Antibiotic misuse among children with diarrhea in China: results from a national survey
Ruili Li1, Feng Xiao1, Xiaoguo Zheng1
1Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China.
Insights
Antibiotic misuse in Chinese children with diarrhea is prevalent at 35.12%. Factors like urban living and higher guardian education reduce misuse, while older age increases risk, highlighting the need for interventions.
Area of Science:
- Public Health
- Pediatrics
- Pharmacology
Background:
- Antibiotic resistance poses a significant global health threat, with China facing a particularly severe situation.
- Understanding antibiotic usage patterns in children is crucial for developing effective public health strategies in China.
Purpose of the Study:
- To investigate the patterns of antibiotic usage among children in China.
- To identify predictors associated with antibiotic misuse in pediatric diarrhea cases.
- To inform public health education and intervention strategies.
Main Methods:
- A cross-sectional study involving 53,665 guardians of children aged 0-6 years across 14 provinces in China.
- Data collected via surveys on antibiotic use for diarrhea without a pediatrician's prescription.
- Multilevel logistic regression models used to analyze associations between antibiotic misuse and predictors.
Main Results:
- The prevalence of antibiotic misuse among children with diarrhea was 35.12%.
- Protective factors against misuse included urban residence, female gender, higher guardian education, parental care, and basic health knowledge.
- Childhood age (1-3 years and 4-6 years) was identified as a significant risk factor for antibiotic misuse.
Conclusions:
- A high rate of antibiotic misuse without prescription in children with diarrhea in China necessitates urgent attention.
- Targeted regulations and interventions are required to combat this public health issue effectively.
Background:
Antibiotic resistance is one of the world's biggest public health issues, and the situation in China is particularly grave. The objective of this study is to investigate the antibiotics usage pattern among Chinese children and provide further insight in developing strategies for promoting public health education.
Methods:
This is a cross-sectional study, in the study, participants are from 53,665 guardians of children aged 0-6 years, who were recruited with multistage stratified random cluster sampling in 2013/2014 from 46 community health centers in 14 provinces across China Mainland. Children's guardians completed surveys on their previous experience on using antibiotics in treating diarrhea of their children without a prescription from any pediatrician. Odds ratios (ORs) and 95% confidential intervals (CIs) for the association between antibiotic use and its predictors were estimated using multilevel logistic regression models, with antibiotic rational use group as a reference group.
Results:
The prevalence of antibiotic misuse among children with diarrhea in the eastern, middle and western areas of China and associations between antibiotic misuse and its predictors were studied. The average rate of antibiotic misuse is 35.12%. Multilevel logistic regression revealed that living in urban areas (OR = 0.79 (0.76, 0.83)), female children (OR = 0.92 (0.88, 0.96)), guardians having higher education (OR = 0.60 (0.55, 0.66)), being raised by parents (OR = 0.90 (0.85, 0.94)), guardians having basic health knowledge (OR = 0.82 (0.79, 0.86)) are protective factors and children's age (1-3 years OR = 1.62 (1.54, 1.71)); 4-6 years OR = 1.90 (1.77, 2.03)) is a risk factor of antibiotic misuse among children aged 0-6 years with diarrhea in China.
Conclusions:
Our findings confirmed that there has been a high rate of antibiotic misuse without a prescription in children with diarrhea in China, which requires considerable attention. Suitable regulations and interventions are needed to solve this problem.
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