Antibiotic use for pneumonia among children under-five at a pediatric hospital in Dhaka city, Bangladesh
Authors Rashid MM, Chisti MJ, Akter D, Sarker M, Chowdhury F
Received 19 April 2017
Accepted for publication 20 June 2017
Published 3 August 2017 Volume 2017:11 Pages 1335—1342
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Doris Leung
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Md Mahbubur Rashid,1,2 Mohammod Jobayer Chisti,3 Dilruba Akter,4 Malabika Sarkar,2 Fahmida Chowdhury1
1Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; 2James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh; 3Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; 4Department of Pathology, Shaheed Tajuddin Ahmed Medical College Hospital, Gazipur, Dhaka, Bangladesh
Background: Pneumonia has been the leading cause of morbidity and mortality among children under 5 for more than 3 decades, particularly in low-income countries like Bangladesh. The World Health Organization (WHO) developed a pneumonia case management strategy which included the use of antibiotics for both primary and hospital-based care. This study aims to describe antibiotic usage for treating pneumonia in children in a private pediatric teaching hospital in Dhaka, Bangladesh.
Methods: We conducted this cross-sectional study among children <5 years old who were admitted to a private pediatric hospital in Dhaka with a diagnosis of pneumonia in November 2012.
Results: We enrolled 80 children during the study period. Among them, 28 (35.4%) were underweight, 14 (17.7%) were moderately underweight, and 13 (16.5%) were severely underweight. On the basis of WHO classification (2005), 43 children (54%) had severe pneumonia and 37 (46%) had very severe pneumonia, as diagnosed by the research physician. Among the prescribed antibiotics in the hospital, parenteral ceftriaxone was the most common 40 (50%), followed by cefotaxime plus amikacin 14 (17.5%), cefuroxime 7 (8.8%), ceftazidime plus amikacin 6 (7.5%), ceftriaxone plus amikacin 3 (3.8%), meropenem 2 (2.5%), cefepime 2 (2.5%), and cefotaxime 2 (2.5%).
Conclusion: Despite the WHO pneumonia treatment strategy, the inappropriate use of higher-generation cephalosporin and carbapenem was high in the study hospital. The results underscore the noncompliance with the WHO guidelines of antibiotic use and the importance of enforcing regulatory policy of the rational use of antibiotics for treating hospitalized children with pneumonia. Following these guidelines may help prevent increased antimicrobial resistance.
Keywords: antibiotic use, under-five children, pneumonia, private hospitals, pediatrics, WHO guidelines, Bangladesh
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