical college hospital in Northern India. Asian J Med Sci. 2014;5(4):69–72.

    Article  Google Scholar 

  23. Paruk F, Richards G, Scribante J, Bhagwanjee S, Mer M, Perrie H. Antibiotic prescription practices and their relationship to outcome in South Africa: findings of the prevalence of infection in South African intensive care units (PISA) study. S Afr Med J. 2012;102(7):613–6.

    Article  PubMed  Google Scholar 

  24. Senn N, Rarau P, Salib M, Manong D, Siba P, Rogerson S, et al. Use of antibiotics within the IMCI guidelines in outpatient settings in Papua New Guinean children: an observational and effectiveness study. PLoS One. 2014;9(3):e90990.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Finkelstein JA, Stille C, Nordin J, Davis R, Raebel MA, Roblin D, et al. Reduction in antibiotic use among US children, 1996–2000. Pediatrics. 2003;112(3):620–7.

    Article  PubMed  Google Scholar 

  26. Marra F, Patrick DM, Chong M, Bowie WR. Antibiotic use among children in British Columbia, Canada. J Antimicrob Chemother. 2006;58(4):830–9.

    Article  CAS  PubMed  Google Scholar 

  27. Datta SK, Paul TR, Monwar M, Khatun A, Islam MR, Ali MA, et al. Patterns of prescription and antibiotic use among outpatients in a tertiary care teaching hospital of Bangladesh. Int J Pharm Pharm Sci. 2016;8(11):54.

    Article  Google Scholar 

  28. Fahad B, Matin A, Shill M, Asish K. Antibiotic usage at a primary health care unit in Bangladesh. Australas Med J (Online). 2010;3(7):414.

    Article  Google Scholar 

  29. Pise HN, Padwal SL, Jadhav RR, Deshmukh VS, Jadhav AD, Kolhe AM. Drug prescribing and dispensing pattern in pediatrics outpatient clinic of a rural tertiary-care teaching hospital. Natl J Physiol Pharm Pharmacol. 2015;5(4):313–7.

    Article  Google Scholar 

  30. Shiva F, Ghanaie R, Shirvani F, Armin S, Tabatabaei SR, Fahimzad SA, et al. Pattern of antibiotic usage in children hospitalized for common infectious diseases. Arch Pediatr Infect Dis. 2018;6(1).

  31. Palikhe N. Prescribing pattern of antibiotics in pediatric hospital of Kathmandu valley. J Nepal Health Res Counc. 2004.

  32. Baidya S, Hazra A, Datta S, Das AK. A study of antimicrobial use in children admitted to pediatric medicine ward of a tertiary care hospital. Indian J Pharm. 2017;49(1):10–5.

    Google Scholar 

  33. Isah A, Ross-Degnan D, Quick J, Laing R, Mabadeje A. The development of standard values for the WHO drug use prescribing indicators.: International Conferences on Improving Use of Medicines. WHO, Essential Medicines and Policy Department 2008. 2008.

  34. Thrane N, Steffensen FH, Mortensen JT, Schønheyder HC, Sørensen HT. A population-based study of antibiotic prescriptions for Danish children. Pediatr Infect Dis J. 1999;18(4):333–7.

    Article  CAS  PubMed  Google Scholar 

  35. Jan D. Antibiotic resistance in Australia. Health Issues. 2001;69:1–5.

    Google Scholar 

  36. Resi D, Milandri M, Moro M. Emilia Romana Study Group on the Use of Antibiotics in Children. Antibiotic prescriptions in children. J Antimicrob Chemother. 2003;52.

  37. Hasan SR, Hossain MM, Akter R, Karim SH, Haque S, Kamaluddin M, et al. Pattern of antibiotics use at the primary health care level of Bangladesh: survey report-1. Stamford J Pharm Sci. 2009;2(1):1–7.

    Google Scholar 

  38. Holstiege J, Garbe E. Systemic antibiotic use among children and adolescents in Germany: a population-based study. Eur J Pediatr. 2013;172(6):787–95.

    Article  PubMed  Google Scholar 

  39. Youngster I, Avorn J, Belleudi V, Cantarutti A, Díez-Domingo J, Kirchmayer U, et al. Antibiotic use in children–a cross-national analysis of 6 countries. J Pediatr. 2017;182:239–44. e1.

    Article  PubMed  Google Scholar 

  40. Mamun KZ, Shears P, Hart C. The prevalence and genetics of resistance to commonly used antimicrobial agents in faecal Enterobacteriaceae from children in Bangladesh. Epidemiol Infect. 1993;110(3):447–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali, Bangladesh

    Rajib Sarker, Md Shafiqul Islam Khan & Md Abu Tareq

  2. International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh

    Sumon Ghosh & Sukanta Chowdhury

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  1. Rajib Sarker
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  4. Sumon Ghosh
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  5. Sukanta Chowdhury
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Contributions

Rajib Sarker, Md Shafiqul Islam Khan, and Sukanta Chowdhury have made substantial contributions to the conception or design of the work, or the acquisition, analysis, and interpretation of data for the research work. Rajib Sarker, Md Shafiqul Islam Khan, Md Abu Tareq, Sumon Ghosh, and Sukanta Chowdhury have drafted and revised the manuscript.

Corresponding author

Correspondence to Sukanta Chowdhury.

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The Research Review Committee of Department of Food Microbiology, Patuakhali Science and Technology University, reviewed and approved the protocol.

Written consent was obtained from parents of the selected children.

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All authors approved the manuscript for publication.

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The authors declare no competing interests.

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Sarker, R., Khan, M.S.I., Tareq, M.A. et al. Antibiotic Use Among Children Under 5 Years of Age in a Tertiary Care Hospital, Bangladesh. SN Compr. Clin. Med. 3, 982–988 (2021). https://doi.org/10.1007/s42399-021-00837-z

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