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<p>Appropriate healthcare utilization and compliance with the WHO treatment guidelines can significantly reduce diarrhea-related childhood mortality and morbidity, while overuse of antibiotics notably increases antibiotic resistance. We studied care-seeking behavior and antibiotic use for childhood diarrhea by analyzing data from 8294 diarrheal episodes of 1–59-month-old children visiting a tertiary-care hospital in rural Bangladesh. Overall, 55% of the study children received antibiotics, while only 6% had dysentery. Notably, 77% of the antibiotics were obtained from a local pharmacy without a prescription. Antibiotics alone, without zinc or ORS, were used by more children with dysentery than watery diarrhea (15% vs. 9%; p &lt; 0.001). While 85% of the children received ORS, only 7% received zinc and ORS without antibiotics. Children who received antibiotics before seeking care at the hospital had a significantly higher rate of hospitalization than those who did not have antibiotics (20% vs. 13%; p &lt; 0.001). The factors that influenced the caregivers’ decision to seek care from the pharmacy were the desire for early recovery, traditional practices, faith in seeking care at pharmacies, and distance to a healthcare facility. Our findings warrant that reducing unnecessary antibiotic consumption requires increasing public awareness and strengthening laws on the sale of over-the-counter antibiotics.</p>

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Healthcare seeking behavior and antibiotic use for diarrhea among children in rural Bangladesh before seeking care at a healthcare facility

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月20日

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  • Sampa Dash,
  • Mohammad Ali,
  • Eva Sultana,
  • Malathi Ram,
  • Jamie Perin,
  • Farina Naz,
  • Bharati Roy,
  • ABM Ali Hasan,
  • Farzana Afroze,
  • Fahmida Tofail,
  • Tahmeed Ahmed,
  • ASG Faruque,
  • Subhra Chakraborty

摘要

Appropriate healthcare utilization and compliance with the WHO treatment guidelines can significantly reduce diarrhea-related childhood mortality and morbidity, while overuse of antibiotics notably increases antibiotic resistance. We studied care-seeking behavior and antibiotic use for childhood diarrhea by analyzing data from 8294 diarrheal episodes of 1–59-month-old children visiting a tertiary-care hospital in rural Bangladesh. Overall, 55% of the study children received antibiotics, while only 6% had dysentery. Notably, 77% of the antibiotics were obtained from a local pharmacy without a prescription. Antibiotics alone, without zinc or ORS, were used by more children with dysentery than watery diarrhea (15% vs. 9%; p < 0.001). While 85% of the children received ORS, only 7% received zinc and ORS without antibiotics. Children who received antibiotics before seeking care at the hospital had a significantly higher rate of hospitalization than those who did not have antibiotics (20% vs. 13%; p < 0.001). The factors that influenced the caregivers’ decision to seek care from the pharmacy were the desire for early recovery, traditional practices, faith in seeking care at pharmacies, and distance to a healthcare facility. Our findings warrant that reducing unnecessary antibiotic consumption requires increasing public awareness and strengthening laws on the sale of over-the-counter antibiotics.