Irrational antibiotic use is a worldwide problem. One of the main reasons for excessive use of antibiotics is the failure to follow the clinical guidelines. Inappropriate use of antibiotics for infectious diarrhea is associated with the risk of increasing the development of antimicrobial resistance and the cost of health care.

The goal of a new study published in Pediatric Health, Medicine and Therapeutics was to assess the appropriateness of the management of diarrhea in children.

In this retrospective cross-sectional study, conducted in the health centers of Addis Ababa, Ethiopia, from September 2014 and February 2015, demographic characteristics, signs of dehydration, stool characteristics, drug types and other relevant information were collected. Data analysis was performed using version 20 of the SPSS. Logistic regression was used to examine the association between dependent and independent variables. Indicators for the appropriateness of diarrhea management were established on the basis of the Standard Treatment Guideline and the guidelines of the World Health Organization (WHO).

Overall, 803 medical records of children were checked. Of these, 54.4% had received inappropriate management; at least one antimicrobial was prescribed to 73.2% of the children who visited the health centers; oral rehydration solution (ORS) and zinc were prescribed only in 66.7% and 47.5%, respectively. Appropriate management among children diagnosed with dysentery was found to be 6.38 times higher than in children with watery diarrhea. Although antibiotics are prescribed inappropriately for most children, it was appropriate when the diarrhea is bloody. Meanwhile, appropriate management of diarrhea among infants aged 2-11 months was 54% less compared to children aged 12-59 months.

The results indicated that the magnitude of inadequate antibiotic prescription while managing diarrhea was high. Contrastingly, a low prescribing rate of ORS and zinc was observed. Thus, there exists a need for urgent action to prevent the development of antibiotic-resistant microorganisms. It was stated that health-care professionals should have clear information on the risks of inadequate diarrhea treatment in children under five.

Source: Pediatric Health, Medicine and Therapeutics. 2020 May 7;11:135-143. doi: 10.2147/PHMT.S243513.