Prevalence and factors related to antibiotic prescription in Benin: a school-based study

Rational use of antibiotics in poor-resource settings countries is challenging. In order to assess the factors related to antibiotic prescription, a cross sectional study was carried out in four school infirmaries from February to June 2008 in the district of Allada in Benin. For each patient, socio-demographic characteristics, symptoms motivating medical visits, diagnosis and therapeutic prescriptions were collected. A malaria rapid diagnostic test was used in case of fever. Data were entered and validated with Epidata(®) software, and analysed with STATA 11(®) software. One thousand six hundred and thirty medical visits occurred during the study period. Fever was reported by 57% of children. Malaria was the leading diagnosis (32%), followed by respiratory infection (17.5%). Antibiotic was prescribed to 40% of the children. Respiratory infection and skin disorders were positively related to antibiotic usage [OR=59.5 (33.4-105.7); P<10(-3) and OR=6.4 (4.6-8.8); P<10(-3) respectively]. Malaria [OR=0.11 (0.03-0.11); P<10(-3)] and fever of unknown origin [OR=0.05 (0.03-0.11); P<10(-3)] were negatively related to antibiotic usage. Further clinical surveys and trials aimed at rationalizing antibiotics usage in this area should focus on the management of acute respiratory illnesses.