The use of antibiotics and antidiarrheal drugs for treatment of acute diarrhea in community based facilities

Abstract

Objective: (1) To determine the extent to which antibiotics and antidiarrhea1 drugs are prescribed to children with acute diarrhea and to detect any urban/rural difference in prescribing pattern. (2) Determine most common forma of antibiotics and anridiarrheal drugs prescribed to those children. This is a pre-Intervention study to determine the current treatment practice of acute gastroenreritis. Design: A cross-sectIonal study using prospective data. The following data were collected for each patient : age, sex, temperature, blood and mucus in stools, ancihmtics and antidiarrheal prescribed. Setting: 10 urhan and 10 rural primary health care government fdcilities Participants: 30 consecutive cases of acute gastroenteritis in mfants and children less rhan 3 years were taken from each facdity. At the end of the study, information was available for 512 children. Intervention: None. Main Outcome Measure(s): Antibiotics and antidiarrheal drugs prescribed. Results: Antibiotics were prescribed m 244 children (49%). Out of those who received annbiotics, 31% had no blood and mucus in stools. Antidiarrhcals were prescribed ro 288 children (56%). No urban/rural difference was found regarding antibiotics or antidiarrheals prescribing (OR 0.62, 95% Cl 0.36-1.06 for antibiotics and OR 1.04, 95% Cl 0.61-1.78 for antidiarrheals).The mosr common antibiotic used was metronidazole (61%), followed by trimethoprim and sulphamethoxazole (32%). The most common antidiarrheal prescribed was kaolin and pectin (85%). Logistic regression showed that factors associated with antibiotics mescribing are: blood and mucus in stools (OR 66, 95% Cl 15.35-283.95); male sex(OR 2.1, 95% Cl l.ll4.02). and older age (OR 1.1, 95% Cl 1.02-1.1). Conclusion: Amyhmtics and amidiarrheal drugs are overused in treating acute diarrhea. There is a great need for an intervention program focusing on a more rational use of such drugs.