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Antibiotic use among children in an urban Brazilian slum: a risk factor for diarrhea?
J B Schorling1, M A De Souza, R L Guerrant
1Division of Geographic Medicine, University of Virginia, Charlottesville.
Insights
Antibiotic use in Brazilian children was linked to a higher risk of new diarrhea episodes. Further studies are needed to confirm if antibiotics are a risk factor for diarrhea in these populations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Antibiotic resistance is a growing global concern.
- The impact of antibiotic use on pediatric health in low-resource settings requires further investigation.
- Diarrheal diseases remain a significant cause of morbidity in young children worldwide.
Purpose of the Study:
- To investigate the association between antibiotic use and new episodes of diarrhea in children.
- To determine the relative risk and odds ratios for diarrhea following antibiotic exposure.
- To assess the potential role of antibiotics as a risk factor for diarrhea in a Brazilian urban cohort.
Main Methods:
- A cohort study was conducted among children in a poor urban setting in Brazil.
- Relative risk was calculated for new diarrhea episodes within two weeks of antibiotic use compared to other periods.
- Odds ratios were analyzed for children ever exposed to antibiotics, controlling for individual factors and prior diarrhea.
Main Results:
- A relative risk of 1.44 (95% CI = 1.33, 2.45) was observed for new diarrhea episodes following antibiotic use.
- The odds ratio for diarrhea among children ever exposed to antibiotics was 1.34 (95% CI = 0.84, 2.16).
- The confidence interval for the odds ratio included 1, suggesting borderline statistical significance.
Conclusions:
- Antibiotic use may be associated with an increased risk of diarrhea in children in this setting.
- Further research is necessary to definitively establish antibiotics as a risk factor for pediatric diarrhea.
- Findings highlight the need for judicious antibiotic prescribing in vulnerable populations to mitigate potential adverse effects.
Abstract:
Among a cohort of children in a poor urban setting in Brazil, the relative risk for the occurrence of a new episode of diarrhea in the two weeks following antibiotic use vs all other weeks was 1.44 (95% confidence interval (CI) = 1.33, 2.45). Among children ever [corrected] exposed to antibiotics, the odds ratio was 1.34 (95% CI = 0.84, 2.16) after stratifying by individual child and controlling for previous diarrhea. Further research is needed to confirm whether antibiotics are a risk factor for diarrhea in such settings.