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Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004-2010

Alexander C Ewing, Nicole L Davis, Dumbani Kayira

    Emerging Infectious Diseases
    |December 19, 2018
    PubMed

    Insights

    Antibacterial drugs are frequently given to HIV-exposed, uninfected infants. Cotrimoxazole preventive therapy may reduce the need for additional antibacterial prescriptions in this vulnerable population.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Pharmacology

    Background:

    • Antimicrobial resistance is a significant global health threat.
    • HIV-exposed, uninfected (HEU) infants are a growing population at increased risk of infections.
    • Antibacterial drug use in HEU infants is not well-documented.

    Purpose of the Study:

    • To analyze factors associated with antibacterial drug administration in HEU infants.
    • To identify patterns of antibacterial drug prescription in the first year of life for HEU infants.

    Main Methods:

    • Study population: 2,152 HEU infants in Lilongwe, Malawi (2004-2010).
    • Data collected on antibacterial drug prescriptions during the first year of life.
    • Statistical analysis to identify factors associated with drug administration.

    Main Results:

    • 80% of infants received antibacterial drugs; 67% of prescriptions were for respiratory issues.
    • Penicillins (43%) and sulfonamides (23%) were most common.
    • Receipt of cotrimoxazole preventive therapy, antiretroviral drugs, and older age were linked to lower prescription rates.

    Conclusions:

    • Antibacterial drug use is common in HEU infants, often for respiratory conditions.
    • Cotrimoxazole preventive therapy may decrease the overall need for antibacterial drugs in this cohort.
    • Further research is needed to optimize antimicrobial stewardship in HEU infants.

    Keywords:
    HIV-1HIV/AIDSMalawiantibacterialantibiotic prophylaxisantibiotic stewardshipantimicrobial resistancedrug resistanceinfantinfectious disease medicinepenicillinspovertytrimethoprim/sulfamethoxazole drug combination

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