Non-prescription antibiotic use for cough among Chinese children under 5 years of age: a community-based
Yao Zhu1, Xuewen Tang1, Rui Yan1
1Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Insights
Nearly one in five young children in China received non-prescription antibiotics for coughs. This highlights a need for public health campaigns on rational antibiotic use in pediatric care.
Area of Science:
- Pediatrics
- Public Health
- Pharmacology
Background:
- Antibiotic resistance is a growing global concern.
- The non-prescription use of antibiotics, particularly in children, contributes to this issue.
- Understanding the patterns of antibiotic use for common childhood illnesses like cough is crucial.
Purpose of the Study:
- To investigate the prevalence and patterns of non-prescription antibiotic use for cough in children under 5 years old in China.
- To identify risk factors associated with non-prescription antibiotic use for pediatric cough.
Main Methods:
- A community-based cross-sectional survey was conducted.
- Face-to-face interviews using a standard questionnaire were administered to caregivers of 3102 children under 5.
- Data were collected from October to December 2019.
Main Results:
- Of 1211 children with cough, 40.2% received antibiotics, and 18.7% of these were non-prescribed.
- Cephalosporins were the most common antibiotic class, and community pharmacies were the primary source.
- Factors increasing the risk of non-prescription antibiotic use included longer cough duration, presence of runny nose, and higher family income.
Conclusions:
- A significant proportion of young children in China are treated with antibiotics for cough without a prescription.
- There is a clear need for enhanced public health initiatives and educational programs to promote the rational use of antibiotics in pediatric cough management.
- Addressing non-prescription antibiotic use is vital for combating antibiotic resistance.
Objective:
This study aimed to investigate the non-prescription use of antibiotics for cough among children under 5 years in China.
Design:
A community-based cross-sectional survey.
Setting:
A face-to-face interview based on a standard questionnaire in the community from October to December 2019.
Participants:
A total of 3102 children under 5 years of age were enrolled with probability proportionate to size sampling method. The children's caregivers provided the responses as their agents.
Outcome Measures:
Cough in the past month, non-prescription use of antibiotics after cough.
Results:
1211 of 3102 children were reported to have a cough in the past month. Of these, 40.2% (487/1211) were medicated with antibiotics, and 18.7% (91/487) of these were not prescribed. Cephalosporins were the most frequently used antibiotic (52.8%), and community pharmacies were the main source (53.7%). Children who coughed for 1-2 weeks (OR 1.73, 95% CI 1.03 to 2.90) or 3-4 weeks (OR 2.39, 95% CI 1.08 to 4.97), with runny nose (OR 1.86, 95% CI 1.13 to 3.19) or those whose family annual income between ¥50 000 and ¥100 000 (OR 4.44, 95% CI 1.52 to 18.95) had a higher risk of non-prescription use of antibiotics than those coughing for <1 week, without runny nose or with family annual income <¥50 000.
Conclusions:
Our findings indicated that a high proportion of infants and young children had been treated with antibiotics for cough, and nearly one in five of them were used without prescription. More public health campaigns and further education on the appropriate use of antibiotics are needed to ensure the rational treatment of cough in children.
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