Abstract
Background
Pneumonia has been the leading cause of morbidity and mortality among children under 5 for more than 3 decades, particularly in low-income countries like Bangladesh. The World Health Organization (WHO) developed a pneumonia case management strategy which included the use of antibiotics for both primary and hospital-based care. This study aims to describe antibiotic usage for treating pneumonia in children in a private pediatric teaching hospital in Dhaka, Bangladesh.
Methods
We conducted this cross-sectional study among children <5 years old who were admitted to a private pediatric hospital in Dhaka with a diagnosis of pneumonia in November 2012.
Results
We enrolled 80 children during the study period. Among them, 28 (35.4%) were underweight, 14 (17.7%) were moderately underweight, and 13 (16.5%) were severely under-weight. On the basis of WHO classification (2005), 43 children (54%) had severe pneumonia and 37 (46%) had very severe pneumonia, as diagnosed by the research physician. Among the prescribed antibiotics in the hospital, parenteral ceftriaxone was the most common 40 (50%), followed by cefotaxime plus amikacin 14 (17.5%), cefuroxime 7 (8.8%), ceftazidime plus amikacin 6 (7.5%), ceftriaxone plus amikacin 3 (3.8%), meropenem 2 (2.5%), cefepime 2 (2.5%), and cefotaxime 2 (2.5%).
Conclusion
Despite the WHO pneumonia treatment strategy, the inappropriate use of higher-generation cephalosporin and carbapenem was high in the study hospital. The results underscore the noncompliance with the WHO guidelines of antibiotic use and the importance of enforcing regulatory policy of the rational use of antibiotics for treating hospitalized children with pneumonia. Following these guidelines may help prevent increased antimicrobial resistance.
Acknowledgments
We acknowledge gratefully James P Grant School of Public Health and MPH Program, the hospital authority, for its support and cooperation. We are grateful to all of the study participants and their parents or caregivers for their patience and for sharing information. We are also thankful to our research assistant Aklima Tasrin for her contribution in data collection. International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) also gratefully acknowledges the following donors who provided unrestricted support: Government of the People’s Republic of Bangladesh, Global Affairs Canada, Swedish International Development Cooperation Agency, and the Department for International Development. The research study was funded by James P Grant School of Public Health, BRAC University, Bangladesh for partial accomplishment of Master of Public Health.
Disclosure
The authors report no conflicts of interest in this work.