Antibiotic prescribing practice in the management of cough or diarrhea among children attending hospitals in Addis Ababa: a cross-sectional study

Figures & data

Table 1 Demographic and clinical characteristics of the children, Addis Ababa, 2016

Characteristics		N (%)
Age (months)	2–11	386 (36.0)
	12–23	260 (24.2)
	24–35	147 (13.7)
	36–59	280 (26.1)
Sex	Male	571 (53.2)
	Female	502 (46.8)
Type of facility (hospital)	Public	137 (12.8)
	Private-for-profit	936 (87.2)
Fever	Yes	536 (50.0)
	No	537 (50.0)
Diarrhea	Yes	490 (45.7)
	No	583 (54.3)
Duration of diarrhea	<3 days	285 (58.2)
	3–11 days	205 (41.8)
Consistency of diarrhea	Watery	475 (96.9)
	Bloody	15 (3.1)
Presence of dehydration	Yes	119 (24.3)
	No	371 (34.6)
Cough	Yes	653 (60.9)
	No	420 (39.1)
Duration of cough	<3 days	273 (41.7)
	3–14 days	382 (58.3)
Chest indrawing	Yes	33 (5.0)
	No	622 (95.0)
Fast breathing	Yes	152 (23.2)
	No	503 (76.8)
Stridor	Yes	48 (7.3)
	No	607 (92.7)
Crackles on auscultation	Yes	50 (7.6)
	No	605 (92.4)
Antibiotic prescribed	Yes	794 (74.0)
	No	279 (26.0)
Inappropriate prescription	Yes	688 (86.6)
	No	106 (13.4)
Reason to say inappropriate prescription	Prescribed while not needed	631 (91.7)
	Wrong spectrum prescribed	57 (8.3)
Type of antibiotics prescribed	Cotrimoxazol	209 (26.3)
	Amoxicillin	185 (23.3)
	Cephalosporines (cephalexine, ceftriaxone, cefixime)	174 (21.9)
	Amoxicillin–clavulinic acid	129 (16.2)
	Others	97 (12.2)
Prescriber qualification	Intern	110 (10.3)
	General practitioner	10 (0.9)
	Pediatric resident doctor	59 (5.5)
	Pediatrician	894 (83.3)

Table 2 Inappropriateness of prescribed antibiotics versus demographic, clinical, and prescriber qualification, Addis Ababa, 2016

Characteristics	Inappropriateness of prescription		p-value	Crude OR (95% CI)	Adjusted OR (95% CI)
	Yes	No
Age, months (n=794)
2–11	221 (32.1)	39 (36.8)	0.680	1	–
12–23	177 (25.7)	25 (23.6)	0.419	1.249 (0.728–2.143)
24–35	108 (15.2)	13 (12.3)	0.262	1.466 (0.751–2.861)
36–59	182 (26.5)	29 (27.4)	0.700	1.108 (0.659–1.861)
Type of facility (n=794)
Public	65 (9.4)	32 (30.2)	0.000	1	1
Private-for-profit	623 (90.6)	74 (69.8)		4.145 (2.547–6.746)	0.545 (0.240–1.236)
Fever (n=794)
Yes	355 (51.6)	67 (63.2)	0.027	1	1
No	333 (48.4)	39 (36.8)		1.611 (1.057–2.458)	1.093 (0.676–1.767)
Diarrhea (n=794)
Yes	353 (51.3)	22 (20.8)	0.000	1	1
No	335 (48.7)	84 (79.2)		0.249 (0.152–0.407)	0.261 (0.095–0.714)
Duration of diarrhea (n=375)
<3 days	196 (55.5)	13 (59.1)	0.744	1	–
3–14 days	157 (44.5)	9 (40.9)		1.157 (0.482–2.777)
Dehydration (n=375)
Yes	87 (24.6)	7 (31.8)	0.453	1	–
No	266 (75.4)	15 (68.2)		1.427 (0.563–3.614)
Cough (n=794)
Yes	396 (57.6)	89 (84.0)	0.000	1	1
No	292 (42.4)	17 (16.0)		3.860 (2.249–6.627)	1.148 (0.374–3.521)
Prescriber qualification (n=794)
Intern/GP	45 (6.5)	27 (25.5)	0.000	1	1
Resident doctor	22 (3.2)	25 (23.6)	0.093	0.528 (0.251–1.113)	0.476 (0.205–1.107)
Pediatrician	621 (90.3)	54 (50.9)	0.000	6.9 (3.972–11.986)	9.967 (4.221–23.532)

Abbreviations: CI, confidence interval; GP, general practitioner.