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Patterns of antibiotic use among children in an urban Brazilian slum
J B Schorling1, M A De Souza, R L Guerrant
1Division of Geographic Medicine, University of Virginia, Charlottesville.
Insights
Antibiotic use is high and often inappropriate in young children in urban Brazil. Poor socioeconomic and nutritional status increase antibiotic consumption, necessitating better drug use control.
Area of Science:
- Pediatrics
- Public Health
- Pharmacology
Background:
- Antibiotic overuse is a global concern.
- Understanding drivers of antibiotic use in vulnerable populations is crucial.
Purpose of the Study:
- To investigate patterns and determinants of antibiotic use in young children in a low-income urban area of Brazil.
Main Methods:
- Prospective study of 105 children under five years old over 16 weeks.
- Data collected on antibiotic prescriptions, recommendations, and healthcare-seeking behavior for diarrhea.
Main Results:
- 65 children received 137 antibiotic courses; 46% were recommended by non-physicians.
- Shorter courses and inappropriate drug choices were common with non-physician recommendations.
- Poor nutritional and socioeconomic status were risk factors for antibiotic use.
Conclusions:
- Antibiotic use is prevalent and frequently inappropriate among children in this setting.
- Interventions to control antibiotic prescribing and improve drug utilization are needed.
Abstract:
Antibiotics are utilized excessively in many areas of the world. To better define how often and why these drugs are used, we prospectively studied antibiotic use among a cohort of 105 children less than five years of age in a poor area of the northeastern Brazilian city of Fortaleza. During a 16-week period, 65 children took 137 courses of antibiotics. Physicians recommended 54% of these, mothers or their associates 39%, and pharmacy workers 7%. Mothers and pharmacy workers recommended drugs for shorter courses than physicians, and were more likely to recommend drugs inappropriate for children. Duration of illness was not a risk factor for antibiotic use, but both poor nutritional status and poor socioeconomic status were. Health care seeking behaviour was further studied in 58 diarrhoea episodes. The type of care sought was related to the duration of illness. Overall, antibiotic use was very common and often inappropriate among children in this poor urban area. More controlled use might decrease the use of potentially dangerous drugs and the use of these drugs when no benefit is likely.